USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 21
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No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issuc such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is nccded.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deathis caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal. or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .-- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., lieart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related eauses, name earlier morbid conditions, if any. related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook -- hotel, etc. For a person who liad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiclaptonsert a recital to that effect.
1
Winthrop
The Commonforalth 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. 55
Registered No.
$ { If death occurred in a hospital or institution, St. [ give its NAME instead of street aud number)
PHYSICIAN - IMPORTANT
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
14 Seymour St
(Usual place of abode)
hospital
yeara
months
I
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5e If married, widowed, or divorced
HUSBAND of
(Give meiden name of wife in full)
(or) WIFE of
( Husband's name in full)
Age of husband or wife if alive
years
9 F STILLBORN. enter that fact here.
8
60
Years
Months
Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Laborer
Industry
City of Boston
11 Social Security No.
East Boston
12 BIRTHPLACE (City)
( Siste or country)
& Mass
Bartholomew
13 NAME OF
FATHER
Bartholomue
Duffy
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Bridget Rourke
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21
l'iace of Burial, Crematinh or Remoyal.
(City or Town)
DATE OF BURIAL.
Mar
24 1943 19
22 NAME OF
FUNERAL DIRECTORFol "O Matey
ADDRESS
Winthrop
Signature of Afent of Board of Health or other) Haltic Office
3/22/43
Reosived and Aled.
... 19 ....
(Official Designation) ( Date of Issue of Permit)
( Registrar)
1
Physician
Major findings :
Of operations
Date of.
Of eutopsy
What test confirmed dlegnosis ?.
Underline the cause to which death should be charged sta- tistically.
20 Was diseese or injury in any wey related to oooupation of deoeesed ?
If so, specify
(Signed)
, M. D.
19 ....
17
Informent
( Address)
Joseph Duffy 14 Seymour St
Brothery
100M-6 - 2-42-8855
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.
PARENTS
PLACE OF DEATH
Suffolk (County)
-
Charles B. Duffy
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
18 DATE OF
DEATH
( Month)
20
1943
(Day)
(Year)
19 | HEREBY CERTIFY,
20
That I attended deceased from
19 ..
...
19
49
I last saw h Lanmalive on
www. 196 death is said to
have occurred on the date stated above, at ..
Mina.v.
10.40 Pm
Pm.
Duration
Immediate cause of death ..
IMPORTANT
4 cps
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT
Due to
Due to.
arturo plus
10 or Business :
atta
I HEREBY CERTIFY that a satisfactory standerd certificate of deeth was filed with me BEFORE the bucket of transit bermit wes Issued ?
should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain
(City or Town)
Winthrop Community Hosptal
No.
I
Male
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physioisn or registared hospital medical officer shall forthwith. after the death of a person whoin 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, furnisb 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 disesse of which he died. defined as re- quired by section one, where ssme was contracted. the duration of his last illness, when last seen alive by the physician or officer aud the date of bia death ... Gen. Laws, Chap. 16, 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 Stsies in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war. and shall sso certify in such certificate both the primary and the secondary or immediate csuse of death ss nearly as he can state the ssine. For neglect to comply with any provision of this aection, such physician or officer shall forfeit ten dollars. For the purposes of thie sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall iucinde the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetwcen February fourteenth, eighteen hundred and ninety. eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chsp. 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 ita 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 undertsker or otber person shall exhume a human body and remove it fromn a town, from one cemetery to another, or from one grave or tomb other thau tbe 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 ahsll be issued until there shall have been delivered to sucb board, egent or clerk, as the case may be, a satisfactory written statenient containing the facts required by law to be returned and recorded, which shall be accompanied, in case of sn original interment, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate aa hereinafter provided. If there is no attending physician, or if, for sufficient ressona, hia 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 ia caused by violence. the medi- cal examiner chall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within the commonwealth cennot be obtained esrly enough for the purpose, the certifleste of death made as above provided and in the possession ot the undertaker desiring to make such renovsl 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 desth certificate contains a recitel, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corpa of the United States in any 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 and certificste, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so giveu and the physician certifying the cause of death shall thereafter furnish for registration any other nece+ sary information which can be obtained as to the deceased. or as to the manner or canse of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a hunian body or the ashes thereof which have been brought Into the commonwealth until lie has re- ceived a permit so to do front the board of health or its agent appointed to issue such permita, or if there is no such hoard, 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. .. . Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall mske examination upon the view of the dead bodies of only such persons ss sre supposed to have died by 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 aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawe calle for the observance of the following rules of practice :
(1) Attending physicians will certify to such deatha only as those of persons to whom they have given bedside care during a last iliness from disease unrelated to any form of injury.
