USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 63
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22 NAME OF
FUNERAL DIRECTOR
ADDRESS
guichard (. July
(Signature of/Agent of Board of Health or other) Health Officer 10/16/41
(Official Designation) (Date of Issue of/ Permit) /
18 DATE OF
DEATH
October
15
1941
(Month)
(Day)
(Year)
19 /
HEREBY CERTIFY,
b attended deceased from
July 10
41
October 15 04/
to.
1Yast saw h.
her
.. alive on.
October1, 1971, death Is said to
have occurred on the date stated above, at 11:30 Pm.
Immediate cause of death ...
Dubacille Bacterial
Duration IMPORTANT
July 1941.
Due to.
Rheumatic Heart Disease
Due to
Rheumatic
1938
Other conditions
none
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
none
Physician
Date of.
Underline the cause to which death should be
Of autopsy
none
What test confirmed diagnosis ?
charged sta- tisticalls.
20 Was disease or injury in any way related to ocoupation of deceased? ....
If so, specify ..
(Signed).
(Address) 0 62 July
2056 Date 10/162941
K ..
17 Such Moran
100m (d)-1-41-4667
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PLACE OF DEATH
No.
Elizabethc
Moran
2 FULL NAME
(If deceased is a married, widowed or divorsed 36 Quebeck Live
(a) Residence. No.
(Usual place of abode)
years
months 2 days.
In this community 20
yrs.
mos.
days.
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, If so specify WAR).
Received and filed
19
(Registrar)
Informant
) 36 Prospect cour
IMPORTANT
Antes.
Endocarditis
4 COLOR OR RACE
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 registration a atandard 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, 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 aud the date of his death ... Gen. Laws, Chap. 46, Scc. 9.
A physician or officer furnishing a certificate of death aa 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, aerved 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 samc. 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 luly fourth, ninetcen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen huudred 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 agent appointed to issue such permits, or if there is no such board, fromn 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 oue grave or tomb other than the receiving tomb to another in the saine 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 selectinen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, tlie 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 conmnouwealth cannot be obtained carly enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such hody shall 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-aix, that the deceased aerved in the army, navy or marine corpa 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 fortliwith 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 ueces- sary information which can be obtained as to the deceased, or aa to the manuer 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 agcut 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., (Terccutenary 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 las 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 lawa calla for the observance of the following rulea 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 discase unrelated to any form of injury, have died without recent medical attendance or whose physi- cian is absent from home when the certificate of tleath is needed.
(3) Medical Examiners will investigate and certify to all deatha 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 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 discase, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the discase causing death, As related causes, name earlier morbid conditions, if any, related to the principal cause and auy important complication of the principal cause.
Statement of Ocoupatlon .- l'recise statement of occupation is very im- portant, so that the relative licalthfulness 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
....................................
-301 A
1
PLACE OF DEATH
Suffolk (County)
Vinthron (City or Town) 571 Shirley St
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or its Agent.
Registered No.
193
[ { If death occurred In a hospital nr Institutinn, St. ? give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME Mary Theresa Harrington
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
571 Shirley St.
.....
.......
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
days.
In this community 37 yrs.
- mos.
" days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4 COLOR OR RACE|
White
5 SINGLE
( write the wurd)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divoroed HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN. enter that fact here.
84
8 AGE Years
Months
-
Days
If less than 1 day
Hours.
.Minutes
Usual
9 Occupation :
Housekeeper
Industry
10 or Business :
Private Family
11 Social Security No ....
St Johnsbury
12 BIRTHPLACE (City)
(State or country)
Vermont
13 NAME OF
FATHER
Robert Francis Harrington
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Bridget O'Connor
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Julia F. Harrington ( Blindany
( Address )
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : M M. S. Children x
(Signature of Agent of Board of Health or other) Healito Office 10/18/41
"(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
DATE
DEATH
October
(Month)
17 1941 (Day) (Year)
19 | HEREBY CERTIFY,
aug 15
That I attended deceased from
19.
41
to.
1941
I last saw her
.. alive on
Oct 16
194%, death Is said to
have occurred on the date stated above, at
39
m.
Immediate cause of death.
Ingocardates
Due to.
Terminal Broncho
Que to.
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Physician
I'mlerline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to ocoupation of deceased ?. If so, specify.
(Signed)
M. D.
(Address) Womentap
Date Oc RIS 1941
21
winthrop
Winthrop
l'lace of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
October 19, 1941.
19
22 NAME OF
FUNERAL DIRECTOR .....
Shut O'malley
ADDRESS
Winthrop Massachusetts
Received and filed.
