Town of Winthrop : Record of Deaths 1941, Part 39

Author: Winthrop (Mass.)
Publication date: 1941
Publisher:
Number of Pages: 546


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 39


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(Specify whether)


years


1


months


days.


In this community 29 yrs. mos. days.


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE


White


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Widowed


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


John J. Reed


(Husband's name in full)


.years


7 IF STILLBORN, enter that fact here.


AGE


Years


7


Months


6


Days


If less than 1 day


Hours


Minutes


Usual


At. Home


11 Social Security No ...


Blanford


12 BIRTHPLACE (City)


(State or country)


13 NAME OF FATHER Louis Phillips


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Mass.


Not Know


15 MAIDEN NAME


OF MOTHER


Maria Watson


16 BIRTHPLACE OF MOTHER (City). (State or country)


Blanferd


17 Lawten Reed


Relation, if any Son


. (Address) 193"Endicott Ive


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Max. Children


(Signature of Ageht of Board of Health or other)


Le altre Officer


7/8/41


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


July


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY! That I attended deceased from


march 15 19.5%./ ... , 1


19 41


I last saw h or alive on 5 19./,/., death is said to


have occurred on the date stated above at ....... 4 9


m.


Duration IMPORTANT 10 years


Immediate cause of death Myocardeto


Due to.


old age


Due to.


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 ?. 200 If so, specify


(Signed).


......


., M. D.


(Address) IMWasser


Data Auxe 7 19411.


Mit.


21.


Place of Burial, Cremation or Remov July 8. 1941 (City of Town) DATE OF BURIAL.


22 NAME OF FUNERAL DIRECTOR .. ADDRESS 147 Winthrop St. wfuthres


Richar


Received and filed.


19


(Registrar)


100m-2-'40-D-729-a


1 3 SEX Fansle 8 83 9 Occupation: PARENTS Informant .. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business:


!


Major findings: Of operations.


Date of.


Of autopsy.


What test confirmed diagnosis?


(If U. S. War Veteran. specify WAR)


St


(If nonresident, give city or town and state)


1 941


6 Age of husband or wife if alive


PLACE OF DEATH


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 helief 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 hy 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 therefrom a human hody which has not been buried, until he has received a permit from the hoard 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 exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiv- ing tomb to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the hody is buried. No such 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 hy law to be returned and recorded, which shall he 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 hoard of health, or em- ployed hy it or by 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 be obtained early enough for the purpose, the certificate of death made as ahove 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 been sooner ohtained hereunder. If the death certificate contains a recital, as required hy 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 heen 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 furnish for registration any other necessary information which can he 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 hody is to he huried 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 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 deatlis 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 supposahly due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia). 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 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 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 various pursuits can he 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 husiness, report the usual occupation prior to retirement. Children not gainfully employed may he 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


A R-301 A


Suffolk


(County)


Winthrop


(City or Town)


The Commonwealth of Mangarhusetts 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. St. ( give its NAME instead of street and number)


2 FULL NAME


Ilsie


Murdeck Tuan


(If deceased is a married, widowed or divorced woman, give also maiden name.)


405 Revere, St


St


(If nonresident, give city or town and state)


Length of stay: In hospital or ind


I Day


years


months days.


In this community угв. mos. day8.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


18 DATE OF DEATH. July 8


(Month)


(Day)


(Year)


19. I HEREBY CERTIFY That I attended deceased from


V


...... .. , 194/1, to


... ,


194/


I last aw her alive on 19%/ ... , death is said to have occurred on the date stated above, at ... 8.45 m.


Immediate cause of death .. myocarditis


Duration IMPORTANT 4-5 year


Other conditions. (Include pregnancy within 3 months of death)


IMPORTANT


PHYSICIAN


Major findings: Of operations.


Date of


Of autopsy.


220 c


What test confirmed diagnosis ?. Clinico Som charged st tistically.


20 Was disease or injury in any way related to occupation of deceased ?.


If so, specify


M. D.


(Signed).


(Address) 18 -20 cad. Que WineryDato May 10 1941


21 .. Burlington N.J.


Place of Burial, Cremation or Removal. July 12 1941 19


DATE OF BURIAL


22 NAME OF


FUNERAL DIRECTOR ...


Richard To Theto


ADDRESS


147 Winthrop St. Winther


Received and filed.


19


(Registrar)


100m-2-'40-D-729-a


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial'or transit permit was issued:


(Sighature of Ageht of Board of Health or other)


Health Ofwar 7/10/41


(Official Designation) (Date of Issue of Permit)/


(write the word)


Widowed


5a If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of Daniel. G


Tuan


(Husband's name in full)


6 Age of husband or wife if alive.


.years


7 IF STILLBORN, enter that fact here.


8 67 Years 7 Months .. 8 Days Hours Minutes Due to.


Usual At Home


12 BIRTHPLACE (City)


(State or country)


13 NAME OF FATHER Franklin K. Murdock


14 BIRTHPLACE OF


Burlington


FATHER (City) ....


