USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 8
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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 board, from the clerk of the town where the body 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 hedside 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 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 hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, but 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 .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every person aged 10 years or over. If the occupation had hecn 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 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
M R-301 A
Every item of
PLACE OF DEATH
Sufi loK
(County)
Winthrop
(City or Town)
No 58I Winthrop St.
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.
22
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME.
John J Ranall
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ...
SEI Winthrop
St
(If nonresident, give city or town and state)
years
months
days.
In this community I6 yrs. mos. days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced HUSBAND of .. Catherine
Corcoran
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive. 56
years
7 IF STILLBORN, enter that fact here.
AGE0 3
Years
U
Months
I2
Days
If less than 1 day
Hours.
Minutes
Usual
Leather Sorter (Retired)
Industry
Leather Factory ( shoe)
11 Social Security No.
East Buston
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
PatrickJ Rahall
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary
?
16 BIRTHPLACE OF
MOTHER (City) ...
(State or country)
Unknown
Informant Catherine Ranalt (
Relation, if any Wire
(Address)
38I Winthrop St.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Im.2. Cebuldrees
(Signature of Agent of Board of Health or other)
Jan 19/41
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
18
1441 (Year) That I attended deceased from
19 I HEREBY CERTIFIY.
19_5.4
19
A last saw h.
Lalive on .....
have occurred on the date stated above, at. 5A m.
Immediate cause of death.
Duration IMPORTANT
Due to.
Due to. Chapin function )3
3 7
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT PHYSICIAN
Major findings: Of operations.
Date of.
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)
4 mmlonghorn Date 1/18
M. D.
(Address) ...
inthrop
] Winthrop Place of Burial, Cremation or Remove !. (City or Town) 41
DATE OF BURIAL ..
Jan ..
20
19 ..
22 NAME OF
FUNERAL DIRECTOR
ADDRESS.
Howard S ynolds
Mars.
Received and filed.
19
(Registrar)
100m-2-'40-D-729-a I. M. WAVIL ALMINLI, WIIn UNPAVING BLACK INK-THIS IS A PERMANENT RECORD. PARENTS
1 3 SEX Male (or) WIFE of. 9 Occupation : 17 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 10 or Business:
(Day)
8
., 19)., death s said to
124
1955
St.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
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, definded 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 therefroin 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 froin a town, from one cemetery to another, or from one grave or tomb other than the receiv- ng 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 aw to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, f 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, is 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 nake the certificate required of the attending physician. If death is caused by violence, the inedical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from ne 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 reinoval shall constitute a permit for such removal; provided, that such body shall be returned to the town froin which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- noval of such body has been sooner obtained hereunder. if the death certificate contains a recital, as required by section ten of chapter forty- ix, that the deceased served in the army, navy or marine corps of the Jnited 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 uch statement and certificate, shall forthwith countersign it and transmit t to the clerk of the town for registration. The person to whom the permit s so given and the physician certifying the cause of death shall thereafter urnish 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 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 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 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 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 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 A
HvCy Licm or
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 is very important. See instructions and extracts from the laws on back of certificate.
1
PLACE OF DEATH
Suffolk UD (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 Agentes
Registered No.
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAMEZ.
Lillian Estelle Rich
(If deceased is a married, widowed or divorced woman, give also maiden name.)
188 Woodside ane.
St
(If nonresident, give city or town and state)
years
months
days.
In this community
yrs. 8
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Wider
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of ...
(Give maiden name of wife in full)
Richard M. Rich
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 AG 73 Years Months. .Days
If less than 1 day .Hours. .Minutes
Usual
9 Occupation :..
Housewife
Industry
10 or Business:
nome
11 Social Security No.
12 BIRTHPLACE (City) ..
(State or country)
maine
13 NAME OF
FATHER
Qui C. Harrington
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
maine
15 MAIDEN NAME
OF MOTHER
Emma & Brown
16 BIRTHPLACE OF
MOTHER (City) ...
(State or country)
maine
12 Donald Rich
Relation, if any Son
Informant ...... (Address) Lincoln St, Fitchburg Masz.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : William D Childress
(Signature of Agent of Board of Health or other)
agent 1/18/41
.... (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan
(Month)
18, 1941
(Day)
(Year)
I HEREBY CERTIFY. That I attended deceased from
1940, to.
cet8, 1941
I last saw h.g .alive on ... Jape 18, 1941 death is said to have occurred on the date stated above, at 2:30 A.m. Immediate cause of death Cardiac Decompensation
Duration IMPORTANT 1/2400
5 yrs.
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 ?. 200
(Signed)
(Address) 26 Wine Way Que Date 1/18/
21. Forest Hilla, Baston mann (City or Town) Place of Burial, Cremation or Removal. DATE OF BURIAL ....... 1 an, 20 19 .... /.
22 NAME OF
Q. Howyfag Clark Lutna Funeral Parlera FUNERAL DIRECTOR.
ADDRESS 866 Main St. Marcusty Mas,
Received and filed .19
(Registrar)
100m-2-'40-D-729-a
Major findings: Of operations
Topsham
Date of.
Of autopsy.
-
What test confirmed diagnosis ?. clinical
If so, specify .....
Liberman
M. D.
.19.46{
Brunswick
.....
No ... 188700 sol che Que.
