USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 64
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No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the hody is to he huried 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. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only ag those of persons who, though disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths 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, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy 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 deatlı. As related causes, name earlier morhid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. if the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
PLACE OF DEATH
(County) Winthrop (City or, Townn 18 Atlantic
The Commonforalth 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.
195
$ (If death occurred in a hospital or institution, * ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, If so specify WAR)
(If deceased is a marriedt widowed or divorced woman, give also maiden name.)
(a) Residence. No.
. 18 Atlantic
(Usual place of abode)
Length of stay : In hospital or institution ...
( Before death)
(Specify whether)
years
months days.
In this community
15 yrs.
6
mos.
3
days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
Grace Afin
(Give maiden name of wife in full) afin
6 Age of husband or wife if alive years
If less than 1 day
Hours
Minutes
12 BIRTHPLACE (City)
(State or country )
Scotland
13 NAME OF
FATHER
James Stain
Scotland
Helen Gifford
Scotland
Relation, if any
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial/or transit permit was issued : Mail. D. Juldress
(Signature of Agent of Board of Health- of others Health Mucer 10/21/41
(Official Designation) (Date of Issue of Permit)
18 DATE OF Oct. 20, 1941
DEATH
(Month)
(Day)
(Year)
19SeptEREBY CERTIFY,
41
Oct. 20, 1941
19
19
to ..
1 last saw h
alive on
Oct. 19, 1941.
death Is said to
have occurred on the date stated above, at
8 a.m.
m.
Duration
Immediate cause of death
Cerebral hemorrhage
Due to.
atriosclerosis.
Iyear .......
a turimete
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
none
Major findings :
Of operations
Date of.
Of autopsy
none
What test confirmed diagnosis ?.
Clinical
20 Was disease or injury in any way related to occupation of deceased ?. no
If so, specify.
Charles Muitoni
(Signed)
...
M. D.
(Address)
305 Havet Spero
Date Oct 201941
21
Woodlawn
, (City or Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL Catcher 23
1971
22 NAME OF
FUNERAL DIRECTOR frank É Brown
ADDRESS
Received and filed OCT 23 1941 19
(Registrar)
IT
IMPORTANT
Physician
Underline the cause to which death should be charged sta. tistically.
100m (d) -1-41-4667
1 .... No. James 2 FULL NAME - 4 COLOR/OR RACE 3 SEX Male White 5a If married, widowed, or divorced HUSBAND of (or) WIFE of (Husband's name in full) 7 IF STILLBORN, enter that fact here. 8 AGE 71 Years 4 Months. 9 .. Days Retired Usual 9 Occupation : 10 or Business : LI Social Security No. 011-12-1131 14 BIRTHPLACE OF FATHER (City) (State or country) 15 MAIDEN NAME OF MOTHER PARENTS 16 BIRTHPLACE OF MOTHER (City) (State or country) 17 Informant,. ( Address) James & Hair, 18 Atlantis &t Want If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effeot. extracts from the laws on back of certificate. time, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and Industry Watchman
St.
Main
St
(If nonresident, give city or town and State)
That I attended deceased from
im
...
MEDICAL CERTIFICATE OF DEATH
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or otlier 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 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 offleer 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, speei- fying the war, and shall also eertify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For negleet to comply with any provision of this section, sueh physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of scetions forty-five. forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall inelude 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 hundreil 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 thercfrom 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 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 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 accompaniedl, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in licu 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, the medi- cal examiner shall make sueh 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 certifieate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for sueh 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 acction 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 aud certifieate, 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 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 reglatrar 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 ageut 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, See. 46. G. L., (Terccuteuary 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 notiee 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 physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attemilanee 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 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 discase 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 gaiufully 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
............................................................... ....
...
1
R-301 A
Suffolk
(County)
Winthrop
(City or Town)
No. 8 Bleasdent
The Commonwealth of Mussarhusetts 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
196 ..... .....
§ (If death occurred in a hospital or institution, ( give its NAME instead of street and number)
2 FULL NAME
Larriett
Albee Idgar
(If deceased is a married, widowed or divorced woman, give also maiden name.)
8 Pleasant
St
(If nonresident, give city or town and state)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
5a If married, widowed, or divorced HUSBAND of.
(Give maiden name of wife in full)
William J. Edgard
(or) WIFE of (Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
8 6
AGE.
Years
1 Months 2 Days
If less than 1 day .Hours.
Minutes
Ueual
9 Occupation :..
Housewife.
Industry At Home
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Maine
13 NAME OF FATHER ? Albee
PARENTS
14 BIRTHPLACE OF FATHER (City) ... (State or country) Maine
15 MAIDEN NAME
OF MOTHER
Not Known
16 BIRTHPLACE OF MOTHER (City). (State or country) Maine
.17 Cheater Wood
Relation, if any eph
Informant ... (Address)Old Sudbury Rd. Lincoln Maas
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Clubdres X
(Signature of Agent of Board of Health or other) Healthe Officer 10/23/41
.... (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Ost.
21
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY That I attended deceased from
19.4/ to. Get 21 19 4/
I last saw h .. @.Y ..... alive on Coef 20, 1941, death is said to
have occurred on the date stated above, at. 7.30 A .m.
Immediate cause of death. Care of
Colon
Due to
Due to
Other conditions ..
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
M. D.
(Address)
Date et 23 194/
21. Gardner
Place of Burial, Cremation or Removal.
(City or Town) DATE OF BURIAL.Oct .... 241941
22 NAME OF FUNERAL DIRECTOR
Rufland & White
ADDRESS 147 Winthrop St Winthrop
Received and filed
19
(Registrar)
100m-2-'40-D-729-2
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.
-
(If U. S. War Veteran. specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
years
months
days.
In this community
34
yrs. -
mos.
days.
Duration IMPORTANT ...... tmos 8
Major findings: Of operations.
Date of
Of autopsy
What test confirmed diagnosis ?.
Clinical Signs
Mstde
1
PLACE OF DEATH
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit 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 from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. if death is caused by violence, the 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 removai; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty- six, that the deceased served in the 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 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 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 Heaith physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths 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 disabied 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 principai cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired fromn 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
R-301 A
PLACE OF DEATH
Suffolk /County)
1 Winthrop (City or Town) 95 Court Rd. No. r Julia J. Barron
The Commonforalth 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.
197
." (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, 20 if so specify WAR)
tuint
( If nonresident, give city or town and State)
months days.
In this community
13 yrs.
mos.
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
22 1941
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
3
1938
to
That
attended deceased from
Cect 22 1941
I last saw hM
alive on
22
1941, death Is sald to
have occurred on the date stated above, at
6 P
.m.
Immediate cause of death.
Durarion IMPORTANT
myocarditis
Due to.
diabetes
Due to
diabetes
5 yrs
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Of autopsy
What test confirmed diagnosis ?.
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) ..
Louis 7. Salerno
M. D.
(Address) 175 Pleasant St
Date Get 23
.194/
21
Holy Cross Quetiny
Malden
Place of Burial, Cremation or Removal.
DATE OF BURIAL ..
October
25
1941
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