USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 43
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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there ia within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;... - General Laws, Chap. 38, Sec. 6.
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 illneaa 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 physi- cian is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and dexihs 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 .- l'recise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be kuown. 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, aa 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)
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.
129
¡ (If death occurred in a hospital or institution, St. į give its NAME instead of street and number)
2 FULL NAME.
Mary a Cunningham
(If deceased As a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
372 meridianst
(Usual place of abode)
Hospital
years
months 21 days.
Length of stay: In hospital or Institution ... )
( Before death)
(Specify/ whether)
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
(write the word)
MARRIED
WIDOWED
Or DIVORCED Married
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
omas If Con
manghan.
( Husband's name in fugh
6 Age of husband or wife if alive 76 years
7 IF STILLBORN, enter that fact here.
8 AGE. 76 Years Months. Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
11 Social Security No ... none
12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
Eugene Suc Carthy
14 BIRTHPLACEOF
FATHER (City)
Ireland
(State or country)
15 MAIDEN NAME
OF MOTHER
nora Leakey
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Thomas A Canningham ()
Relation, if any
Informant (Address) 372 meridian
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed, with me BEFORE the burial or transit permit was issued : Www.D. Childrens
(Signature of Agent of Board of Health or other)
Health Officer 7/21/41
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
July
19
1941
(Months
(Day)
(Year)
19 | HEREBY CERTIFY,
19 41.
That I attended deceased from
to.
Jul 19
1941
1/last saw
be alive on
July19/ 194%, death Is said to
have occurred on the date stated above, at
4.05Pm
Immediate cause of death.
Cardiac Decompensation
Due to.
Due to.
Nicides - Phlebitis
Endarteritis obliterans
Other conditions.
I amgrene left lower leg
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
Date of
Of autopsy
What test confirmed diagnosis ?.
? yrs 3 tweeles 2 weeks ....
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? no
If so, specify.
C. Nathan Caplan
(Signed)
....
M. D.
(Address)
186 /rucelin st Date Jul 21 1941
EBara
Winthrop
DATE OF BURIAL.
July
Place of Burial, Cremation or Romqual.
(City or Town)
22
194
....
21
22 NAME OF
FUNERAL DIRECTOR
R.C. Kinh
ADDRESS
Received and tiled
1911
19
(Registrar)
1
-
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
St.
( If nonresident, give city or town and State)
In this community
yrs.
4 COLOR OR RACE|
white
(Give maiden name of wife in full)
MEDICAL CERTIFICATE OF DEATH
Duration IMPORTANT
6 weeks 0
100m (d)-1-41-4667
1 3 SEX Female If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain Industry 10 or Business :
- Winthrop (City or Town) Winthrop Community Hospital No.
Registered No.
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 atandard certificate of death, stating to the best of his knowledge and belief the naide of the deceased, his supposed age, the disease of whielt he died, defined aa re- quired 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 hia death ... Gen. Laws, Chap. 46, Scc. 9.
A physician or officer furnishing a certificate of death aa required by the preceding seetion or by seetion forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speei- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he ean state the same. For neglect to comply with any provision of this section, such physician or offieer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border serviee of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, See. 10.
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 sueli 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 receiving tomb to another in the same cemetery, until he has received a permit frodi 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 faets 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 physi- cian who is a member of the board of health, or employed by it or by the selcetinen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal 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 connorwealth 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 aection ten of chapter forty-aix, that the deceased aerved 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 certifleate, 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 neces- sary information which can be obtained as to the deceased, or as to the maurer 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 re- ceived a permit so to do from the board of health or its agent appointed to issue sueh permita, 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. See. 46. G. L., (Tercenteuary Edition).
Medical examiners shall make examination upon the view of the dead bodiea of only sneh persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, ile shall forthwith go to the place where the body lies and take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
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 physiclans 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 niedieal attendance or whose physi- cian is absent from home when the certificate of death is needed.
