USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 69
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(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
26 min.
years
৳ months
(Per hackital)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
Married
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
William Homer Barry
(Husband's name in full)
6 Age of husband or wife if alive. 37
.years
7 IF STILLBORN, enter that fact here.
8
AGE ... 40Years .. 2 ...... Months ...
30 Daye
If less than 1 day
Hours
Minutes
Ueual
9 Occupation :.
At home
10 or Business:
1I Social Security No ....
12 BIRTHPLACE (City)
Brooklyn
(State or country)
New York
J3 NAME OF
FATHER
Grant Garfield Wetherell
14 BIRTHPLACE OF
FATHER (City)
New York
(State or country)
New York
15 MAIDEN NAME
OF MOTHER
Louise Besson
16 BIRTHPLACE OF
MOTHER (City).
I.e.W ...... York
(State or country)
New York
17 Willique Barry mas Relation, if any
Informant.Nimm .. (Address) 600 Shirley St inthrop Mass
I HEREBY CERTIFY that a satisfactory etandard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Childressg-
(Signature of Agent of Board of Heakh or other) Weatthe Office
11/10/41
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
november - 7-
1941
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully Hemorrhage due To Ruptured uterus Spontaneous Precipitate Labor Full Term childbirth
20 Accident, suicide or homicide (specify)
Date of occurrence-
19
Where did
Injury occur?
(City or Town and State)
Did injury occur in or about home, on farm, in industrial place, in public place?
(Specify type of place)
Manner of Injury.
Nature of
Injury.
While at work?
20
Was there an autopsy?
21 Was disease or injury in any way related to occupation of deceased?
If so, specify
Hun Suckling
(Signed)
M. D.
(Address)
Bustin
1941
Rockville Cemetery Imbrookd I. I Place of Burial, Cremation or Removal.
(City or Town) N
TY
DATE OF BURIAL
November
11 1941
19
23 NAME OF
FUNERAL DIRECTOR
Charles R. Bennison
. ADDRESS ....... inthrop .......... a.s.s
Received and filed
NOV 1 2 1941
19
(Registrar)
25m-2-'40-D-729-b
I 3 SEX Female PARENTS 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 Industry
2 FULL NAME ...
gladys
Besson
Barry
.....
(If deceased if a married, widowed or divorced woman, give also maiden name.)
600 Shirley St. Winthrops.
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution Inspital
(Specify whether)
In this community
4
yrs.
mos. -
days.
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 forthwitb. 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 tbe 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 bls last illness, when last seen alive by the physician or officer and the date of bis deatb . . . 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 otber person shall exbume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing tomnb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town wbere tbe body is buried. No such permit shall be issued until there shall have been delivered to sucb 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 sball 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, bis certificate canuot be obtained early enough for the purpose, or is in- sufficient, a physician who is a meniber of the board of health, or em- ployed by it or by tbe selectmen for the purpose, shall upon application make the certificate required of the attending physician. if death is caused by violence, tbe medical examiner sball make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to anotber within the commonwealth cannot be obtained early enough for the purpose, the certificate of deatb 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 bours after such removal, unless a permit in the usual form for the re- moval of such body has beeu 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 tbe permit. The board of bealtb, or its agent, upon receipt of sucb 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 otber necessary information which can be obtained as to the deceased, or as to the manner or cause of the deatb, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person sball bury a human body or tbe asbes thereof which have been brought Into the commonwealth until he has received a permit so to do from the board of health or Ita agent appointed to issue such permits, or if there is no such board, from the clerk of the town wbere the body is to be buried or the funeral is to be beld, or from a person appointed to have the care of the cemetery or burial ground In which tbe interment is made. . . . Chap. 114, Sec. 46, G. L., (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 forthiwith 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 tbe 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 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 bave 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 diseasc unrelated to any form of injury, have died without recent niedical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatisin (including resulting septicemia), and by the action of ciemical (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 when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol slot wound of tbe 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 shows 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
-
R-303A
1 3 SEX Male 8 PARENTS 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 Industry 10 or Business:
25m-2-'40-D-729-b
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
Health Officer 21/10/4
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
aboutearly november-1941
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are
as follows: (If an injury was involved, state fully.) «
Born dead
(still horas)
dead in uterus
Kell term -
Quil
20 Accident, suicide or homicide (specify) ...
Date of occurrence.
19
Where did Injury occur? (City or Town and State)
Did injury occur in or about home, on farm, in industrial place, in public place?
(Specify type of place)
Manner of Injury.
