USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 19
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No undertaker or other person shall bury a human body or the ashes thereof which have hcen brought into the commonwealth until he has received a permit so to do from the board of health or its sgent appointed to issue such permits, or If there is no such board. from the clerk of the town where the body is to be hurled or the funeral Is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the Interment is made .... Chap. 114, Seo. 46, G. L., (Torcentenary Edition)
RULKS OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as these of persons to whom they have given bedside care during a last ill- ness from discase unrelated to any form of Injury.
(2) Board of Hoalth physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendance or whose physiclan is absent from home when the certificate of death is needed.
(3) Medical Examinera will investigate and certify to all deaths supporably due to injury. These inelude not only deaths caused directly or indirectly hy traumatism (including resulting septice- mia), and hy the action of chemical (drugs or polsons), thermal, or eleetrleai agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupa. tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complleation which causes death. not the mode of dying. c. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earller morbid con- ditions, If any, related to the principal cause and any important complieation of the principal cause.
Statement of Occupation .- Precise statement of occupation is very Important. so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usunl oceupatlon prior to iliness. If the deceased had retired from husi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, ax housekeeper-private family, cook -- hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
51
§ (If death occurred In a hospital or Institution, St. { give its NAME instead of street and number)
2 FULL NAME.
Baby Boy Riordan
(Stillbarn)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
187 Shore Drive
St
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Nale
4 COLOR OR RACE
White
8 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Single
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY.
19
,
to
That I attended deceased from
19
I last saw h .............. alive on
19
death is said to
m.
Duration
IMPORTANT
Due to.
Due to fulltem
2%.
Other conditions.
(Include pregnancy within 3 months of death)
Major findings: Of operations
Date of.
Of autopsy.
What test confirmed diagnosis ?.
IMPORTANT PHYSICIAN 3 Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
(Signed) ..
(Address)
21 ..
St. Michael
Boston. (City or Town)
19 .. 41
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
9 Chelsea Street East Boston.
Received and filed. 19
(Registrar) X
Date of bath
100m-2 -* 40-D-729-8
is very important. See instructions and extracts from the laws on back of certificate.
PARENTS
15 MAIDEN NAME
OF MOTHER
Louise Santarpio
16 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
East Boston
Relation, if any
17 Michael Riordan
( father
Informant.
(Address)
187 Share Drive
Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other) Health officer 3/10/41
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
mane 6 %
1941
Sa If married, widowed, or divorced HUSBAND of
(Give malden name of wife in full)
(or) WIFE of. (Husband's name In full)
6 Age of husband or wife if alive.
.years
7 IF STILLBORN, enter that fact here.
Stillborn
8 AGE .Years Months .. .Days
If less than I day Hours Minutes
Usual 9 Occupation :.. Industry 10 or Business :.
11 Social Security No ....
12 BIRTHPLACE (City)
(State or country)
Winthrop
13 NAME OF
FATHER
Michael Riordan
14 BIRTHPLACE OF FATHER (City) .... (State or country) Manchester N. H.
6Date - 3-894h
Place of Burial, Cremation or Reinoval.
DATE OF BURIAL, March-10
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
1
No. Winthrop Comunity .. Hospital.
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
have occurred on the date stated above, at.
Immediate cause of death ..
stillborn
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of tbe deceased, his supposed age, the disease of which he died, defined as required by seetion one, where same was contraeted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue sueh permits, or if there is no sueh board, from the elerk of the town where the person died; and no undertaker or other person shall exhumne a human body and remove it froin a town, from one cemetery to another, or from one grave or tonib other than the receiv- ing tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the elerk of the town where the body is buried. No sueh permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in ease of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician wbo is a member of the board of health, or em- ployed by it or by the seleetmen for the purpose, shall upon application make the certificate required ofthe attending physician. If death is caused by violenee, the medical examiner shall make sueh certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make sueh removal shall constitute a permit for such removal; provided, that such body sball be returned to the town from which it was removed within thirty-six hours after sueh removal, unless a permit in the usual form for the re- moval of such body has been sooner obtained hereunder. If the deatb certificate contains a recital, as required by section ten of chapter forty- six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, sueh reeital shall appear upon the permit. The board of health, or its agent, upon receipt of sueh statement and eertificate, shall forthwith eountersign it and transmit it to the elerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the elerk or registrar may require .- Chap. 114, Sec. 45. G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a perniit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the eare of the ecmetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition) .