(3) Medioal Examiners will investigate and certify to all deatha sup- posably due to Injury. These inelnde not only deaths eaused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deatha following abortion, but also deathis 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 .- l'recise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can 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 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 domestie 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-303A
MARGIN REOERYEO FOR DINDING
25m-2-'40-D-729-b
PLACE OF DEATH
Juffer
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
a hospital or institution, Pustead of street and number)
(If U. S.
War Veteran,
specify WAR)
St
1 hr
In this community 40 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Marrie
(Give maiden name of wife in full)
(Husband's name in full)
years
If less than 1 day Hours .Minutes
Usual
Building Contractor
13 NAME OF
FATHER
unknown
15 MAIDEN NAME
OF MOTHER
Untenour.
Italy
(Address)1 79 Hermon St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
1+17
(Signature of Agent of Board of Health or other) 7/03/41
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
Sale
1946 (Year)
(Day)
19 IHEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an inj Cry was involved, state fully
20 Accident, suicide or homicide (specifyd Date of occurrence.
22/49
Where did Injury occur ?.. (City or Town and State)
Did injury occur in or about home, on farm, in industrial place, in public place? trval Home [ .. .......
(Speciy type of place) 14.000
Mall.
Manner of Injury Nature of Injury While at work ?.
Was there an autopsy !. Y
21 Was disease or injury in any way related lo occupation of deceased ?.
If so, speciły .....
(Signed)
Date 7/2/4/
22.Calvary
B.o.s.ton
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
July 24 1941
19
23 NAME OF
FUNERAL DIRECTOR
michaeld Prilla
LD No.Benett 'St. , Boston
ADDRESS
Received and filed ...
July 29.
19
(Registrar)
.. .
1
Poceti
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ............. Hermon (Usual place of abode) Hospital (Specify whether)
years
months
days.
18 DATE OF
DEATH.
(If nonresident, give city or town and state)
1
(City or Town)
No .................
2 FULL NAME
Length of stay: In hospital or institution
3 SEX
4 COLOR OR RACE
Male
White
Sa If married, widowed, or divorced
HUSBAND of ....
MaryFopiano
(or) WIFE of ...
6 Age of husband or wife if alive.
6.7
7 IF STILLBORN, enter that fact here.
8 55
AGE
Years
Months.
Days
9 Occupation :.
Industry
10 or Business :
Building
11 Social Security No ......
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF
FATHER (City)
(State or country)
PARENTS
16 BIRTHPLACE OF
MOTHER (City) ....
(State or country)
17
Informa
Mary ..... Noceti
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
of Death. See reverse side for extracts from the laws relative to the return of certificates of death.
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
Italy
Italy
Relation, if any
( ....... Wife ..
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospitai medicai officer shall forthwitb, after the death of a person whom he has attended during bis last iilness, 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 bis last illness, when last geen alive by tbe physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shali bury or otherwise dispose of a human body in a town, or remove therefrom a human body which hag not been buried, untii he has received a permit front 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 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 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 auch 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 medical examiner shail 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 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 tbe United States in any war in which it has been engaged, such 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 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 of other person snail oury a human body of the ashes thereof which have been brought into the commonwealth until he has recelved 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 funerai 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).
Medical examiners shali make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
.. He shall in all cases certify to the town clerk or registrar In the place where the deceased died his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -General 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 fulfiilinent of the purpose of these laws calls for the observance of the foliowing 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 Heaitil physicians will certify to sucb deaths only 2s those of persons wbo. though disabled by recognized disease unrelated 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) Medicai Examiners will investigate and certify to all deaths supposabiy 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
Medical Examiners in certifying to a death 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, the mode of its production together with the circumstances wben these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with asso- ciated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation sbows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the cir- cumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (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
ORM R-301
MARGIN RESERVED FOR BINDING
1 PLACE OF DEATH 3 SEX 8 Usual 9 Occupation: PARENTS Informant (Address) 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 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 10 or Business: 200m-10-'39. No. 8427-d
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