USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 31
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RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance 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 illness 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 unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent 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 caused directly or indirectly hy traumatism (including resulting septicemia). and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disahled 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, asphyxla, asthenia, etc. As principal cause name the disease causing death. As related causes, 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 occupation is very Important, so that the relative healthfulness of varlous pursuits can be known. Make some entry In this section for every person aged 10 years or over. If the occupation had heen given up or changed on account of the disease causing death, report the usual occupation prior to Illness. If the deceased had retired from business, 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
ORM R-301 ||
Suffolk
(County)
Winthrop
1
(City or Town)
PLACE OF DEATH
(Usual place of abode)
3 SEX
4 COLOR OR RACE
Female
White
5a If married. widowed, or divorced
HUSBAND of
(or) WIFE thomas H. L.
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
AGE 8I
Years.
Months.
Days
Usual
9 Occupation:
Housewife
Industry
11 Social Security No.
12 BIRTHPLACE (City)
Boston
14 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Ma.sg
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
Ireland
17
Informant MAY's
Frank Sauntry
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
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
10 or Business:
Own Home
200m-10-'39. No. 8427-d
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or wansit permit was issued: N. D. Children
(Signature of Agent of Board of Health or other) Healthe shear 5/26/41 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF may
24
1941
(Year)
19 I HEREBY CERTIFY
That I attended deceased from
Samary 10
1932 May 24
194/
I last saw ben alive on.
May 24
195./ ... , death is said
to have occurred on the date stated above, at 6 15 p.m.
Immediate cause of death ...............
acute Coronary Mumbosis
Duration
...... 7 days
Due to
auterineteroris
... 3 zeano ......
Due t
Senility
2years .......
Other conditions
Pernicious Quenua
(Include pregnancy within 3 months of death)
Major findings :
Of operations
none
.. Date of ..
Of autopsy
not done
charged sta-
What test confirmed diagnosis ? Clinical Flanistically.
20 Was disease or lojury In any way related to sccopation of deceased ? no
If so, specify.
(Signed)Jacob Alamo M. D.
562 Pauley rifiutaRaj0 5/25 pct
21
St. Josephs
Boston
Mais
22 NAME OF
FUNERAL DIRECTOR
Place of Burial, Cremation/or Removal.
TO(City of Town)
DATE OF BURIAL.
John Finally
ADDRESS
inthron
Roceived and filed. MAY 2 8 1941
19
A TRUE COPY ATTEST:
(Registrar)
-
(Give maiden name of wife in full)
.years
If less than 1 day
Hours ...
Minutes
(State or country)
MOSS
13 NAME OF
ennot be learned
15 MAIDEN NAME
OF MOTHER
Goodbrand
Relation, if any
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
93
Registered No. (If death occurred in a hospital or institution,
St. (
give its NAME instead of street and number)
2 FULL NAMElizabeth G Lind
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ...
57 ... Cutler ... S.t.
St.
(If nonresident, give city or town and state)
Length of stay : In hospital or institution
(Specify whether)
years
months
6
days.
In this community 4
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
MARRIED
WIDOWED
or DIVORCED idowed
(write the word)
DEATH
(Month
(If U. S.
war Veteran.
specity WAR)
(Day)
5 years ....
PHYSICIAN Underline the cause to which death should be
, M. D.
(Address)
27 Slade Rd Belmont
No Tinthron Community Hospital
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 samc was contracted, the duration of his last iliness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not heen huried, 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 elerk of the town where the person died ; and no undertaker or other person shail exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomh 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 huried. 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 he returned and recorded, which shall be accompanied, in case of an original interment, hy 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 he obtained early enough for the purpose, or is insufficient, a physician who is a member of the hoard 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 hy 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 a removal shail 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 shail 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 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 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 hury 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 ita 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, Seo. 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 supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septlee- mia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 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 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, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
A R-301 A
PLACE OF DEATH
Suffolk (county ) Winthrop (City or Town)
Cliff Que No. 12.5-
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME
Hattedy Frank
(If deceased is a married, widowed or divorced woinan, give also maiden name.)
24- @wax
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution .. (Specify whether)
....
years
months
days.
In this community 3 2 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED WIDOWED or DIVORCED
Mamed
5a If married, wido wed, or divorced HUSBAND of.
(Give maiden name of whe in full)
(Husband's name in full)
6 Age of husband or wife if alive ..
7 IF STILLBORN. enter that fact here.
AGE. 56 Years Months ...... .. Days
11 Social Security No ...
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Moreno Frank
14 BIRTHPLACE OF FATHER (City) ... (State or country)
15 MAIDEN NAME
OF MOTHER
Ida- Commonly
16 BIRTHPLACE OF MOTHER (City) .. (State or country)
.17 Informant terme
Frank ( WY
(Address) 24- Proas At.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Man-S. Children (Signature of Agent of Board of Health or orier).
