USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 40
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ashes thereof which have been brought into the commonwealth until be has received a permit so to do from the board of health or its agent appointed to Issue sucb permits, or If there is no such board, from the clerk of the town where the body Is to be buried or tbe funeral is to he beld, or from a person appointed to have the care of the cemetery or burial ground in which the interment Is made .... Chap. 114, Scc. 46, G. L. as amended.
Medical examiners shall make cxamination upon the view of the dead bodies of only such persons as are supposed to bave died by vlolence. If a medical examiner has notice that there is within his county the body of such a person, be shall forthwith go to the place where the body lics and take charge of the same :... - General Laws, Chap. 38, Sec. 6.
.. He sball in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known ; otherwise a description as full as may be, with the cause and man- ner of death .- Gencral Laws, Chap. 38, Sec 7.
The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 bome when the certificate of death Is needed.
(3) Medleal 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 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 deaths of persons not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a deatb will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences ; and (2) under manner, tbe mode of its production togetber with the circumstances wben these are known. For example: "Compound fracture of the femur with ensuing septicemia (gus bacillus) caused hy a steam railway ac- cident." "Pistol shot wound of the cbest with associated hemor- rhage, homicidal." "Aspbyxiation by suspension, suicidal." "Syn- copc while under the influence of ether administered as a surgical anaestbetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If discase or injury was related to occupation, specify. If inves- tigation sbows the death to have been due to disease, specify: (1) Under cause, its known or presumahle nature; and (2) under man- ner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of tbe hrain (basal ganglia) (found dead In bed)." "Heart disease, presumably coronary sclerosis. (Sudden death) ."
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
I R-301 A
PLACE OF DEATH
(County)
throp (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.
[ (If death occurred in a hospital or institution. St. (give its NAME instead of street and number)
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
G383 Maverick
St. Earl Surton
(If nonresident, give city or town and state)
Length of stay: In hospital or institution. (Specify whether)
years
months days.
In this community yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED ARE
Sa If married, widowed, or divorced HUSBAND of ..
(Give maiden name of wife In full)
(Husband's name In full)
6 Age of husband or wife if alive. .years
7 IF STILLBORN, enter that fact here.
If less than 1 day
8 AGE .Years Months ...... .. Days! .Hours ........... .Minutes
li Social Security No ..
12 BIRTHPLACE (City) (State or country)
Mentech. Man.
13 NAME OF
FATHER
Jimmy.
Soglia
14 BIRTHPLACE OF
FATHER (City) ...
(State or country)
Maly
18 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF MOTHER (City) .... (State or country)
Relation, if any Jemmy Sophia( Father)
I HEREBY CERTIFY that a satisfactory standard certificate of death way filed with me BEFORE the burial or transit permit was issued: w. p. Children.
{Signature of Agent of Board of Health or other) The alth officer
7/14/41
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July 10 1941
(Month)
(Day)
(Year)
19 HEREBY CERTIFY 19.4,
That I attended deceased from
10
1941
Mast saw him
alivo-on.
. 19
., death is said to
have occurred on the date stated above, at. Immediate cause of death
m.
Duration IMPORTANT
Due to.
Stillbien
Due to.
Other conditions. (Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tisticaily.
20 Was disease or injury in any way retated in occupation of deceased?
Costanza ........... M. D.
21 AliMichael
Place of Buriall Cremation Removal. (City or Town)
DATE OF BURIAL ... .........
July 124
41
22 NAME OF
FUNERAL DIRECTOR ..
ADDRESS 9 Chellegift Card Putin
Received and filed.
18
(Registrar)
--
Major findings: Of operations.
Date of.
Of autopsy.
What test confirmed diagnosis ?. clinical
If so, specify .. (Signed) (Address) 235 Gerichts Date 2/11/201/1 Dostan
100m-2-'40-D-729-a
.... 1 .. No 3 SEX Male (or) WIFE of. Industry 10 or Business: PARENTS 17 (Address) 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 Usual 9 Occupation:
Bouton Magad 0. 0.41
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
(write the word)
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 agc, the disease of which he died, defincd as required by section one. where same was contraeted, the duration of his last illness, when last seen alive by the physician or offieer 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 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 tomnb 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 such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the ease 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 ecrtificate 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 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 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 reeital, 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 it's 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 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 rceeived a permit so to do from the board of health or its agent appointed to issue sueli 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 physielans 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 needcd.
(3) Medieal 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 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, ete. As prineipal eause 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 Oceupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits ean be known. Make some entry in this seetion 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 oeeupation 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
FORM R-301 |
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
(City or town making return) .......