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
MARRIED
WIDOWED
or DIVORCED
Due to hypertensive , Coronary
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, fter the death of a person whom he has attended during his last iliness, t the request of an undertaker or other authorized person or of any ember of the family of the deceased, furnish for registration a standard ertificate of death, stating to the best of his knowledge and helief the ame of the deceased, his supposed age, the disease of which he died. efined as required hy section one, wiiere same was contracted, the uration of his iast illness, when last seen alive hy the physician or officer nd the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shaii bury or otherwise dispose of a uman body in a town, or remove therefrom a human hody which has ot been buried, until he has received a permit from the board of heaith, r its agent appointed to issue such permits, or if there is no such board, rom the cierk of the town where the person died; and no undertaker or ther person shaii exhume a human hody and remove it from a town, from ne cemetery to another, or from one grave or tomb other than the receiv- ng tomb to another in the same cemetery, until he has received a permit om the board of heaith or its agent aforesaid or from the cierk of the own where the body Is buried. No such permit shaii be issued until here shail have been delivered to such board, agent or clerk, as the case hay be, a satisfactory written statement containing the facts required by w to be returned and recorded, which shall be accompanied, In case of an riginal interment, by a satisfactory certificate of the attending physician, any, as required hy law, or in lieu thereof a certificate as hereinafter rovided. If there is no attending physician, or if, for sufficient reasons, is certificate cannot be obtained early enough for the purpose, or is In- ufficient, a physician who is a member of the board of health, or cm- ioyed by it or hy the selectmen for the purpose, shail upon application nake the certificate required of the attending physician. If death is caused y violence. the medical examiner shail make such certificate. If such a ermit for the removal of a human body, not previously interred, from ne town to another within the commonwealth cannot be obtained early nough for the purpose, the certificate of death made as above provided nd in the possession of the undertaker desiring to make such removal haii constitute a permit for such removal; provided, that such body shaii e returned to the town from which it was removed within thirty-six ours after such removai, uniess a permit In the usual form for the re- noval of such body has been sooner ohtained hereunder. If the death ertificate contains a recitai, as required hy section ten of chapter forty- ix, that the deceased served in the army, navy or marine corps of the Jnited States in any war in which it has been engaged, such recitai shall ppear upon the permit. The board of heaith, or its agent, upon receipt of uch statement and certificate, shali forthwitli countersign it and transmit t to the cierk of the town for registration. The person to whom the permit s so given and the physician certifying the cause of death shali thereafter urnish 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 cierk or registrar may require .- Chop. 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 untli he has received a permit so to do from the board of heaith or its agent appointed to issue such permits, or If there is no such board, from the cierk of the town where the body Is to be buried or the funeral is to be heid, or from a person appointed to have the care of the cemetery or hurlai ground in which the interment is made. ... Chap. 114. Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfiliment of the purpose of these laws calis for the observance of the following rules of practice:
(1) Attending physicians wiii certify to such deaths oniy as those of persons to whom they have given bedside care during a iast iliness 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 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 deatins supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resuiting septicemia), and by the action of chemical (drugs or poisons), thermai, or electrical agents, and deaths following abortion, but aiso 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 name the disease causing death. As related causcs, name eariier morhid conditions, if any, related to the principal cause and any important complication of the principai cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative heaithfuiness of various pursuits can he 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 iliness. If the deceased had retired from husiness, report the usual occupation prior to retirement. Children not gainfuiiy employed may be returned as at school or at home. For a woman whose only occupation was that of homc 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
M R-301 A
PLACE OF DEATH
Suffolk Middlesex (County)
Winthrop
(City or Town)
No 33 Court Road
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.
21
(If death occurred in a hospital or institution, St.
2 FULL NAME
GustafAdolph
OLSON
(If deceased is a married, widowed or divorced woman, give also maiden name.)
33 Court Road
St
(If nonresident, give city or town and state)
(Specify whether)
years
months
days.
In this community
yrs.
6
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Married
5a If married, widowed, or divorced HUSBAND of .. Anna .... Peterson
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
68
6 Age of husband or wife if alive. .. years
7 IF STILLBORN, enter that fact here.
8 AGE .... 7.8 ... Years. .00 .Months. 5 Days
If less than 1 day
Hours
Minutes
Usual
General helper
11 Social Security No ... Retired 1930
12 BIRTHPLACE (City)Lidkoping. (State or country)
Sweden
13 NAME OF
FATHER
Peter Olson
14 BIRTHPLACE Cannot be learned FATHER (City) (State or country)Sweden
15 MAIDEN NAMECannot be learned OF MOTHER
Cannot be learned (State or country)Sweden
:17 Relation, if any
Informant Mrs. Anna Peterson Olson will (Address) 33 Court Road, Winthrop
100m-2-'40-D-729-a
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with me BEFORE the burial ur transit permit was issued: Www. D. Childress (Signature of Agent of Board of Healthfor other) Health Officer 1/21/4/
(Official Designationy (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jau. 20
1941
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. oct. 24 1940, Jan 20 19 41
I last saw h ..!.......... alive on. Jan . 19
19 41, death is said to have occurred on the date stated above, at. 12 noon m.
Immediate cause of death Cancer Cung- medicotmum
mediastinomy
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Major findings: Of operations
.Date of.
Of autopsy.
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to occupation of deceased? 40
If so, specify
(Signed)
a Emest hills
M. D.
(Address) 76 Boston Con W. Medford Date Jan. 201941
.Woodlawn Everett Mass.
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
Jan 23
...
22 NAME OF FUNERAL DIRECTOR. a.E- Yong Tfm the.
ADDRESS .... 1.9.79 Mass ..... Ave ........ Cambridge
Received and filed .. 19
(Registrar)
"ILID IS A TENMANGNA ALUUND. Every item or
1 3 SEX Male White 9 Occupation : 10 or Business: PARENTS 16 BIRTHPLACE MOTHER (City). information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 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 Industry Club
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