Healite officer
55/31/41
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
hay
30
1941
(Month)
(Day)
(Year)
Vigy 939 HEREBY CERTIFY .)
That I attended deceased from
I last saw h can alive on hay 30 to ...
19 41
19 41, death is said to have occurred on the date stated above, at 9:00 Pm. Immediate cause of death. Duration IMPORTANT Coronary Thrombosis Centenial Thrombosis + gausalue
Due to ....
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations.
Date of.
Of autopsy.
2200
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
(Signed).
(Address) 26Wave Way
ebenway M. D. 1941
Data 3
21 ... Withor
Place of Burial, Cremati nor Removal. (City or TownĄ
DATE OF BURIAL ... 20 194%.
22 NAME OF
FUNERAL DIRECTOR ....
Manual Stonetali
ADDRESS 10-Wed By Du.
Received and filed 19
JUN 4"
1941
(Registrar)
Underline the cause to which death should be charged sta- tistically.
100m-2-40-D-729-a
1 3 SEX male (or) WIFE of. Usual 9 Occupation : PARENTS 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 information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business:
To be filed for burial permit with Board of Health or its Agent.
St.
(If U. S. War Veteran, specify WAR)
(a) Residence. No ...
(Usual place of abode)
Judelaw
49 years
If less than 1 day Hours. .Minutes Due to atentie
teamed
Relation, if any
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 hest of his knowledge and helief the name of the deceased, his supposed age. the disease of which he died, defined as required hy 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 hody in a town, or remove thercfrom a human hody which has not been huried, 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 hoard. from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing tomh 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 hody is buried. No such permit shall he issued until there shall have heen delivered to such hoard, agent or clerk. as the case may be, a satisfactory written statement containing the facts required by law to he returned and recorded. which shall be accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed hy It or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner 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 he 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 hody shall he 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 re- moval of such hody has heen sooner ohtained 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 hoard 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 furnish for registration any other necessary information which can be ohtained 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 he held, or from a person appointed to have the care of the cemetery or hurial 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 observance 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 illness 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahiy due to injury. These include not only deaths caused directly or indirectly hy 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 from injury or infection related to occupation, 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 complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the discase causing death. As related causes, 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 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 husiness, 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, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 Al Suffolk (County)
1
PLACE OF DEATH
Winthrop (City or Town) 41 Lincoln No ..... Elizabeth Schieb
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.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(y deceased is a married, widowed or divorced woman, give also maiden name.) 41 Lincoln
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ....
210
(Specify whether)
years
months
days.
In this community
7
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
Female White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Widowed
5a If married, widowed, or divorced
HUSBAND of
....
Bernard 3 chel
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive deceased
years
7 IF STILLBORN, onter that fact here.
If less than 1 day
AGE
8 78 Years Months Days Hours Minutes
Due to
Carcinoma Large Pour Lyes
Usual House work
9 Occupation:
Industry
own home
10 or Business:
11 Social Security No. none
12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
John Sloan
Major findings : Of operations
PHYSICIAN Underline the cause to Date of. Of autopsy 2 ore which death should be charged sta- What test confirmed diagnosis ?.
tistically.
20 Was disease or Injury in any way related to occupation of deceased? 20
If so, specify
(Signed)
tired O Regana
M. D.
(Address) 070Saracoger.fr
Date
5/3/ 1941
21 Winthrop, Winthrop Place of Burial, Cremation or Removal. gity or Town) 41 19
DATE OF BURIAL
June
....
22 NAME OF
FUNERAL DIRECTOR
7. Kelly
ADDRESS
1) Vleridelhi
Sty 8.13.
Received and filed.
JUN 4
1941
.19
(Registrar)
is very important. See instructions and extracts from the laws on back of certificate.
PARENTS
15 MAIDEN NAME
OF MOTHER
Tuary Kenny
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Dieland
Relation, if any 17 Josephine E. Schieb ( daughter) Informant. (Address) 41 Lincoln St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal or transit permit was issued: Mag. D. Childress (Signature of Agent of Board of Herth other) Health offices K(Official Designation Y (Date of Issue of Permit) 624
18 DATE OF
DEATH.
May
(Month)
30
(Day)
1941 (Year)
19 I HEREBY CERTIFY
1001
, 199 to
May 30
19 81
That I attended deceased from
I last saw heralive May 300 to have occurred on the date stated above, at 10/40/4 V.y .. m.
death is said
Immediate cause of death.
Duration IMPORTANT
Due to
Other conditions
(Include pregnancy within 3 months of death)
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
100m-10-'39. No. 8427-e
-
St.
(Sloan)
(If U. S.
War Veteran,
specify WAR)
no
St.
(If nonresident, give city or town and state)
-
.
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
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.
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