Town of Winthrop : Record of Deaths 1941, Part 47

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 47


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- within the commonwealth cannot be obtained early enough for the purpose, the certificate of death madle 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 anch body has been sooner obtained herennder. If the death certificate contains a recital, as required by section ten of chapter forty-xix, 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 physiclan certifying the cause of death shall thereafter fur- nish for registration any other necessary Information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L., (Tercentenary Edition.)


No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until he has received a permit so to do from the board of health or Its agent appointed to issue such perinits, or if there is no such board, from the clerk of the town where the body is to be burled 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, Scc. 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 these 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 snch deaths only as those of persons who, though disabled by recognized disease nn- related to any form of Injury, have dicd without recent medical attendance or whose physician is absent from home when the certificate of deatii Is needed.


(3) Medical Examiners will investigate and certify to all deaths supporably due to Injury. These include not only deaths caused directly or indirectly by traumatism (ineinding 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 porsons not disabled by recognized disease, and those of persons found dead.


1


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 prinelpal cause.


Statement of Occupation .- Precise statement of occupation is very important, so that the relative bealthfulness of various pursuits can be known. Make some entry in this section for every person axed 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 lllnesa. If the deceased had retired from bust- 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 domestle service for wages, bowever, designate the occupation by the appropriate terms, as housekasper-private family, cook-hotel, etc. For a person who had no oceupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


1 R-302


Essex


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Danvers


(City or town making return)


Registered No


143


(If death occurred in a hospital or institution,


St. ¿


give its NAME instead of street and number)


secased "s & metrical wido felllortdivorced woman, give also maiden name.)


(a) Residence. No ...


(Usual place of abode)


Length of stay: In hospital or institution


(Specify whether)


years


months


1


days


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


August 2,


.1941


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY


That I attended deceased from


19 41


I last saw ... 1.x] .. alive on. 9, 19. 41 death is said


to have occurred on the date stated above, at. 7.2012


Duration


Immediate cause of_death .. Generalized arteriosclerosis dyrs Arteriosclerotic neart dis. ...


Due To".


Bronchopneumonia


4 days


Due to


Other conditions


(Include pregnancy within 3 months of death)


PHYSICIAN


Major findings : Of operations


Of autopsy


What test confirmed diagnosis ?.


clinica1


20 Was discasa or lajury In any way related to occupation at deceased ?


If so, specify


(Signed)


Abraham Gardner


M. D.


(Address)


Date


8/15/41


21 PLACE OF BURIAL.


CREMATION OR, REMOVAL


Winthrop


(Centthrop


(City or Town)


DATE OF BURIAL


8/12/47


19


22 NAME OF


FUNERAL DIRECTOR Richard D. White


ADDRESS


Winthrop


Received and filled 19


(Registrar of City or Town where deceased resided)


1


2 FULL NAME


3 SEX


male


white


5a If married, widowed, or divorced


HUSBAND of


(Give maiden dame Of


(or) WIFE of


(Husband's name in full)


AGE ......?. 1 .... Yoars.


Months ...


.Days


Usual


9 Occupation:


WPA


Industry


10 or Business:


12 BIRTHPLACE (City)


(State or country)


England


13 NAME OF


FATHER


14 BIRTHPLACE OF


FATHER (City)


16 BIRTHPLACE OF


PARENTS


MOTHER (City)


(State or country)


50m-10-'39. No. $427-f


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time


(State or country)


England


of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible


after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


4 COLOR OR RACE 5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED Separated


6 Age of husband or wife if alive .. Dann.ot .... betearneur 7 IF STILLBORN, enter that fact here.


If less than 1 day


Hours


Minutes


11 Social Security No. Cannot be learned


Cannot be learned


15 MAIDEN NAME


OF MOTHER


Catherine Parr


Engrand


17 Mary K . McPhillipsRelation, if any


Informant.


(Address)


DSH


alvestaChans


A TRUE COPY.


ATTESTI


(Registrar of city or town where death occurred)


DATE FILED 8/16/41


19


1


PLACE OF DEATH


(County)


No. Danvors.State-Hospital


.........


St.


(If nonresident, give city or town and state)


(If U. S.


War Veteran,


specify WAR)


of Wife


belearned


July


5.


.....


. 19.


Date of.


Underline the cause to which death should be charged ste- tistically.


A R-301 A


-


PLACE OF DEATH


County Winthrop


Winthrop Community Hospitals No.


(If death occurred in a hospital or institution, give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME


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


650 Jacattqu


(a) Residence. No.


(Usual place of abode)


Length of stay : In hospital or Institution ....


( Before death)


(Speaky whether)


Hospital


years


- months


- days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


4 COLOR OR RACE|


Mute


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


5a 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. Stillbons V


8


AGE ...


Years


Months.


Days


If less than 1 day Hours ....... .Minutes


11 Social Security No. Wanthuk


12 BIRTHPLACE (City)


(State or country)


mass


13 NAME OF


FATHER


John Kirby


14 BIRTHPLACE OF


FATHER (City)


(State or country)


East Boston


mars


15 MAIDEN NAME


OF MOTHER


mary mc mullin


16 BIRTHPLACE OF


MOTHER (City)


....


(State or country)


East Boston


mass


100m (d)-1-41-4667


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued : VWw.D. Childress


(Signature of Agent of Board of Health or other) Healthe Official 8/13/41


( Official Designation) (Date of Issue of Permit)


18 DATE OF


DEATH


august


SMonth)


11 1941 (Day) (Year)


19 | HEREBY CERTIFY,


19.


to


That I attended deceased from


19 ...


