USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 79
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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 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 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 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 board, from the clerk 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., (Terccuteuary Edition).
Medical examiners shall make examination upon the view of the dead hodies 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 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 liave 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical 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 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 ocoupation, 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 causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Ocoupation .- 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, desiguate the occupation by the appropriate terms, as housekeeper-private fainily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
PLACE OF DEATH
suffolk
(County)
No 25 Tewksbury St.
The Commonmealth 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. 244
S (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Frances Scannell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
25 Tewksbury
St
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
Signed for board of health
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December
(Month)
(Day)
19 1942
(Year)
19
HEREBY CERTIFY,
That I attended deceased from
19-, to Con Doc 19, 1942
I last saw her alive on
Dec 17, 19 47 death is said to
have occurred on the date stated above, at.
Immediate cause of death
Heute endo carditis
Duration IMPORTANT
general septicemia
Due to
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT PHYSICIAN
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 ?. ..........
If so, specify
(Signed).
M. D.
(Address) Winthrop, Trass Date Dan 20,1842
21 .. Holy Cross falden
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL.
December 21,
1942
19
FUNERAL DIRECTOR 22 NAME OF Charles Treason
ADDRESS
East Boston
Received and filed .19
(Registrar)
1
1
Winthrop
(City or Town)
3 SEX
FEMALE
4 COLOR OR RACE
White
5a If married, widowed, or divorced
(or) WIFE of
6 Age of husband or wife if alive.
8
AGE ...
Usual
9 Occupation :
None
10 or Business:
Il Social Security No ..
None
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF
FATHER (City) ....
(State or country)
PARENTS
(State or country)
3
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
is very important. See instructions and extracts from the laws on back of certificate.
information should be carefully supplied. AGE should be stated EAACILI. PHYSICIANS should state
Industry
None
5 SINGLE
(write the word)
MARRIED
WIDOWED Single
or DIVORCED
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
.years
7 IF STILLBORN, enter that fact here.
1
Years.
2
.Months
26 Days
If less than 1 day .Hours ... ........ Minutes
South Boston
13 NAME OF
FATHER
John T. Scannell
Roxbury
15 MAIDEN NAME
OF MOTHER
Lillian F, Crowley
16 BIRTHPLACE OF
MOTHER (City).
East Boston
17 Relation, if any Lillian Scannell. ( Mother)
Informant. (Address) 25 Tewksbury
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
100m-2-'40-D-729-8
(Signature of Agent of Board of Health'or other)/ health Officer, 12/2/140
"(Official Designation) (Date of Issue of Permit)
years
months
days.
Registered No.
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
1.10 2.
.m.
24 hours
Underline the cause to which death should be charged sta- tistically.
-
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 hest 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 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 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 hoard of health or its agent aforesaid or from the clerk of the town where the body Is huricd. 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 by law to be returned and recorded, which shall be accompanied, In case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy 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 by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human 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 body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval of such body has been sooner 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 hoard 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 .- 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 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 hedside care during a last illness from disease unrelated to any forın 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 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 by 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, 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 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 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-302
1
PLACE OF DEATH
Middlesex
(County)
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Cambridge
(City or town making return) 245
Registered No.
S (If death occurred in a hospital or institution, St. give its NAME instead of street and number)
2 FULL NAME
Baby Boy Riley
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
171 Cottage Park Road
St.
Winthrop Mass
(Usual place of abode)
Hospital
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
years
months
Idays.
In this community
yrs.
mos.
1 days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
i-a le
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
Single
18 DATE OF
DEATH
December 22,
1942
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
19
to
19.
1 last saw h ....
..... alive on
19
death is said to
have occurred on the date stated above, at.
m.
Duration
Immediate cause of death
Stillborn
7 IF STILLBORN, enter that fact here. Stillborn
8 AGE Years Months .Days
If less than 1 day Hours. ...... .Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Cambridge, Mass.
13 NAME OF
FATHER
Charles Riley
14 BIRTHPLACE OF
FATHER (City)
Boston
(State or country) 712se
15 MAIDEN NAME
OF MOTHER
Mary Barry
16 BIRTHPLACE OF
MOTHER (City)
(State or country) Mass .
Boston
17 Mary Riley
Informant.
Relation, if, any (Address) 171 Cottage Fark Rd."
