USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 26
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M. D.
(Signed)
Mate 30-1943
22
Place of Burial, Cremation or Removal. (City or Town) abril 19.513
Relation, If any DATE OF BURIAL
23 NAME OF
FUNERAL DIRECTOR Judenikmanuel
ADDRESS
East Gate
Received and filed.
& 1943
19
(Registrar)
V
1
No.
Caroline Mary Flannery
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
If so speolfy WAR)
St.
50m (g)-1-41-4667
13 NAME OF
FATHER
Michael J. Bradshaw
14 BIRTHPLACE OF FATHER (City) (State or country)
Bptm masa
(Address)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medldal offioer shall forthwith, after the death of a person whom he has attendkil during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deera smil, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed ago, the disease of which he died, defined as required by section one, where same was contractoil, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 16, Sec. 9.
A physician or officer furnishing a certificate of death as required hy the preceding section or by sretion forty-five uf chapter one humlred 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 sail chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the l'hilippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and duly fourth, nineteen hundred and two, and the Mexi- can border service of nineteen humlred 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 perinit 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 exhumie a human body and remove it from a town, froin one cemetery to another, or froni one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit froin the board of health or its agent aforesald or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been 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 obtainedl 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 medical examiner shall make such certificate. If such a permit for the removal of a human boily, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of ileath made as above provided and in the pos- session 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 re- moval, unless a perinit in the usual form for the removal of such body has been sooupr 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 heen 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 regis- tration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtainedl as to the decederd, or as to the mamer or cause of the death, which the clerk or registrar may re- quire .- 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 isstte sucht permits, or if there is no such board, from the clerk of the town where the boily is to be buried or the funeral is to be held, or from a per- aon appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion ).
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.
.. lle shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the observance of the following rules of practice :.
(1) Attending physicians will certify to such deaths only aa 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 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 abortion, but also deaths from disease resulting from Injury or Infeclion 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) umler manner, the mode of its production together with the circumstances when these are known. For example: "Con- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway acculent." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether adininistered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify : (1) Under cause its known or presumahle nature; and (2) maler manner, indicate the circuin- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain ( basal ganglia ) ( found dead in bed)." "lieart disease, presumably coronary sclerosis. (Sudden death. )"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected 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
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 effeot. PARENTS
PLACE OF DEATH
Suffolk (County)
1
Winthrop
.........
(City or Town) 151 Pleasant St
The Commontoralth of Massacintsetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Ägauty
Registered No.
( If deeth occurred in a hospital or institution, St.
give Its NAME instead of street and nuniber)
2 FULL NAME
Ella Augusta Rich
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
151 Pleasant St.
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: tn hnsoltal or Institution
(Before death)
(Specify whether)
yeero
months days.
in this community 50 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACEİ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
OF DIVORCED Widowed
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Henny mi
"Fadeprangof wife in full)
( Husband's name In full)
6 Age of husband or wife if alive
years
> IF STILLBORN. enter that fact here.
AGE
8
.91 Years
3
Months
15 Days
if less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
At Home
10 or Business:
11 Social Security No.
None
Truro
12 BIRTHPLACE (City)
( State or country)
Mass.
13 NAME OF
FATHER
James H Cordes
14 BIRTHPLACE OF
Truro
FATHER (Clty)
(State or country) Mass
15 MAIDEN NAME
OF MOTHER
Bettøy Rich
16 BIRTHPLACE OF
MOTHER (City)
Truro
(State or country) Mass .
17 Lillian Ruch
Relation, If any
Informant ( Address)
94 Birch Rd Winthrop Daughter
I HEREBY CERTIFY that a satisfactory standard certificate of death wes filed with me BEFORE the burial or transit permit was Issued: Min. D. Children
(Signature of Agent of Board of fredith or other)
The alla
Oficer
3/31/43
(Omcial Designation) ( Dete of Traue of Permit)
18 DATE OF
DEATH
3
30
43
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
19
Ło ..
19
i last saw h
alive on
19
death is said to
have occurred on the date stated above, at .... .m.
Immediate cause of death.
Due to arten pluvios
Due to
Other conditions ..
.... ( Include pregnancy within 3 months of death)
Major findIngs:
Of operations.
Dete of.
Of eutopsy
What test confirmed diagnosis ?
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, speoity.
(Signed)
(Address)
4 comtempo monte 3-30
M. D.
21
winthrop
Winthrop
l'lace of Burial, Cremation or Removal.
April
1
(City or Town)
43
19.
22 NAME OF
FUNERAL DIRECTOR.
Howard ) Wynolds
------
ADDRESS
Reoaivad and Aled
WAR 3 - 1943
19
( Registrar)
V
Duration
.. ISABORTANT
DATE OF BURIAL ..
100M-6 - 2-42-8855
1 R-301 A
No.
PHYSICIAN - IMPORTANT
(Wes deceased"
U. S. War Veteran,
if so specify WAR)
.....
