USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 75
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Relation, if any Neice
Informant. (Address) 319 Bowdoin St ., Winthrop/ CCcc
V
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit parmit was issued: Www. X. Childreng. (Signature of Agent of Board of Health or other) Health Officer 11/21/4
(Official Designation) 0
(Date of Issue of Permit) /
MEDICAL CERTIFICATE OF DEATH
18 DATE OF Moreselam
18
(Month)
(Day)
(Year)
LHEREBY CERTIFY 1. September 1941, to. November 18 1941 I last saw her alive on November 17, 1941, death is said to have occurred on the date stated above, at 29. m.
Immediate cause of death. Broncho - pneumonia
Due to.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations
Date of.
Of autopsy.
2200
What test confirmed diagnosis? ClinicalSigns
Underline the cause to which death should be charged sta- ... tistically.
20 Was disease or injury in any way related to occupation of deceased? 220
If so, specify.
Daniel 20 Juin
(Signed)
M. D.
(Addre Winthrop mass Date Nov. 18/1941
21 ... Glenwood Iverett
Place of Burial, Cremation or Removal. (City or Town) DATE OF BURIAL Nov. 21, 1941 19
22 NAME OF FUNERAL DIRECTOR Richard 9695 hots
ADDRESS ..
147 Winthrop St.
Winthrop
Received and filed. .. 19
(Registrar)
100m-2-'40-D-729-a
....
St.
winthrop
(If nonresident. give city or town and state)
years
months
days.
In this community
25
yrs. - mos. - days.
1941
That I attended deceased from
Duration IMPORTANT Nor 14, 1941
(County) Winthrop 1 (City or Town) 2 FULL NAME 3 SEX Temale 6 Age of husband or wife if alive. 8 85 Months AGE .. Years 11 Usual 10 or Business: 11 Social Security No ....... 12 BIRTHPLACE (City). (State or country) PARENTS 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 Industry Retired
PLACE OF DEATH
Registered No
(If U. S.
War Veteran.
specify WAR).
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 tbe deatb of a person wbom be bas 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, tbe duration of his last illness, when last seen alive by tbe 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 buman 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 anotber, or from one grave or tomb otber than tbe 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 tbe town where the body is buried. No such permit shall be issued until there shall bave 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 enougb 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 sucb removal; provided, tbat sucb 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 forthwitb countersign it and transmit it to tbe 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 deatb, 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 tbereof which bave 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 rulcs of practice:
(1) Attending physicians will certify to such deatbs 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 wbo, 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 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, 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 deatb means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, aspbyxia, asthenia, etc. As principal cause name tbe 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 cbanged on account of the disease causing deatb, 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
M R-301 Ai
PLACE OF DEATH
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
226
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
Revere, Mas
(If nonresident, give city or town and state)
in this community
41
yTS.
mos. - days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX 4 COLOR OR RACE | 5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
Sa If married, widerdie digoshaker Torrey
Give maiden name of wife in full)
Forthaber
(Husband's name in full)
Years
If less than 1 day
11 Months 14 Days Hours Minutes Due to . Tufiction
12 BIRTHPLACE (City)
(State or country)
Maine
Deer Isles
Date of.
Of autopsy
What test confirmed diagnosis ?
Bland Yamaha
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease or Injury la any way related to occupation of deccased? 200
If so, specify
(Signed)
Date ....
11/18
.
1.1. D
19.4/
21 Mt. Auburn
Cambridge
{City er Town)
19
22 NAME OF
FUNERAL DIRECTOR
Richard 76 Whats
ADDRESS
147 Winthrop St. Winthrop
Received and filed
NOV 2 1" 1941
19
(Registrar)
)
Health afficher 11/28/41
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
Nov. 18
1941
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. That I attended deceased from
19.07, to 202-18
19.
4/
Vast saw b. w alive of Zur. 19
death is said to have occurred on the date stated above, at. 11-25A .. m. Duration ALIPORTANT
Immediate cause of, death
6 days
6 day 2day
Detoptococce & infectein blood
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
(Address)
Relation, if any Wife
Informant .. (Address) 56 Cresent Ave., Revere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the Mural or transit permit was issued: Www. S. Children (Signature of Agent of Board of Health or other)
REVERE NOTIFIED
No .... Winthrop ... Comunity .... Hospital .
St.
2 FULL NAME Warren G Torrey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. Nc ..... 56CresentAre ...... Jerere
(Usual place of abode)
Length of stay : In hospital or institution.
(Specify whether)
.......
St.
- years - months
2
days.