122
Registered No.
.....
5
(If death occurred in a hospital or institution,
St. give its NAME instead of street and number)
2 FULL NAME
Male Hanna ford
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No ..
35 Fremont St.
St.
(If nonresident, give city or town and state)
(Usual place of ahode)
Length of stay: In hospital or institution (Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
SiDRIE
5a If married, widowed, or divorced
HUSBAND of
(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 1 day
Hours.
.Minutes
Usual
9 Occupation:
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
Tinthrow
(State or country)
Massachusetts
13 NAME OF
FATHER
Joseph D. Hannaford
14 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Gertrude McAuliffe
16 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country)
Massachusetts
Relation, if any
Informant
17 Joseph D. Hannaford father
(Address)
35 Fremont St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the buried or transit permit was issued: Www. D. Childress x
( Signature of Agent of Board of Health of other)
The alite Officer 7/11/41
( Official Designation) (Date of Issue of Permits
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July
11,1941
( Year)
19 | HEREBY CERTIFY, That I attended deceased from
19.
., to.
19.
I last saw h ...
.. alive on
19.
death is said
to have occurred on the date stated above, at.
....... m.
Duration
Immediate cause of death .... ...
Stel for
1.
C
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
...
Date of.
Of autopsy
What test confirmed diagnosis?
20 Was disease or Injury In aoy way related to occupation of deceased ?
If so, specify
-
(Signed)
M. D.
(Address) 311 Barack. Refom
Date 7/11
1941
21 Vinthron
Winthrop
Place of Burial, Cremation or Remoyal 12(City
(City10) Epyn)
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
....
Jahr Fr. Omalen
ADDRESS
Winthrop Massachusetts
Received and filed.
19
A TRUE COPY ATTEST:
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
MARGIN RESERVED FOR BINDING
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
200m-10-'39. No. 8427-d
per mr. O'malley- 10 - 8-44
PARENTS
Underline the cause to which death should be charged sta- tistically.
...
(Month)
(Day)
(Give maiden name of wife in full)
(write the word)
(If U. S. War Veteran. specify WAR)
No Winthrop 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 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 hury or otherwise dispose of a human body in a town, or remove thercfrom a human body 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 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 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 buried. No such permit shall be issued until there shall have been de- livercd to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required hy 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 be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed hy it or hy 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 crough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a 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 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 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 hrought Into the commonwealth untll 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 funcral is to be 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 ohserv- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those ot 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 disahled 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 hy traumatism (including resulting septice- mia), and hy 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 oreupa- 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 morhid con- ditlons, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precisc 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 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 husl- 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-302
PLACE OF DEATH
Middlesex (County)
Stonehem (City or Town)'
No .... New .... Eng.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Stoneham
123
(City or town making return)
Registered No
109
(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
Annie Elizabeth Bartlett
(If deceased is a married, widowed or divorced woman, give also maiden name.)
years
months 28 days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH ..
July
1]
1941
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
That I attended deceased from
19
June
20
41
to
I last saw h ............ alive on
10
19.4.1
death is said
to have occurred on the date stated above, at ............
.m.
Immediate cause of death ..
Adenocarcinoma of ovary
Duration
Feb. '41
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Adenocarcinoma of,
Underline the cause to
Date Feb, 1841 which death
Of autopsy
none
What test confirmed diagnosis ?.
Biopsy
20 Was disease or injury In any way related to occupation of deceased ? no
If so, specify.
(Signed)
P. L. Fisher
M. D.
(Address) .....
.. Stoneham,.
Mass. Dato 7/17 19 47
21 PLACE OF BURIAL,
CREMATION OR REMOVALWoodlawn
Everett
DATE OF BURIAL
(Cemetery)
July
13
(City or Town)
47
19
22 NAME OF
FUNERAL DIRECTOR
Richard V.
White
ADDRESS
Winthrop Mas.s
Received and filed.
19
(Registrar of City or Town where deceased resided)
2 FULL NAME
63 Winthrop
(a) Residence. No.
(Usual place of abode)
hospital
Length of stay: In hospital or institution.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
white
5a If married. widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
7 IF STILLBORN, enter that fact here.
8
AGE
74 Years
8
.Months
29
Days
Usual
9 Occupation:
Bookkeeper, reitred
Industry
10 or Business:
11 Social Security No.
Annapolis
13 NAME OF
John Hill Bartlett
FATHER
14 BIRTHPLACE OF
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