USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 86
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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 exhunie a human hody and remove it from a town, from one cemetery to another, or from one grave or tonib other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall he 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 he returned and reconled, which shall be accompanied. in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law. oi 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 physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence. the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained carly enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual forin for the removal 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 hren engaged, such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwith counter-ign it 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 nr.ces- sary information which can he obtained as to the deceased, or as to the manter or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tereentenary Edition).
No ulaleriaker or other person shall bury a human hody 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 agent appointed to issue such permits, or if there is no such hoard, from the elerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died by violence. If a innlical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the body lies 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 beilside care during a last illness from disease unrelated to any forin of injury.
( ") Board of Health physicians will certify to such deaths only as those of persons who, thengh disabled by recognized disease unrelated to any form of injury. have died without recent inedical attendance or whose physl- cian is absent from home when the certificate of death is needed.
(3) Medioal 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 deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death. not the mode of dying. e. g .. heart failure, asphyxia, asthenia, etc. As principal cause naine the disease causing death. As related causes, naine 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 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-301JA
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town)
No 18 Cliff Av.e.
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. 257
[ (If death occurred in a hospital or institution, .. St. ¿ give its NAME instead of street and number)
2 FULL NAME
Elisabeth Mc Dermott Sharkey
(If deceased is married) widowed or divorced woman, give also maiden name.)
18 Cliffe Une.
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
None
(Specify whether)
years
months
days.
In this community /5 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
December
24
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY,
19 ..
.. , to
I last saw halive on
19
death is said to
have occurred on the date stated above, at. 4:30 P.M m.
Immediate cause of death.
Sudden death-Natural causes
Due to.
Cardiac failure
Due to Chronic pinocarditis
Ipertensione
Other conditions ....
(Include pregnancy within 3 months of death)
Major findings:
Of operations.
-
Date of.
Of autopsy.
What test confirmed diagnosis? clinical
20 Was disease or injury in any way related to occupation of deceased? no
If so, specify ................
Signed) Lothar & Carry
.... , M. D.
(Address) Samt hora, Grand pil
.. Date.
12/25 1941
21.
Winthrop Com
Place of Burial, Cremation or Removal.
(City or Town)
....
DATE OF BURIAL.
Dec. 27,
: 19 41
22 NAME OF
FUNERAL DIRECTOR:
Richard 16 White ADDRESS 147 Winthis St Minthus
Received and filed 19.
(Registrar)
per tal call Q
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
. murray
13 NAME OF
FATHER
Patrick Mc Dermott
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Dopherty
Nakfertig
freland
17 Walters Sharkey
Relation, if any Low)
(Address)
18 Cliff Ave winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transit permit was issued: William D. Childress
(Signature of Agent of Board of Health or other)
Cegent- Dec. 22/4/
(Official Designation) (Date of Issue of Pefmit) 2%
5 SINGLE
(write the word)
married
MARRIED
WIDOWED
or DIVORCED
(Give maiden name of wife in full)/
Walter A Sharkey
(Husband's name in full)
77
years
If less than 1 day
.Hours.
.Minutes
Boston, Mais.
Elizabeth se ut off white
AGE
77 Years
..... Months.
Days
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
at home
1
(a) Residence. No .....
(Usual place of abode)
3 SEX
female
4 COLOR OR RACE
white
Sa If married, widowed, or divorced
HUSBAND of
........
(or) WIFE of
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
9 Occupation :..
10 or Business:
11 Social Security No ...
none
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF
FATHER (City)
(State or country)
16 BIRTHPLACE OF
MOTHER (City) ...
PARENTS
(State or country)
Informant.
100m-2 -* 40-D-729-8
NOR-WRITE-DI AINTV _WITH __ TINDIRINA
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
Usual
housewife
(If U. S.
War Veteran,
specify WAR).
1941
That I attended deceased from
19
Duration
IMPORTANT
×
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 iliness, 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 hy 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 shali bury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not been huricd, 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 hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing tomh to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the hody is huried. No such permit shail be issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shali he 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 in- sufficient, a physiclan who is a member of the hoard of health, or em- pioyed hy it or by 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 shali make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot be ohtalned early enough for the purpose, the certificate of death made as ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall he returned to the town from which it was removed within thirty-six hours after such removai, 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 sectlon 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 shail 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 he 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).
SPACE FOR ADDITIONAL INFORMATION
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 heid, or fromn 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 physiclans 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 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 supposa biy 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 clectrical 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, asphyxla, asthenia, etc. As principai cause name the disease causing death. As related causes, name earlier morbld conditions, If any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation la 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 heen given up or changed on account of the disease causing death, report the usual occupation prior to Illness. If the deceased had retired from husiness, report the usual occupation prior to retirement. Children not galnfuily 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.
