USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 13
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by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the I'nited States in auy war In which it has heen engaged. such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement aml 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 neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar ulay require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human hody or the achea thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issne such permits, or if there is no such hoard, from the clerk of the town where the hoily is to he 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 Editiou).
Medical examiners shall make examination upon the view of the dead bodies 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 hoily of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiclans 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 nicdical attendance or whose physi- cian is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting aepticemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, amd deaths following ahortion, 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 moile of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause naine 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 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 occupatiou whatever write uone.
SPACE FOR ADDITIONAL INFORMATION
I R-301 A
1
PLACE OF DEATH
Suffolk (County) Hinthrop
Boston (City or Towp) Wuthrok Community Hack No.
The Commonforalth ot 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.
35
{{If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence.
No.
10 Pelas
St.
Malden
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
( Before death )
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
MIL
4 COLOR OR RACE|
Wie
5 SINGLE
(write the wurd)
MARRIED
WIDOWED
or DIVORCEO
Sa If married, widowed, or divorced
HUSBANO of
(Give maiden name of wife in full)
(or) WIFE of
(TInshand's name in full)
6 Age of husband or wife if alive
7 IF STILLBORN. enter that fact here. still fora
8
AGE
Years
Months
Oays
If less than 1 day V
Hours5
Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( State or country)
Withrup Tions
13 NAME OF
FATHER
alfred queix
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Bothways
(State or country)
newark. new Jersey
15 MAIOEN NAME
OF MOTHER
alice Coscia
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
dangus, mais.
17
alfred Fysi
Informant.
10 Leland It. malde (father)
Rolatidy, if any
OATE OF B
Feb. 20
19.4.2
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was Issued : Www. D. Childress
...
(Signature, of Agent of Board of Health or other) 2/20/42
(Date of Issue of Permit)
18 DATE OF
DEATH
february
16
(Month)
(Day)
1942 (Year)
19 I HEREBY CERTIFY, That I attended deceased from feb 16. . 19 42 to Zula 16 19 .... 2 I last saw h ................ alive on. 19 ., death Is sald to
have occurred on the date stated above, at 10:50 p. m.
years
Immediate cause of death
Uterine infection
1
moltur
Due to
Due to.
Other conditions
-
(Include pregnancy within 3 months of death)
IMPORTANT
Physician
I'nderline The cause to which Jeath should be charged sta- Istically.
20 Was disease or injury in any way related to ocoupation of deceased ?..... If so, specify ....... com
M. D.
(Sigred)
( Address )
9 Porque It Hot Date 2/18/19/2
21
St. michael
Roslindale man
l'lace of Burial, Cremation or Removal.
(City or Town)
22 NAME OF
FUNERAL DIRECTOR.
Permacchia e Som
ADORESS
59 So, margin St. Boston
Reoelved and filed
19
(Registrar)
Duration IMPORTANT
per a. Lalimi
Major findings : Of operations
Oate of ..
Of autopsy
What test confirmed diagnosis?
clinical
100m (d) -1-41-4667
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physlolans to Insert a recital to that effeot. pu Ds. Saleme
malden notified 3/9/42
2 FULL NAME
Baby
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Usual place of abode)
months
days. .
In this community
yrs.
mos.
days.
gars
5 min.
Registered No.
(Official Designation)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall fortliwith. 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 value of the decraseil. his supposed agc, the disease of which he died. defined as re- quired by section one. where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... t'en. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall. if the deceased, to the best of his knowledge and belief, served in the army. navy or marine corps of the I'nited States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war. and shall also certify in such certificate both the primary ail the secondary or inimediate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bundred and fourteen, the word "war" shall include the China relief ex- pedition and the l'hilippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town. from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a pernrit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law. or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is 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 attemling 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 form 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 l'uited 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 countersign it and transmit it to the clerk of the town for registration. The person to whom the perunt is so given and the physician certifying the catre of death shall thereafter furnish for registration any other neces- sary information which catt be obtained as to the deceased, or as to the manter or canse 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 hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a perinit 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 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).
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 forthwith go to the place where the body liea and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose physi- cian is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably doe to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting aepticenria), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resolting from injury or Infection related to occupation, the sodden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the discase, 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 morhid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very 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 ou account of the disease causing death, report the usual occupatinu 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 honre. 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 terins, as housekeeper-private family, cook-hotel, etc. For a person who had no occupatiou whatever write tione.
SPACE FOR ADDITIONAL INFORMATION
M R-302
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
50m (e)-1-41-4667
A TRUE COPY.
ATTEST:
& Fay
(Registrar of city or town where death occurred)
DATE FILED
2/24/42
.19
18 DATE OF
DEATH
Feb 19 1942
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
7/7/42
19.
...
to ..