, Winthrop
A TRUE COPY.
Frederick H. Burke
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
December 30, 1942
19
22 NAME OF
FUNERAL DIRECTOR
M.J. Kelly
ADDRESS
Eoston, ....... a.s.s ...
Received and filed
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
resided in another city or town at the time of death should be made forthwith and transmitted on Form I-802 to the clerk of the city or town in which the deceased resided. (Sec Chap. 46, Sec. 12, G. L.)
PARENTS
What test confirmed diagnosis ?
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify
(Signed)
P. McGovan
M. D.
(Address)
Cambridge
Date1.2/241942
21 PLACE OF BURIAL,
Holy Cross -- Ma lden
CREMATION OR REMOVAL
(City
DATE OF BURIAL
(Cemetery )
December
- -
1942
Physician
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy
Underline the cause to which death should be charged sta- tistically.
Due to.
Due to
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
MARRIED
WIDOWED
or DIVORCED
Cambridge
(City or Town)
No. Cambridge City Hospital
(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and State)
D
3
R-301 A
1
Winthrop
No.
(City or Town) Winthrop Comunity Hospital
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. 246
Registered No.
f ( If death occurred lu a hospital nr Institutinn,
St. [ give its NAME instead of street and number)
2 FULL NAME
Leona Foster Buchnam
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 993 Shirley St
(Usual place of abode)
4
In this community 32 yrs.
mos.
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
Female
white
MARRIED
WIDOWED
or DIVORCED
Single
Sa If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Ihusband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN. enter that fact here.
8
60
10
Months
AGE
Years
27
Days
If less than 1 day
Hours
Minutes
Usual
9 Occuoation :
Designer
Industry
Dress
10 or Business :
11 Social Security No.
None
Portland
12 BIRTHPLACE (City)
(State or country)
Maine
13 NAME OF
FATHER
Alonzo
14 BIRTHPLACE OF
FATHER (City)
Portland
(State or country)
Maone
15 MAIDEN NAME
OF MOTHER
Adriana
16 BIRTHPLACE OF
Bath
MOTHER (City)
(State or country)
Maine
17 Paul Buchnam
( Address )
ReBrother 6 Loring Rd. Winthrop
I HEREBY CERTIFY that a satisfactory, standard certificate of death was filed with me BEFORE the burial or transit permit was Issued: Www. D. Childress (Signature of Ment of Board of Health of other) Heatthe Office 12/3/42
(Official Designation ) (Date of Issue of Permit>
18 DATE OF December
33
DEATH
( Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
That I attended deceased from
Novembre.
19 42
to ..
December 30
1942
I last saw h ..
En
alive on
DEC Suster 3, 19/2.
death Is sald to
have occurred on the date stated above, at ..
Immediate cause of death,
Carcinoma -uterus-+
Due to.
Due to
Carcinoma . Breasts- Lives- Intestines Other conditions.
( Include pregnancy
IMPORTANT
Physician
Major findings :
Of operations.
Date of.
Of autopsy
What test confirmed diagnosis ?
I'mderline 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)
Edward Y' Granger
M. D.
(Address) 200 Utadranach
Date 12,31
19/12
21
Woodlawn Creantory
Everett
43
(City or Town)
l'lace of Burial, Creniation of Removal.
Jan. 1
42
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
Howard S Brinales
ADDRESS
Wnutrof mars.
Received and filed .19
( Registrar)
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
100m (d)-1-41-4667
PLACE OF DEATH
Suffolk (County)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
Length of stay: In hosoltal or Institution
years
Hospital
1
months
days.
MEDICAL CERTIFICATE OF DEATH
1942
3.11
m.
Duration IMPORTANT
62
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 lias atteicled 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 drath, stating to the best of his knowledge and belief the name of the decrased, 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 seetion or by seetion 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 reeital 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 inchide the China relief ex- pedition and the Philippine 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 Slexi- can border service of nineteen hundred and sixteen and nineteen bundred 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, froin the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it froin a town. from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the sanie 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 be returned and recorded, which shall 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 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 selectinen 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 form for the reinoval of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served In the army, navy or marine corps of the United States in any war in which it has been engaged. such recital shall apprar upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwitb countersign it and transmit it to 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 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 hunian 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 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 lies and take charge of the same ;... - General Laws, Chap. 38, Sec. 6.
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