(2) Board of Haalth phyalolans will certify to such deaths only aa those of persons who, though disshled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbyaf- cian is absent from home when the certificate of death is needed.
( 3) Medloal Examiners will investigate and certify to all deatha sup- possbly due to Injury. These include not only deaths cansed directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and dealbs following ahortion, but also deatha from diseasa rasulting from injury or Infection ralated to occupation, the sudden desths of persons not disabled by raoognizad disease, and those of persons found dead.
Statament of Causa of Desth .- Canse of death means the disease, or complication which causea death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease causing death, As related causes, name earlier morbid conditiona, if any, related to the principal cause and any important complication of the principal cause.
Statamant of Occupation .- Precise statement of occupation ia very Im- portant, so that the relative bealthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 yeara or over. If the occupation had been given up or changed on account of the dixcase causing desth, report the usual occupation prior to illness. If the deceased bad retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at home. For a woman whose only occupatiou was that of honie bousework, write bousework. For a person engaged in domestic service for wages, however, designste the occupation by the appropriate terma, aa housekeeper-private family, cook-hotei, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
1
PLACE OF DEATH
Suffolk (County)
REVĂRE NOTIFIED +2.8.43
The Commontoralth 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. 56
{ { If death occurred In a hospital or institution, St. [ give its NAMIE instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
82 Hitchhorn St.
(a) Residence. No. (Usual place of abode)
Length of stay: In hospital or Institution.
( Before death)
( Spogify whether)
years
months / 8 days. In this community - yrs. - mos. 18 days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
female
4 COLOR OR RACEI
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Mar. 3
That I attended deceased from
19 43, 1.,
to
mar. 21,
19.
+3
I last saw he
.allve on
mai
20,, 1999, death Is said to
have occurred on the date stated above, at
6:15A
m.
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8
AGE
Years
Months
18 Days
If less than 1 day - Hours. .Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
Winthrop
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
13 NAME OF
FATHER
Irving Rubin
Major findIngs:
Of operations ..
-
14 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Lydia De Filippo
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Operere Mars.
17 Lydia Rubin
Relatlon_ if any
Informant. (Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burtal or transit permit was Issued : Nom. D. Kuldress
22 NAME OF
FUNERAL DIRECTOR.
Charles Bruno + Son
ADDRESS
14 Prochain ame Parece Man
XSignature of Agent of Board of Units or other) 1 health office 3/21/43
(Officlai Designation) (Date of Issue of Permit)'
(Registrar)
100m (d) - 1-41-4667
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.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physlolans to Insert a recital to that effect.
1
Hemin. of actional pluies
Due to.
Of autopsy
as above
Date of.
Physician Underline the cause to which death should be charged sta- tistically.
What test confirmed dlagnosis ?.
Duration
Immediate cause of death ...
Broncho - Preum.
IMPORTANT 1 day ......
Due to
Premature Berte
12 BIRTHPLACE (City)
(State or country)
mass.
PARENTS
TZ
20 Was disease or injury in any way related to oooupation of deceased ?
If so, speoify
Las Susel
M. D.
(Signed)
(Address)
12 Alicily A Date N/
/2/
19.43
Holy Cross Cemetery Malten Man
Place of Burial, Cremation or Reinovai.
(City or Town)
DATE OF BURIAL March 22
1943
Received and filed. 19
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
0
St.
Revere
(If nonresident, give city or town and State)
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
18 DATE OF
DEATH
MAR.
21
1943
No. Baby girl Rubin
Winthrop (City or Town) Winthrop Communities Hospital.
Registered No.
should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain
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 whoin 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, bis supposed age, 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 ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa 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 canse 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 thia 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 purposea. 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 permita, 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 aforesaid or from the clerk of the town where the body is huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case inay be, a satisfactory written statement containing the facts required by law to he 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 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 auch 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 auch 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, aa required
by aection ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the ('nited States in any war in which it has been engaged. such recital shall appear upon the perinit. 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 neces- sary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No uinteriaker 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 front 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 apointed 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 hy 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.
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 deatha 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 aa 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 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 ouly 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 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 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 discase 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 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 terms, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
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