2/19/42
19
I last saw h ..
.... j.m.alive on
2/19/42
., 19.
.... , death Is sald to
have oocurred on the date stated above, at
10/02P
m.
Immediate oause of death. anasarca .... and .... emaciation
Due to carcinoma of lung
rt lower lobe
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
should be charged sta- tistically.
What test confirmed diagnosis?
20 Was disease or Injury in any way related to ocoupatlon of deceased ?.
If so, speolfy
(Signed)
I ..... S .... Hamilton
M. D.
(Address)
Boston.
Date 2/20/1942
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthrop
(Cemetery)
(City or Town)
DATE OF BURIAL
Feb 23 1942
... 19.
22 NAME OF
FUNERAL DIRECTOR
C R Bennison
ADDRESS
Winthrop
Reoelved and filed TTTT 9"1942
19
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATH
SUFFOLK! BOSTO
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON 36
(City or town making return)
Registered No.
1602
(If death occurred in a hospital or institution,
> give its NAME instead of street and number)
Arthur H
Baker
(If deceased is a married, widowed or divorced woman, give also maiden name.)
203 Woodside Ave
stWinthrop
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
years
months
days.
In this oommunity
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE
(write the word)
widowed
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divoroed.
HUSBAND of
Isabella ... McDonald.
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 AGE .. 6.1 ..... Years Months. Days
If less than 1 day
Hours ............ Minutes
Usual
9 Occupation :
Industry
10 or Business :
landscape gardener
11 Social Security No ..
12 BIRTHPLACE (City)
(State or country)
Nova Scotia
13 NAME OF
FATHER
William Baker
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Rachel Pottil
16 BIRTHPLACE OF
MOTHER (City)
France
(State or country)
2/24/42
Miss MacDon
Relation, if any 10
17
Informant.
(Address)
sister-in-law
Of autopsy
Physician Underline the cause to which death
PARENTS
(City or Town)
No.
Mass General Hospital
St.
(If U. S.
speolfy WAR)
(a) Residence. No.
(Usual place of abode)
(Specify whether)
2 FULL NAME
(Give maiden name of wife in full)
That I attended deceased from
Duration
3 2 mos
ti d q il
if f: a t
Р
b I
C
1 Ł 1 I
1
R-301 A
Suffolk
(County)
Tinthron
(City or Town)
No. Commelescent
The Commonturalth 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.
37
f(If death occurred in a hospital or institution, .. 'St. fgive its NAME instead of street and number)
2 FULL NAME
Mary E. Ready
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
4 Linden =X
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before desth)
(Specify whether)
25
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACEJ
Thite
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
Sa 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.
AGE
8
79
Years
Months.
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Vouskeeper
Industry
Own Home
10 or Business :
11 Social Security No.
St John
12 BIRTHPLACE (City)
(State or country)
New foundland
13 NAME OF
FATHER
lillian Ready
Major findings:
Of operations.
IMPORTANT Physician
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Annegret Farer
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21
Catholic Cemetery
Poury toro
Place of Burial, Cremation or Removal.
DATE OF BURIAL
February
21
(City or Town)
19+2
22 NAME OF
FUNERAL DIRECTOR
John F. @ healey
ADDRESS
inthron 1200
Received and filed V
.19
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
Feb
19
1942
(Year)
19
Dec 12
HEREBY CERTIFY,
19.41
...
to ..
Feb 19
1942
i last saw h In alive on
Feb 18 , 1942, death is said to
have occurred on the date stated above, at.
11 A
m.
Immediate cause of death.
Duration
IMPORTANT
Cerebral Hemorrhage
4 days.
Due to.
Due to.
Other conditions.
Hypertension
(Include pregnancy within 3 months of death)
1 gr
Underline the csuse to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ?
If so, specify
Louis 7 Salerno
(Signed)
M. D.
(Address) 175 Pleasant St.
Date Tek19 1942
17
Tilliam Kenner.
Informant.
( Address)
4 Lingen St, inthron
I HEREBY CERTIFY that a satisfactory standard oertifloata of death was filed with me BEFORE the borjal or transit permit was Issued : Mm. D. Childress 2
(Signature of Agent of Board of health or other) Health Officer 3/20142
( Registrar)
100m (d) -1-41-4667
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
1
PLACE OF DEATH
Home 125 Cliff Live !. Inst
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
(Usual place of abode)
1
For. Home - years
-
months
6
days.
(Month)
(Day)
That I attanded deceased from
Date of.
Of autopsy
What test confirmed diagnosis ?.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medioal 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 atandard 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 aa re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried. until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same 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 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 insufficient, a physi- ciau who is a member of the board of health, or employed by it or by the aelectmen 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 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 body has been sooner obtained hereunder. If the death certificate contains a recital, as required
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