I last saw h.


allve on


19


death Is sald to


par ses.


have occurred on the date stated above, at


9:05 p


Duratim


MPORTANT


Immediate cause of death


Due to ....


Still Born


6 Mo


Due to.


Other conditions


(Include pregnancy within 3 months of death)


MPORTANT


Physician


Underline the cause to which death should be charged sta- Elalically.


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


If so, specify.


(Signed)


tred 0llegan /124


670 Sacar of


.. Dato


(Address) Amuscula


Basta


Place of Burial, Cremation or Removal.


DATE OF BURIAL ..


(City or Town)


13


19.


41


22 NAME OF


FUNERAL DIRECTOR .....


ADDRESS


FOR Thederck magrath


East Botox 1


Received and filed


19


(Registrar)


1 3 SEX Female (or) WIFE of Usual 9 Occupation : PARENTS 17 if deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to insert a recital to that effeot. 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 :


BOSTON NOTIFIED


Suffolk 0 1941


The Commontoralth 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.


144


Registered No.


Kirby


(Was deceased a


U. S. War Veteran,


if so specify WAR)


St.


(If nonresident, give city or town and State)


Date of.


Of autopsy


0


What test confirmed diagnosis ?


-


Major findings :


Of operations


0


21


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, furnisli 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 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 his death ... Gen. Laws, Chap. 46, Sec. 9.


A physician or officer furnishing a certificate of death as required by the preceding section or by section 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, speci- 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 can state the same. For neglect to comply with any provision of this section, such physician or officer 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 service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 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 sgent 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 froma 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 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 insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen 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 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 body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required


by section ten of chapter forty-six, that the deceased served in the army. navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary 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 re- ceived a perinit so to do from the board of healthi 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. T .. , (Tercentenary Edition).


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 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.


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :


(1) Attending physloians 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 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 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 ocoupation, 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 Oocupation .- Precise statement of occupation is very im- portant, 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


RM R-301 || SEP 1 0 1941


Suffolk (County) 1 PLACE OF DEATH 3 SEX 4 COLOR OR RACE 1 ale White 5a If married, widowed, or divorced HUSBAND of (or) WIFE of. 6 Age of husband or wife if alive 7 IF STILLBORN, enter that fact here. 8 AGE ..... 91 12 Years Usual Farmer 9 Occupation: II Social Security No. Orangev 12 BIRTHPLACE (City) (State or country) 14 BIRTHPLACE OF FATHER (City) PARENTS 16 BIRTHPLACE OF MOTHER (City) 17 Informant.M. 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 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country) New York 200m-10-'39. No. 8427-d


Winthrop (City or Town) NStation Hospital, Fort Pan


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


(City or town making return)


145


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


2 FULL NAME


NATHAN IRVING THOMPSON


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


(a) Residence. No ... 30 Deane Road, Brookline. M.


(Usual place of ahode)


hospital


'.ength of stay : In hospital or institution


(Specify whether)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


August


12


1941


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY. That I attended deceased from


Aumist 8


19 ...... , to ...


August 12


19.11


I last saw bild


.... alive on ..


00 AM Aus 12 1941


to have occurred on the date stated above, at ....


2:35 Am


Immediate cause of death.Cerebral Hemorrha


Duration


8 da


Due to


Cerebral arteriosclerosis


? ye


Due to


Old ase


Other conditions


Chronic myocarditis


(Include pregnancy within 3 months of death


Major findings :


Of operations


PHYSICIAN Underline the cause to which death


Of autopsy ..


What test confirmed diagnosis ?


charged sta- tistically.


20 Was disease or fajury in any way related to occupation of deceased ? no


If so, specify


Hyman B. Fisher


M. D.


(Signed)


(Address)


Hanf Banke Mass Date aug. 12 19 41


21


Hartford


Michigan


Place of Burial, Cremation or Remoyal.


(City or Town)


DATE OF BURIAL


Aug


1/4.


19:41


22 NAME OF


FUNERAL DIRECTOR


muna


ADDRESS


28


Beachst Renne


Received and filed 19


8


A TRUE COPY ATTEST:


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Widowed


Tuttle


(Give maiden name of wife in full)


(Hushand's name in full)


Dead .....


years


0


Months


Days


If less than 1 day Hours. Minutes


Industry


10 or Business:


Farming


13 NAME OF


FATHER


Nathan Thompson


15 MAIDEN NAME


OF MOTHER


Clavissa Elmer Hutchinson


Western, Orvida Co. N. Y.


(State wk Suland Relation, if any Heland, Col.QUICson-in-law (Address) Hq. 1st Corps Area, Boston, Dass.


......


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial ortransit permit was issued; Www. D. Children


(Signature of Agent of Board of Health of other)


Health Officer


8/12/41


(Official Designation) (Date of Issue of Permit)


years


0


months


days.


In this community


yrs.


mos.


days.


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


St.


8


(If nonresident, give city or town and state)


death is said


Date of.


should be


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physician or registered bospital medleal officer shall forthwith, after the death of a person whom he has attended during hla 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 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 been buried, until he has received a permit from the board of health or its agent appointed to issuc 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 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 heen de- livered to such hoard, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required hy 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 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 carly enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth caunot 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 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




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