USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 3
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8
62
Years
10
Months
-
.. Days
If less than 1 day Hours Minutes
Usual
Retired
9 Occupation:
Industry
Warrant Officer, U. S. Army
11 Social Security No.
ireland
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
William J. McCartney
PARENTS
14 BIRTHPLACE OF
FATHER (City) ........
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Catherine Redman
16 BIRTHPLACE OF MOTHER (City) .... (State or country)
Ireland
17 Emma McCartney
Relation, if any wife
Informant (Address) 40 Haulmonth St Boston
100m-2-'40-D-729-8
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Nyu. S. Fuldrest of (Signature of Agent of Board of Health of othery Healthe Officer 1/9/42
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January
9,
1942
Male
19 | HEREBY CERTIFY. That I attended deceased from January 4,, 1942, to January 9, 19.42 I last saw h .. im .... alive on ...... January O . ... , 19 ... 4.2, death is said to
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive 46
years
10 or Business:
None
Major findings: Of operations.
Date of ..... --
Of autopsy.
-
What test confirmed diagnosis ?. --
Duration IMPORTANT
7 IF STILLBORN, enter that fact here.
years
- months
5 days.
In this community
- yrs.
mos.
5 days.
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 is very important. See instructions and extracts from the laws on back of certificate.
PLACE OF DEATH
Registered No.
Ny. Station Hospital, Fort Banks, Mass.
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, defined as required hy section one, where same was contractcd, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been huried, until he has received a permit from the hoard 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 tomh 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 shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required hy law to be returned and recorded, which shall be accompanied, In case of an original Interment, hy a satisfactory certificate of the attending physician, If any, as required hy law, or in lieu thereof a certificate as hereinafter provided. If there's no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who Is a member of the board of health. or em- ployed hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall 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 obtained 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 removal, unless a permit in the usual form for the re- moval of such body has been sooner ohtained 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 physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be ohtalned 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 hury a human hody 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 huried or the funeral is to be held, or from a person appointed to have the care of the cemetery or hurial 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 ohservance 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 physlclans will certify to such deaths only as those of persons who, though disahled 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 supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disahled hy 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 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 important, so that the relative healthfulness of various pursults 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 illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not galnfully 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.
ORM R-303A
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS
PLACE OF DEATH
Swillis c / (County)
No cu ranti to Fort Bauts Hospital
2 FULL NAME
Robert Bjorncon
(If deceased is a married, widowed or divorced woman, give also maiden name.)
63 Center S Winthrop
St.
(If nonresident, give city or town and state)
mos.
days.
3
11
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
MARRIED
WIDOWE
or DIVOROLD
(write the word) Beagle
(Give maiden name of wife in full)
.years
If less than 1 day Hours Minutes
12 BIRTHPLACE (City)
(State or country)
Hinterof Inaso
13 NAME OF
HER Changes Riyornad
14 BIRTHPLACE OF FATHER (City) (State or country) Queland
15 MAIDEN NAME
alice m. Erakeine
Gast Breton
Johannes Bjorngo
Informant (Address) 63 Centre 1. 0hotel
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wir D. Children f. 7Signature of Agent of Board of Health or other) Seattle Officer (Official Designation) (Date of Issue of Permit)
1/12/42
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Tam-11-1942
(Month)
(Day)
{
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Crash of 0
Crush ) Upper Cheet
20 Accident, suicide or homicide (specify).
accidental
Date of occurrence
1/am-11 -
19 42
Where did
Injury occur?
(City or Town and State)
Did injury occur in or about home, on farm, in industrial place, in public place? Reanuda
Manner of
(Specify type of place)
Said to have been rene wals a
Injury
Mure of
mister Truck, at WithnotJun-11-42
Injury
While at work ?.
Was there an autopsy?
11 ml
21 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed) M. D.
Date -11- 1942
Thathrob anthrop Place of Burial, Cremation or Fe .oval.
13 (City or Town)
DATE OF BURIAL.
23 NAME OF
FUNERAL DIRECTOR.
ADDRESS
B00
Received and filed
19
(Registrar)
MARGIN RESERVED FOR BINDING
25m-2-'40-D-729-b
1 (City or Town) (a) Residence. No .. (Usual place of abode) Length of stay: In hospital or institution. 3 SEX 4 COLOR OF RACE State male Sa If married, widowed, or divorced HUSBAND of. (or) WIFE of .. (Husband's name in full) 6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here. 2Days AGE .. Usual 9 Occupation : Industry 1 st grade 10 or Business: 11 Social Security No. nove 16 BIRTHPLACE OF MOTHER (City) ... (State or country) mass 17 information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes 8 6 Years 3 Months ..... at School
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No ..