Nature of
Injury(
While at work?
Was there an autopsy ?.
40
21 Was disease or injury in any way related to occupation of deceased ?.
If so. specify.
(Signed)
M. D.
19.4/5.
22.
Rockville Cemetery Lynbrookd L. I Place of Burial, Cremation or Removal. November 11, 7941 19
DATE OF BURIAL
23 NAME OF
FUNERAL DIRECTOR
Charles R. Bennison
ADDRESSWinthrop
Mass
Received and filed
19
-
(City or Town)
The Commonwealth of Massarquartis 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.
211
Registered No. § (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
600 Shirley Struttureh.
St.
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, or divorced
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.
Stillborn
AGE
.. Years
Months
.Daysl
If less than 1 day Hours. Minutes
Usual
9 Occupation :...
11 Social Security No.
12 BIRTHPLACE (City)
int.hrop.
(State or country)
Massachusetts
13 NAME OF
FATHER
Villiam Homer Barry
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston
15 MAIDEN NAME
OF MOTHER
Gladys Besson Wetherell
16 BIRTHPLACE OF
New York
MOTHER (City)
(State or country)
New York
17 William H harry
Relation, if any
Informant
(Address) 60 Shirley St Winthrop lass
PLACE OF DEATH
Sulfulla . ((County)
No ... Baby Boy
..... .
Barre
St.
(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
(Registrar)
Y
ar-Town) N.Y
(Address)
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 whichi 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 hody in a town, or remove therefrom a human body which has not been huried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such hoard, 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 toinb 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 hody 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 hy law to be returned and recorded, which shall he accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed hy 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 permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval of such body has been sooner obtained hereunder. If the death certificate contains a 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 hoard of health or its agent appointed to issue auch permita, or If there is no such board, from the clerk of the town where the body is to be 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).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy 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 hody 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 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 attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examinera will investigate and certify to all deaths supposahly due to Injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and hy the action of cheniical (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 disahled 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 when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas hacillus) caused hy a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ethcr 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 shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under munner, 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)
231
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
-
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.
100m-10-'39. No. 8427-e
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
officer (Signature of Agent of Board of Health BYother) Wealth (Official Designation)
(Date of Issue of Formit)
18 DATE OF
DEATH.
november
10
(Month)
(Day)
1941. (Year)
19 I HEREBY CERTIFY.
That I attended deceased from
to
Www.10
19.
41
I last saw h. Wmalive WWW. 7.2001 death is said
to have occurred on the date stated above, at 9 a:m Duration IMPORTANT 146
Due to
ramla le
Due to
Dinkitas Welliton
2 yes
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
.Date of.
Of autopsy
What test confirmed diagnosis ?
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
23 Was disease or Injury In any way related to occupation of deceased?
If so, specify
(Signed) (Address)
this Wy Date 11/10 .19 .. 561
Maldin
Place of Bufal, Cremation or Removal DATE OF BURIAL (/M)
(City or Town) 3.41
22 NAME OF FUNERAL DIRECTOR ADDRESS 98kiawah8036
19
(Registrar)
1
R-301 A: Infolk
(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.
212
Registered No
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.) 76 Hrodride Ave.
.St.
(If nonresident, give city or town and state)
- years months days. In this community POyrs. - mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 GCX
Viale
A COLOR OR RACE
Photo
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
the word) Married
Sa Il married, widowed er divorced Mancuso 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. 7 IF STILLBORN, onter that fact here.
.years
8 70 Yours
If less than 1 day
Hours.
Minutos
Usual 9 Occupation:
Industry 10 or Business
Barber Hairdressing + Shaving
11 Social Security No. 12 BIRTHPLACE (City) (State or country)
13 NAME OF
FATHER
Frank Verront
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Atak
15 MAIDEN NAME OF MOTHER Ofilomena -Internos
16 BIRTHPLACE OF MOTHER (City) (State or country)
Citato
17 Grace Genome.
bergon, if any
1
PLACE OF DEATH
(City or m) 76 trodside Are. No
LeonardoPersone
St.
(If U. S. War Veteran, specify WAR).
(a) Residence. No ..
( Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
55
AGE
Months
Days
PARENTS
Informast
(Address)
76 Wordside Ave. With
, M. D.
21
Rocelved and filed.
mellitera.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and helief the name of the deccased, 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 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 hoard, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the sanie cemetery, until he has received a permit from the board of health or its agent aforcsaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 he obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or hy the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot he obtaincd 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 hody has heen 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 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.)
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