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physloian or registered hospital medioal 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 ans meniber of the family of the deceased, furnisb for registration a standard certifcate of death, stating to the best of his knowledge and behef the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one. where ssme was contracted. the duration of his last illneaa, when last seen allve by the physician or officer and the date of his death ... Cen. 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 helief, aerved 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 and the secondary or immediate csuse 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 thia aec- 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 Philippine insurrection, which shall, for said purposea, 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 sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been buried, until he haa received a permit from the board of health, or ita agent appointed to lasue 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 from a town. from one cemetery to another, or from oue grave or tomb other than the receiving tomb to another in the same cemetery, until be 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 sucb board, agent or clerk, as the case inay 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 internient, by a satisfactory certificate of the attending physician, if any, aa required by law, o1 in lieu thereof a certificate aa 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 pbysi- cian who ia 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, tbe medi- cal examiner shall make such certificate. If sucb a permit for the removal of a ltumait body, not previously interred, from one town to another within the cominonwealth cannot be obtained esrly enough for the purpose, the certificate of desth made as above provided and in the possession ot tbe 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 United States In any war in which It has been engaged. sucb recital shall appear upon the permit. The board of health, or its agent. upon receipt of such ststenient and certificate, shall forthwith countersign it and transniit 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 mauer or canse of the death, which the clerk or registrar way require .- Cbap. 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 front the hoard 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 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 tbe interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall mske 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 body of such a person, he shall forthwith go to the place where the body ifes 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 phyalclana will certify to such deatha only aa 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 Health phyalolans 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 phyef- cian is absent from home when the certificate of death is needed.
(3) Medioal Examinera will investigate and certify to all deaths sup- poaably due to injury. These include not only deaths caused directly or in- directly by traumatism (Including resulting septicemia), and by the action of clientical (drugs or poisons), thermal, or electrical agents, and deatbs following abortion, but also deaths from dlacasa resulting from Injury or Infeotlon related to ocoupatlon, the sudden deatha of peraona not disabled by recognized dlaeaac, and those of persons found dead.
Statement of Cause of Death .- Cause of deatlı meana the disease, or complication which causes death, not the more of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name tbe disease causing death, As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complicstion of tbe principal cause.
Statement of Oooupatlon .- Precise statement of occupation ia 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 out account of the discase causing death, report the usual occupation prior to Illuesa. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at borne. For a woman wbose only occupatiou was that of honre bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, aa housekeeper-private faniily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
FORM R-305
PLACE OF DEATH
Suffolk (County)
Boston
(City or Town)
No. 818 Harrison Ave
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
69 2944
St. (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
22 Charles St
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Feb 23, 1943
(Month)
(Day)
(Year)
5a 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 faot here.
8 AGE 65 Years 10 Months. Days
If less than 1 day .Hours. ...... Minutes
Usual
9 Occupation :
Carpenter
Industry 10 or Business :
11 Soolal Security No.
009-09-7154
12 BIRTHPLACE (City)
(State or country)
Salem Mass
13 NAME OF
FATHER
Salime Vincent
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country) Canada
15 MAIDEN NAME
OF MOTHER
Demepilpa Trottier
16 BIRTHPLACE OF MOTHER (City) (State or country) Canada
17 InformantMrs Amanda Perrin daughter
(Address)
15 Orient St
Worcester
A TRUE COPY.
Francis
× 4ans
ATTEST:
(Registrar of city of town where death occurred)
decak
DATE FILED
Mar 26, 1943
19
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.) Acute dilatation of the heart
Neglect Pediculosis Alcoholism
20 Aooldent, suloide, or homloide (specify)
Date of ooourrenoe.
19
Where did
Injury oocur?
(City or town and State)
Did Injury occur In or about the home, on farm, In Industrial place, or In publio place?
(Specify type of place)
Manner of Injury
Nature of Injury
While at work?
Was there an autopsy ?.
no
21 Was disease or Injury In any way related to oooupation of deceased?
If so, speolfy
(Signed)
T ... Leary.
M. D.
(Address)
Boston.
3/23/1043
22
Notre dame
Worcester ..... Mass
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Mar 25/43
19
23 NAME OF
FUNERAL DIRECTOR
A P Lachapelle
ADDRESS
Worcester Mass
Received and filed 19
(Registrar of City or Town where deceased resided)
I
=
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD of the city or town in which the deceased resided as soon as possible after the close of the month in which the death resided in another city or town at the time of death should be made forthwith and transmitted on Form R.305 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
occurred. (See Chap. 46, Sec. 12, G. L.)
25m (h)-1-41-4667
3 SEX
Male
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
Ethel Stanhope
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
Napoleon S Vincente
1
RM R-302
1
PLACE OF DEATH
Suffolk ( County)
Boston (City or Town)
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
2490 70
No. Ne.w. England Deaconess Hospital St. ( If death occurred in a hospital or institution, give its NAME instead of street and number)
Mrs. Carrie L. Smith
(If deceased is a married, widowed or divorced woman, give also maideu name.)
(a) Residence. No.
461 Pleasant
St.
Winthrop.
Mass.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
.... years
months
11
days.
In this community
yrs.
mos.
11
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March
11
1943
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, Feb 28
19.
45,
That ,I attended
March 11
19
45
I last saw h
er
alive on
March 11
1943
death is said to
have occurred on the date stated above, at
12:24 B
m.
Duration
Immediate cause of death
Heart failure
10 min.
Due to.
Coronary embolism
10 min.
Due to
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings :
Benign tumor of
Of operations
Neural
origin
Date of.
Of autopsy
Refused permission
charged sta- tistically.
What test confirmed dlagnosis ?.
20 Was disease or injury In any way related to oocupatlon of deceased?
(Signed)
If so, specify
B. H. Cotton
M. D.
(Address)
Boston
Date.
3-11-913
21 PLACE OF BURIAL,
Winthrop Cemetery
CREMATION OR REMOVAL
(Cemetery)
March 14
43
19
Winthrop
(City or Town)
DATE OF BURIAL
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