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observanee of the following rules of praetiee:
(1) Attending physicians will certify to sueh deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will eertify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendanee or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths eaused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting fromn injury or infection related to oceupation, tbe sudden deathis of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, ete. As prineipal eause name the disease eausing death. As related eauses, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of oceupation is very important, so tbat tbe relative healthfulness of various pursuits ean be known. Make some entry in this section for every person aged 10 years or over. If the oeeupation had been given up or changed on aeeount of the disease eausing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual oeeupation prior to retirement. Children not gainfully employed may be returned as at school or af home. For a woman whose only occupation was that of home housewerk, write housework. For a person engaged in domestic serviee for wages, however, designate the oeeupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no oeeupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
RM R-301 Ali
Suffolk
synty) Winthrop (City or Town) 22 Adams No ..
...
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No .. 55
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
22
Adams
St.
(If nonresident, give city or town and state)
Length of stay: In hospital or institution ...
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
Female White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Widowed
5a ff married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
AGE
78%
Months.
Days
Hours ...
If less than f day
Minutos
Usual 9 Occupation:
House work
10 or Business:
own home
If Social Security No. none
12 BIRTHPLACE (City)
(State or country)
roeland
13 NAME OF
FATHER
Thomas Gleeson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Aun Preston
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
17 Henry T Hartwere son Relation, if any
Informant (Address) 19 Churchchill Rd. W. Rox.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the buttaf of transit permit was issued: Ww. S. Cluldress (Signature of Agent of Board of "Health or other ) Health oficer
3/13/41
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deceased from
19 ........ , to.
4/6, 1941
I'last saw h .... In alive on 15, 1946, death is said to have occurred on the date stated above, at ........ 2P .m.
.. years Immediate cause of death ...
Duration IMPORTANT
1
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease or lejury In any way related to occupatica of deceased?
If so, specify .....
(Signed)
(Address) YC
. M. D. 11 1941
2f
Holy Otos tualden Place of Burial, Cremation or 5 Town ) DATE OF BURIAL. 13 19 4/1
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
11 Meridian St, ET./3.
M. R. Kelly
Roceived and fled. .. 19
(Registrar)
1 3 SEX 8 PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 100m-10-'39. No. 8427-c N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION Industry
PLACE OF DEATH
Annie Startmere
(Gleeson)
(If U. S. War Veteran, specify WAR)
(a) Residence. No ..
(Usual place of abode)
Ato.
years
months
days.
In this community /0 yrs.
mos.
days.
1941
Due to
Outra solução
................
10
St.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall cxhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal ; provided, that such body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death Is needed.
(3) Medical Examiners will investigate and certify to all deaths anpposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deathe of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to Illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
RM R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No 42 Lewis Avenue
....
........
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
56
Registered No. § (If death occurred in a hospital or institution. .St. give its NAME instead of street and number)
2 FULL NAME.
Mary Evelyn
(Thurber) Ham
(If deceased is a married, widowed or divorced woman, give also maiden name.)
42.Lewis Avenue
St
(If nonresident, give city or town and state)
48
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Widowe
5a If married, widowed, or divorced HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of.
William Hạm
(Husband's name in full)
6 Age of husband or wife if alive.
.years
7 IF STILLBORN, enter that fact here.
8
91 Years.
1.1Months.
3 Days
-
If less than 1 day
Hours
Minutes
Usual
9 Occupation :..
At home
11 Social Security No.
Providence
12 BIRTHPLACE (City) ..
(State or country)
Rhode Island
13 NAME OF
FATHER
John H. Thurber
14 BIRTHPLACE OF
Providence
FATHER (City)
(State or country)
Rhode Island
15 MAIDEN NAME
OF MOTHER
Mary Bicknell
16 BIRTHPLACE OF
MOTHER (City)
Providence
(State or country) Rhode Island
17 William C. Ham
con
Informant. (Address) 42 Lewis Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: MrM. D. Culdes
(Signature of Agent of Board of Health or other)
Le alite Offeret
3/18/41
(Official Designation) (Date of Issue of Permit) .
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
March 16
1941
(Year)
19 I HEREBY CERTIFY, March3, 1944 to.
That I attended deceased from
I last saw h ^^ alive on .... , 19 ........ , death is said to have occurred on the date stated above, at. 2 0. .m.
Immediate cause of death
0 1 -.
Techno
2 wen
4000 1
v
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify ...
(Signed)
M. D.
(Address)200 Washimalin Date 3-1 / 19/4/
21.
Woodlawn
Everett
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
March 18
1941
19
22 NAME OF
FUNERAL DIRECTORCharles R. Bennison
ADDRESS.
Winthrop, Mass.
Received and filed .19
(Registrar)
......
Duration IMPORTANT
Due to.
Clinic Myocarditis
Due to.
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
(Month)
(Day)
MARRIED
WIDOWED
or DIVORCED
months
days.
In this community
yrs.
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
1 3 SEX Female PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION AGE 100m-2-'40-D-729-8 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of Industry 10 or Business:
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