USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 28
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Date 4/2
19 43
21 .
Winthrop
Cem.
l'lace of Burial, Cremation or Removal.
April
4 (City or Town) 43
19.
........
22 NAME OF
Howard Scrissaldo
FUNERAL DIRECTOR
ADDRESS
nurbs
Reosived and Aled. .19
( Registrar) V
....
FUJIAN so se CAUSE OF DEATH in plain
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, Seotion 10, requires physiolans to insert a reoltal to that offoot. PARENTS extracts from the laws on back of certificate.
100M-6 - 2-42-8855
18 DATE OF
DEATH
april
1
1943 .....
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Sept 5
194 2, to
That I attended deceased from
1943
I last saw ht
.. allve on.
march 31
19.413, death is said to
have occurred on the date stated above, at.
11
A
m.
Duration
Immedlate cause of death
Carcinoma of right ling
IMPORTANT 140
Due to.
Due to
Other conditions
( Include pregnancy within 3 months of death)
Major findIngs:
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
Winthrop
DATE OF BURIAL
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so spoolfy WAR)
(Usual place of abode)
years
months
days.
In this community 25 yrs.
mos.
days.
6 Age of husband or wife if alive
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, 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 disease of which he died. defined as re- quired by section one. where ssme was contracted, the duration of his last iliness, 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 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, served in the army, navy or marine corps of the I'nited States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, sud shall also certify in such certificate both the primary and the secondary or immediste cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, sucb physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-Ave, forty-six and forty-seven of said chapter one bundred 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 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 bundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury 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 dled; and no undertaker or otber person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other thau the receiving tomb to another In the same cemetery, until he has received a permit from the board of health or ita 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 may be, a satisfactory written statement containing the facts required by law to be returned sud recorded, which shall be accompanied. in case of an original internient, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient ressons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a pbysi- 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 medl- cal examiner shail make such certificate. If aucb a permit for the removal of a human body, not previously interred, from one town to another within the comunonwealth cannot be obtained esrly enough for the purpose, the certificate of desth made as above provided and in the possession of the undertaker desiring to make such renioval 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 hody has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased aerved 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 forthwltb countersign it and transnrit it to the clerk of the town for registration. The person to whom the permit Is so giveu and the physiciau 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 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 s permit so to do from 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 buris! ground in which ibe interment ia 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 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 aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deaths only as those of persons who, though disshled by recognized disease unrelated to any form of injury. have died without recent medicai attendance or whose pbyaf- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigste and certify to all deatha sup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatiam (including resulting septicemia), and by the action of chienical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseass 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 meana the disease, or complication which causes death. nnt the moile of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name tbe disease caualng 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 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 on account of the disease causing death, report the usual occupation prior to illness. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at hoine. For a woman wbose only occupation was that of honie housework. write housework. For s person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, aa housekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
)RM R-301 JI
(County)
1
PLACE OF DEATH
2 FULL NAME
3 SEX
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Male
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.
7 IF STILLBORN, entor that fact here.
8
68
Years.
-
Months.
AGE
-
Days
Usual
9 Occupation:
Retired
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF
Boston
FATHER (City)
15 MAIDEN NAME
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
Boston
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
10 or Business:
is very important. See instructions and extracts from the laws on back of certificate.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
Industry
Ship Yards
10
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
(State or country)
class.
200m-10-'39. No. 8427-d
Suffolk Winthrop (City of Town) Winthrop Community Hospital No ... ...
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Thomas F, M: Manus
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No ..
40 Juincy
Are.
St.
Winthrop
(Usual place of abode)
Hospital
length of stay: In hospital or institution
(Specify whether)
...
years
months
2
days .
In this community 28 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
Suigle
.Years
If less than 1 day
Hours
Minutos
Painter
11 Social Security No.
032-03-3896
East Boston
ruasa
13 NAME OF
FATHER
Thomas J. M: Manus
OF MOTHER
Ellen Leary
(State or country)
ulara.
17 Wirs. Mary L. Kearney Relation, if any
Iniormant.
40 Quincy Ade, Wir.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Tom. D. Jehildress
Signature of Arettet Board of Health or other) april 3 4 3
(Official Designation) (Late of Issue of Perinie)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Cepmig
2,
1943
(Month)
(Day)
(Year)
19 1 HEREBY CERTIFY, That I attended deceased from
nerea 15, 1943, to C2011/2
.19 .... 3
I last saw h .. L !.... alive on
april2
19.43, death is said
to have occurred on the date stated above, at .....?.....
.. m.
Immediate cause of death
Gerebral Hemorrhage
24hours ... ...
....
......
2 years ......
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
.Date of.
Of autopsy
.....
What test confirmed diagnosis ?
Clinical Jogas
...
charged sta-
tistically.