RM R-3011
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 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS 200m-10-'39. No. 8427-d
PLACE OF DEATH
LAfolk (County) Winthrop (City or Town) 19 Sagamore Ave No ...
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return) ....
258 3339
Registered No ..............
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Many A Downey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ... (Usual place of abode)'
19 Sagamore que
St.
(If nonresident, give city or town and state)
ilength of stay: In hospital or institution (Specify whether)
years
months
~ days.
In this community -
yrs. mos. - days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widowed
5a lf 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.
AGE 79 .Years. - .Months. Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Housework
Industry
10 or Business:
at Home
11 Social Security No.
12 BIRTHPLACE (City)
Westwood
(State or country)
mass
13 NAME OF
FATHER
Thomas + Walsh
14 BIRTHPLACE OF
FATHER (City)
Co Waterford
(State or country) Ireland
15 MAIDEN NAME
OF MOTHER
Ellen Mc Carthy
16 BIRTHPLACE OF
MOTHER (City)
Co Waterford 0
(State or country)
Ireland
17 mary 7 Downey Relation, if any-
Informant./
(Address)
19 Sagamore The Wind
1 HEREBY CERTIFY that a satisfactory standard certificate of death was Bled with me BEFORE the burial or transit permit was issued: William D. Children (Signature of Agent of Board of Health or other)
agent Dea, 21/4/
(Official Pelignation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
(write the word)
DEATH
Dec
25
1941
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY. That I attended deceased from
nor 4
19.4 ..... , to ......
25
19.4 ....
I last saw h .. . In alive on.
Due 25
19.5./ .. , death is said
to have occurred on the date stated above, at 5.05 0m.
Immediate cause of death Corona Thrombin
Duration
12. 50mi
...
2-3 yrs
Due to
Hypertension Heart Derne
Cubano Sclerosis
...
PHYSICIAN
Major findings :
Of operations
Date of .
Of autopsy
What test confirmed diagnosis ?
Clinical
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ? 20
If so, specify.
(Signe
Richard Instead
M. D.
(Address) 148 km Cho St
Como Date De 25 1941
21
Holywood
Brovereine
Place of Burial, Cremation or Removal
(City or Town)
DATE OF BURIAL
19/1
22 NAME OF
Edward & Mulvaney
FUNERAL DIRECTOR
ADDRESS
40
moder walkolem
Received and filed
19
À TRUE COPY ATTEST:
(Registrar)
1
St. (
(If U. S.
War Veteran.
specify WAR)
Due to
Corona Duenne
Other conditions Lest Hemille Hemipug (Include pregnancy within 3 months of deaths
in 7 with 2 days
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medles! 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 belief the name of the deceased, his supposed age, the disease of which he died, defined as required hy section one, where same was contracted, the duretlon of his last illness, when last seen alive by the physiclan or officer and the date of his death ... Gen. Laws, Chap. 46. Sec. 9.
No undertaker or other person shall hury or otherwise dispose of a human 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 heaith 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 tomh 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 aforesald 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 physielan, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physleian, or if, for zuffielent reasons, his certificate cannot be obtained early enough for the purpose, or is insuffielent, a physician who is a member of the board of health, or employed hy it or by the selectmen for the pur- pose, shall upon application make the certificate required of the st- 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 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 a removal zhall 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 much removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contalna s 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 reristrar 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 ro to do from the board of health or its agent appointed to issue auch permits, or if there is no such board. from the clerk of the town where the body le to be toried or the funeral is to be held, or fron a person appointed to have the card of the ecmetery 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 certify to such deaths only &s those of persons to whom they have given bedside care during a last ill- ness from disease unrelated to any form of Injury.
(2) Board of Health physlelans will certify to such deaths only & those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendance or whose physlolan 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 hy traumatism (including resulting septice- mis), and by the action of chemical (drugs or polsons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or lufection related to occupa- Hoa, the sadden deaths of persons not disabled by recognised disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, rot the mode of dying, «. g., heart failure, aspbyxla, asthenla, etc. As principal cause name the disease causing death. As related causes. name earlier morbid con- ditlors, if any, related to the principal cause and any important complication of the principal cause.
Statement of Ocenpation .- Precise statement of occupation is very important, no that the relative healthfulness of various pursuita 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 secount of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from basi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as et school or at home. For a woman whowe 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 30 occupation whatever write nona.
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