MEDICAL CERTIFICATE OF DEATH
Winthrop 1 (City or Town) m Male White HUSBAND of (or) WIFE of 6 Age of husband or wife if alive 69 7 IF STILLBORN, enter that fact here. 8 69 AGE Years Usual 9 Occupation: Sales Manager Industry Tlour Mills 10 or Business: 11 Social Security No. Deer Isles 13 NAME OF FATHER Grafton Torrey 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME Lenora Warren OF MOTHER PARENTS 17 Mrs. Jessie T.Torrey 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 stato is very important. See instructions and extracts from the laws on back of certificate. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country) Maine 100m-10-'39. No. 8427-C
16 BIRTHPLACE OF
Deer Isles
MOTHER (City)
(State or country)
Maine
Place of Burial, Cremation or Removal. DATE OF BURIAL .... NOV.
1941
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shali 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 belief the name of the deceased, his anpposed 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 hody 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 thers is no such board, from the elerk 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 recelving tomb to another in the same cemetery, until he has received & perinit 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 de- livered to sueh board, agent or clerk. as the case may be, a satisfac- tory written statement containing the facts required by law to he returned and recorded, which shall be accompanled, 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 physician who is a member of the hoard 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 shail make such certificate. If such a perinit 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 euch removal, unless a permit in the usual form for the removal of auch body has been sooner ohtalned hereunder. If the death certificate contalns 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 trar 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 elerk 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 nceessary information which can be obtained as to the deceased, or as to the manner or cause of the death, whleh the elerk or registrar may require .- Chap. 114, Ses. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall hury 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 sueh permits, or if there is no such board, from the elerk of the town where the hody 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 observ- ance of the following rules of practice :
(1) Attending physicians will eertify to such deaths only ss those of persons to whom they have given bedside care during a last ill- ness from dlsease 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 un- related to any form of injury, have died without recent medieal attendance or whose physician is ahsent from home when the certificate of death is needed.
(3) Medieal Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or Indirectly hy traumatismi (including 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 persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complieatlon , which causes death, not the mode of dying, c. g .. heart failure, asphyxia, asthenia, ete. As principal cause name the disease causing death. As related eauses, name earlier morbid con- ditions, if any, related to the principal cause and any important complleation of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits ean be known. Make zome 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 bual- 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 domestie service for wages, however, designate the occupation by the appropriate terms, as housckeeper-private family, cools-hotel, ete. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
A R-301 A
Sufi olk
(County)
1
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.
227
Registered No. (If death occurred in a hospital or Institution, St. { give its NAME instead of street and number)
2 FULL NAME
Cal.i.60 Phelan
(Coggins)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
509 Pleasant
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
-
(Specify whether)
years
months
days.
In this community
1 4 yrs
yrs. - mos. -
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED marrie
Sa If married. widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Lloyd A. Phelan
(Husband's name in full)
6 Age of husband or wife if alive.
48
years
7 IF STILLBORN, enter that fact here.
8
AGE ... 4.9 Years.
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
housewife
Industry
10 or Business :.
-
11 Social Security No. none.
¿12 BIRTHPLACE (City)
Westport
(State or country)
Nova Scotia
13 NAME OF
FATHER
Albert E. Coggins
14 BIRTHPLACE OF
FATHER (City) ..
Westvort
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Lealah Peters
716 BIRTHPLACE OF
MOTHER (City) ...
Westport
(State or country)
Nova Scotia
Relation, if any
Informant
Lloyd A. Phelan
(husband
.)
(Address) 509 Pleasant St.
Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: VimD. Childress
Signature of Agent of Board of Health or other)
He alte Officie 11/21/41
(Official Designationy (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Nov. 19
(Month)
(Day)
(Year)
19
REBY CERTIFY.
194 )
to hov19
.,
19.
41
I last saw h & alive on
Von 19, 199, death is said to
have occurred on the date stated above, at.
10-45 P
m.
Immediate cause of death.
Cerebral / herbario
Duration IMPORTANT 2 Months
Due to.
arturo Silver
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)
Le Circuit Cute
Date 11/19
M. D.
19:41
21 Winthrop Cemetery
inth"o)
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL.
05. 22.
19.4.1
22 NAME OF
Michael. Fiscella
FUNERAL DIRECTOR
ADDRESS.
10 No, Bennet St.,
Boston
Received and filed 19
(Registrar)
Pervoting in
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 ---
- --
100m-2-'40-D-729-a
PARENTS
17
Major findings:
Of operations.
(Address)
Date of
Of autopsy
-
What test confirmed diagnosis?
-
PLACE OF DEATH
No ....
(If U. S.
War Veteran,
specify WAR).
1941
That I attended deceased from
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 hc 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 hy the physician or officer and the date of hisdeath . . . 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 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 exhumne 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 cierk, 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, hy 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 sufficlent 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 hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy 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 commonwealthi 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 suclı 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 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 physiclan certifying the cause of death shall thereafter furnish for registration any other necessary information which can be ohtained 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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