20 Was disease or Injury in any way related to occupation of deceased ?
If so, specify
(Signed)
Winthrop, Mass Date 9at1/2 193
(Address).
21
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
DATE OF BURIAL
April
{City or Town)
1943
22 NAME OF
FUNERAL DIRECTOR
M. F. Kelly
ADDRESS
11 Meridian ST., E. 0 13.
Received and filed 19
.1013.
A TRUE COPY ATTEST:
(Registrar)
(If U. S.
War Veteran.
70
specify WAR)
(If nonresident, give city or town and state)
Duration
Due to
Hypertension
PHYSICIAN Underline the cause to which death should be
M. D.
nece
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 wbom 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 regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, bis supposed agc, the disease of which he died, defined as required 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.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died : and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No sueh permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician wbo is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is eaused by violence, the medieal exam- iner 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 a 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 eorps of the United States in any war in which it has been engaged, sueh 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 elerl: of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish 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 buman 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, Scc. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance 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 ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons wbo, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is absent from bome 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 septice- mia), 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 occupa- tion, 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 deatb, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name tbe disease causing death. As related causes, name earlier morbid con- ditions, 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 busi- ness, 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 wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
1
Winthrop
(City or Town)
42 Main St.
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. 80
Registered No. ( If death occurred in a hospital or institution, St. [ give Its NAME instead of street and nuniber)
2 FULL NAME
Alexander McLean
( If deceased is a married, widowed or divorced woman, give alao maiden name.)
(a) Rasidence. No.
42 Main St
(Usual place of abode)
St.
(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
3 SEX
Male
4 COLOR OR RACEJ
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
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!
9 IF STILLBORN. enter that fact here.
8
AGE7.5
Years
Months ... Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Painter
Industry
10 or Business:
House
11 Social Security No.
12 BIRTHPLACE (City)
Pictou
( State or country)
Nova Scotia
13 NAME OF
FATHER
Hugh McLean
Major findIngs:
Of operations
Dete of.
Of autopsy
What test confirmed dlagnosis?
IMPORTANT Physician L'uderline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way relatad to occupation of decaased ?..........
If 80, spacity Ofhoney
(Signed)
. M. D.
(Address) GWashet ud to Y-3-1945
Holy Cross "Maiden
21
l'lace of Burial, Cremation of Ren
(City or Town)
DATE OF BURIAL ..
April 6 1943
19
I HEREBY CERTIFY thet e satisfactory standard oartificata of daath wes filed with me BEFORE the burist or fransit permit was Issued ?
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
John SO Maty
Raceived and Alad
.19
( Registrar)
100M-6 - 2-42.8855
17 DanielMcLean BY's' They
Informant
( Address)
42 Main St.
( Signature of Agent of Board of Health or other) I Haltto Melilla 4/5/43 (Omclal Designation) ( Date of Issue of Permits
18 DATE OF
DEATH
( Month)
(Day)
3
1450
(Year)
19 | HEREBY CERTIFY,
19
..
to
19
I lest saw h .............
.allve on
19 ...... , daath Is sald to
have occurred on the date stetad above, at.
6P
.m.
Immediate osuse of death ..
Duration
IMPORTANT
....
Due to
arteno silaiso
Due to
Other conditions.
( Include pregnancy within 3 months of death)
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Cape Breton
15 MAIDEN NAME
OF MOTHER
Catherin Mac Donald
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Cape Breton
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 ofisot. PARENTS
PLACE OF DEATH
Suffolk (County)
No.
PHYSICIAN - IMPORTANT
(Was deocesed a
U. S. War Veteran,
if so specify WAR)
40
That I attended decaased from
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 best of his knowledge and belief the uante of the decessed, 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 illnesa, when laat aeen alive hy the physician or officer and the date of hia death ... Gen. Lawa, 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 hest of his knowledge and helief, served In the ariny, 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 cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, auch physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sectinns forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, 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 horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not been buried, until he has received a permit from the board of health, or ita agent appointed to laque 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 hody and remove it from a town. from one cemetery to another, er from oue grave or tomb other than the receiving tomh to another in the same cemetery, until he haa received a permit from the board of health or ita agent aforesaid or from the clerk of the town where the hody is buried. No such permit ahall he Isaued until there shall have been delivered to such hoard, agent or clerk, as the case inay he, a satisfactory written statement containing the facta 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, aa required by law, 01 in lieu thereof a certificate aa hereinafter provided. If there ia no attending physician, or if, for sufficient reasona, hia certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who ia a meniber 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 ia caused by violence, the medl- cal examiner shall make such certificate. If auch a permit for the removal of a human body, not previously interred, from one town to another within the cominonwealth cannot be obtained early enough for the purpose, the certificate of death made as ahove provided and in the posaesaion of the undertaker desiring to make such renioval 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 hody has heen sooner ohtalned hereunder. If the death certificate containa a recital, aa required
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