*
19
( Registrar)
Duration IMPORTANT
months
Major findings :
Of operations.
.....
2
Date of
Of autopsy
What test confirmed diagnosis? Clinical Signs
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to insert a recital to that offect. PARENTS
100m (d)-1-41-4667
No.
(Was deceased a .
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
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 attemled during his last illness, at the request of an undertaker or other anthorized 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 behef the name of the deceased, bis supposed age. the disease of which he died, defined as re- quired hy section one, where same was contraetel. 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 aring, navy or marine corps of the I'nited 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 ilollars. 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- peilition and the Philippine insurrection, which shall, for sail purposes, he deemed to have taken place hetween February fourteenth, eighteen humlred 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 perinit 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 body and remove it fromn & town, from one cemetery to another, or from one grave or tonib 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 body is huried. No such permit shall he 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 he 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 hoard 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 hy 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 carly 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 forin for the reinoval of such body has been sooner obtained hercunder. 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 I'nited 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 counter-ign it aml transmit it to the clerk of the town for registration. The person to whom the permit is so given aml the physician certifying the cause of death shall thereafter furnish for registration any other nece+ sary information which can he obtained as to the deceased, or as to the manber or canse of the death, which the clerk or registrar uray require .- Chap. 114. Sec. 45. G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human hody or the ashes thereof which have been hronght into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the hoily is to he buried or the funeral is to he 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. $6. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have ilied by violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the body lies aud take charge of the same; ... - General Laws, Chap. 38, Scc. 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 physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to any form of injury. have died without recent nicdical attendance or whose phyai- 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 inchide not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisuns), thermal, or electrical apenis, 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 naine the disease causing death. As related causes, namne 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 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 discase 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 occupatiou 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 fanrily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
.............................................................................................
R-301 A
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
To be filed for burial permit with Board of Health or its Agent.
Registered No.
194
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Mary E. Kiernan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
61 Johnson Ave
Winthrop
St
(If nonresident, give city or town and state)
In this community 2 5
yrs.
mos.
days.
1
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
Lawrence J. Kiernan
(or) WIFE of.
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
AGE
Months ..
Days
Hours
Minutes
Usual
Bookeeper
9 Occupation:
Industry
Wool Scouring
10 or Business:
11 Social Security No.
028-03-5391
12 BIRTHPLACE (City)
(State or country)
Boston
Mass
13 NAME OF FATHER John Dwyer
PARENTS
14 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
Mass
15 MAIDEN NAME
OF MOTHER
Annie Mclaughlin
16 BIRTHPLACE OF
MOTHER (City).
(State or country)
Boston
Ma88
_17 Her Own Record
Informant (Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the buriaf or transit permit was issued: J. Children ,
(Signature of Agent of Board of Health or other) Health Officer 10/26/41
(Official Designation) (Date of Issue of Permit)
19
I HEREBY CERTIF
That I attended deceased from
18
194to
caux
19.
A last saw h. M alive on
aux 18, 1945 death is said to
have occurred on the date stated above, at 5.20P
.m.
Duration
Immediate cause of deathniti 1 Cholangitis
IMPORTANT 2 days
Chicchicilia
Due to
Chillithisis
4 ms
Due to.
Cholecalci
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 ?. -
If so, specify
(Signed)
(Address) Y Washington on Date 10/1/ 194.
M. D.
21.
Holy Cross
Malden
Place of Burial. Cremation or Removal.
City of Town)
October 21
1941
19
DATE OF BURIAL.
22 NAME OF
FUNERAL DIRECTOR.
W.F. Cassidy
ADDRESS160 Harrison Ave, Boston
Received and filed 19
(Registrar)
100m-2-'40-D-729-8
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.
1
Winthrop Community Hospital
No.
(If U. S.
War Veteran, No
specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution Let TI
(Specify whether)
years
months 3
days.
18
1941
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Widowed
MARRIED
WIDOWED
or DIVORCED
8 51 Years
If less than 1 day
Major findings:
Of operations.
Bald Hadde
Date of 10/16/41
Of autopsy hinter
What test confirmed diagnosis ?.
Relation, if any
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and helief the name of the deceased, his supposed age, the disease of which he died, defined as required 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 hody in a town, or remove therefrom a human hody which has not heen 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 hoard, 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 tomh 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 huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to be returned and recorded. which shall he 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 he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or hy 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 perinit for the removal of a human hody, 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 heen sooner obtained 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 hoard of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shail 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 .- Chop. 114, Sec. 45, G. L., (Tercentenary Edition).
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