(State or country)


N.J.


15 MAIDEN NAME


OF MOTHER


Not Known


16 BIRTHPLACE OF MOTHER (City). (State or country)


Not Known


17 Welfare Records


Relation, if any


.. Informant. (Address) . Town of Winthrop


(


1 3 SEX Female AGE 9 Occupation : PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business:


PLACE OF DEATH


Winthrop Comumity Hospital No.


(Specify whether)


(If U. S. War Veteran, specify WAR)


(a) Residence. No .. (Usual place of abode)


Harpitale


22


1941


4 COLOR OR RACE


Whit


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


If less than 1 day


Due to.


11 Social Security No.


Burlington ... N .. J ..


Underline the cause to which death should be


(City or Town)


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 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 froin 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 exhume a human body and remove it from a town, from one cemetery to another. or from one grave or tomb 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 clerk of the town where the body is buried. No such 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 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the inedical 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 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 re- moval 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 ariny, 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 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 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 froin 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 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 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 traumatisin (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 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 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 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


M R-303


PLACE OF DEATH


Jaffalic · (County)


1


2 FULL NAME


3 SEX


Male


White


(or) WIFE of


(Husband's name in full)


52


7 IF STILLBORN, enter that fact here.


8


75


AGE


Years.


Months.


Day3


10 or Business:


.....


II Social Security No ...


PARENTS


17


Informant.


Mary J. MacDonald


DEATH in plain terms, so that it may be properly classified under the International Classification of Causes


information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF


of Death. See reverse side for extracts from the laws relative to the return of certificates of death.


N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of


13 NAME OF


FATHER


James MacDonald


50m-10-'39. No. 8427-h


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed wyh me BEFORE the burial or transit permit was issued: Win. D. Childreng (Signature of Agent of Board of Health or other) Health officer Foichat Designation) (Date of Issue of Perfuit)/ 7/16/41


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


(Month)


(Day)


10 -


1941


(Year)


19 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state) fully.) acute Cardiac Factura


20 Accident, suicide, or homicide (specify)


Date of occurrence


19


Where did Injury occur ?.


(City or town and State)


Did injury occur in or about home, on farm, in industrial place, in


public place?


(Specify type of place)


Manner of


Injury


Collapsed + died quickly


Nature of


Injury


While at work ?.


Was there an autopsy ?..


40


21 Was disease or Injury lo any way related to occupation of deceased ?


If so, specify.


1


(Signed)


Ihr-V duckling


(Address)


But


00 10


M. D.


110 1941


22


Winthrop


Winthrop


Place of Burial, Cremation or Removal.


DATE OF BURIAL


July 14.


(City or Town)


1941.


19


23 NAME OF


FUNERAL DIRECTOR


ADDRESS


Winthro, Massachusetts


Received and filed 19


A TRUE COPY ATTEST:


(Registrar)


--


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE| 5 SINGLE


MARRIED


WIDOWED


or DIVORCED Married


(write the word)


5a If married, widowed, or divorced,


... Mackill


HUSBAND of


(Give maiden name of wife in full)


6 Age of husband or wife if alive. .Years


If less than 1 day


Hours


Minutes


Usual


9 Occupation:


Policeman


Retired


Industry


Winthrop Folice Dep't


12 BIRTHPLACE (City)


(State or country)


Prince Edward Island


14 BIRTHPLACE OF


FATHER (City)


(State of country)


Prince Edward Island


COK.


15 MAIDEN NAME


OF MOTHER


Clementine MacDonald


16 BIRTHPLACE OF


MOTHER (City)


(State or country) Prince Edward Island


Relation, if any WIIt


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH


(City or town making return) ...


Registered No. § (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)


( U. S.


War Veteran.


spocify WAR)


.......


(a) Residence. No .....


(Usual place of abode)


Length of stay: In hospital or institution


(Specify whether)


years


months


(If nonresident, give city or town and state) days. In this community 50 yrs.


mos.


days.


(City or Town) 105 Junall ap Withup No. Why heeth mac Donald


(If deceased is a married, widowed or divorced woman, give alsg maiden name.) 105 Demall Our Futures


(Address)


105 Sewall Ave Hthrop


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physiclan 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 hest of bis knowledge and belief the name of the deceased, bis 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 buman body in a town, or remove therefrom a buman body which has not been buried, until he has received a permit from the board of bealth, or its agent appointed to issuc 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 exhumc 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 hody is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the casc may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which sball be accompanied, in case of an original interment, by a satisfactory certificate of tbe attending physician, if any, as required by law, or in lieu thereof a certificate as bereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early cnougb 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, sball 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 witbin 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 sucb removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If tbc 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, auch recital shall appear upon the permit. The board of bealth, 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- nlsb for registration any other necessary Information which can be obtained as to the deceased, or as to the manner or cause of tbe death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L., as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.




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