St.
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
(If U. S.
War Veteran,
specify WAR)
none
-years months - days.
In this community
6
yrs.
(Specify whether)
Her Father 22.
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 bis 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 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 shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not heen huried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another. or from one grave or toinh 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 buried. No such permit shall 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 hy law to he returned and recorded. which sball he 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 sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient. a physician who is a member of the board of health, or em- ployed hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall 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 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 hody shall he 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 ohtained hereunder. If the deatb 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 physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue auch permits, or if there la no such board. from the clerk of tbe 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 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 lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
. .. He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otber- wise a description as full as may he, with the cause and inanner of deatb. -General Laws, Chap. 38, Sec. 7.
. The medical examiner certifies the cause and inanner of death to the best of his knowledge and belief.
RULES OF PRACTICE
Tbe fulfillment of the purpose of these laws calls for the observance of tbe 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 forni of injury.
(2) Board of Health physicians will certify to auch 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 abortion, but also deaths from discase resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas hacillus) caused hy a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage. bomicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with asso- ciated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have heen due to disease, specify: (1) Under cause its known or presumahle nature; and (2) under manner, indicate the cir- cumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the hrain (hasal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person).
1
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injceted into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
RM R-301 A
PLACE OF DEATH
Suffolk. (County) Winthrop (City or Towy
Isaac
The Commontoralth ot Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH une
To be filed for burial permit with Board of Health or its Agent.
8
((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 deceased is a married, widowed or divoreed woman, give also maiden name.)
49 Craie
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
years
months
- days.
In this community
20 STs.
mos.
- days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
write the word)
MARRIED
WIDOWER
Or DIVORCEaniebel
Movie Berman
(Give maiden name of wife in full)
( Tlushand's name in full)
6 Age of husband or wife if alive 48
years
If less than 1 day Hours .Minutes
Usual
9 Occupation :
Leather Merchant
11 Social Security No.
011-12-9882
Boston Mass
13 NAME OF
FATHER
Hyman Cohen
14 BIRTHPLACE OF
FATHER (City)
Russia
15 MAIDEN NAME
OF MOTHER
Leah Hack
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
Relation if any
49 heart ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued: Wie S. Children
(Signature, of Agent of Board of Health or other) Healthe Officer 1/12/42
(Official Designation) (Date of Issue of Permit) /
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January 11
(Month)
(Day)
1942 (Year)
19 | HEREBY CERTIFY,
June 15
1941
...
That I attended deceased from
to.
January 11 1942
I last saw h.
un
alive on.
January 11. 1942 death Is said to
have occurred on the date stated above, at
Immediate cause of death ...
Carcinoma of Rectum
Duration IHSORTANT 9 mos.
Due to ... General carcinomaloris 4 mos.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings:
Of operations.
Carcinoma of Rectum
with metastasio
Date of June 20/4/
Of autopsy.
nous
What test confirmed diagnosis ? Clinical & labe charged sta-
tistically.
20 Was disease or injury in any way related to occupation of deceased 20
If so, specify
(Sig
(Address) 562 Plurtay St. Lund top
M. D.
182/42
21 Mishkay Terea miliony man.
l'lace of Burial, Cremation or Removal.
(City or Town)
42
DATE OF BURIAL
Jan 13
19
22 NAME OF
FUNERAL DIRECTOR EURY LEVERER
ADDRESS
470 Harvarit pustili
Received and filed JAN 1 3 1042
.19
gistrar)
Physician U'nderline The cause to which death should be
17 Mollie Cohen i + hurtige
100m (d) -1-41-4667
1 No. 2 FULL NAME (a) Residence. No. (Usual place of abode) 3 SEX 4 COLOR OR RACE| Mute Male HUSBAND of (or) WIFE of 7 IF STILLBORN. enter that fact here. 8 48 AGE. Years - Months. - Days 10 or Business : 12 BIRTHPLACE (City) (State or country) (State or country) PARENTS Informant. (Address) If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. 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 should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information Industry Proprietor
Registered No.
Cohen
(If nonresident, give city or town and State)
4 p:
m.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physloian 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 sn 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 re- quired 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.
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 cau 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 inchide the China relief ex- pedition atul 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 po undertaker or other person shall exhume a human body and remove it fromn 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 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 he 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 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 hy it or by the selectmien 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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