USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 31
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... 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 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 forin of injury.
( 2) Board of Health physiclans will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to auy forin of injury, have died without recent medical attendance or whose physi- cian is absent from home when the certificate of death is needeil.
(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 deathis 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
Medical Examiners in certifying to a deatb will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and ( 2) under manner, the mode of its production together with the circumstances when these are known. For example: "Coin- pound fracture of the femur with ensuing septicemia (gas hacillus) caused by a steam railway accilent." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suichlal." "Syncope while umler the influence of ether adininistered as a surgical anaesthetic." "Fracture of the skull with associated interual 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) under manner, indicate the circuin- stances leading to medico-legal inquiry. For example: "Hemorrhage spou- taneous of the brain ( basal ganglia ) ( found dead in bed)." "Heart 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
R-301 A
1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 158 Highland ave. No.
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. 86
Registered No.
St. f (If death occurred in a hospital or institution, Į give its NAME instead of street and number)
2 FULL NAME
Margaret Agnes Caffrey (If deceased is married, widowed or diverged woman, give also/maiden name.)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death )
(Specify whether)
years
months days.
In this community 20
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE|
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCE
(write the word)
Widow!
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive quedecade years
7 IF STILLBORN, enter that fact here.
AGE
00
70
Years
-
Months.
Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
Canton
(State or cuuntry )
maso
13 NAME OF
FATHER
Jeren
ereminh
PARENTS
14 BIRTHPLACE OF
Randolph
FATHER (City)
(State or country)
maso.
15 MAIDEN NAME
OF MOTHER
Catherine Carlin
16 BIRTHPLACE OF
MOTHER (City)
(State or country )
Ireland
17 informant. ( Address)
Marquer Caffrey
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burgiay ar transit permit was Issued : Www. S. Chuldrug 8. ...
(Signature of Agent of Board of health or other)
Health office 4/14/43
( Official Designation) ( Date of Issue of Permity
18 DATE OF
DEATH
(Month )
(Day)
13
1942 ....
( Year)
LHEREBY CERTIFY,
That I attended deceased from
1943
amil 13
19 43
I last saw h/24
.alive on.
Email 13/2043
have occurred on the date stated above, at.
4.450
m.
Immediate cause of death
Duration
IMPORTANT
...
1
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to oooupation of deceased ?. ..........
If so, specify ...
.
(Signed)
M. D.
(Address) /computing conto4-6-
.19 .. /
21-
Place of Burial, Cremation or Removal
DATE OF BURIAL
Laprise 16
(City or Town)
194.3
22 NAME OF
FUNERAL DIRECTOR ...
Hachand O. July
ADDRESS
Bratin
....
Received and filed TIL J 1 1943
19
(Registrar)
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, Section 10, requires physiolans to Insert a reoltal to that effeot.
100m (d)-1-41-4667
IMPORTANT
Physician
Underline the cause to which death should be charged sta- tistically.
Carton
Due to arturo palermo
158 Highland Canal.
(If nonresident, give city or town and State)
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 atandard 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 seetion one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of hia death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by aeetion forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, aerved In the ariny, 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 cffeet, 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 negleet to comply with any provision of this section, such physician or offieer 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 include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be 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, See. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the elerk 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 such permit shall be issued until there shall have been delivered to sueh 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 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 seleetmen 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, as required
by section ten of chapter forty-aix, 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 ecrtifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained aa 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 haa re- ceived a permit so to do from the board of health or its agent appointed to issue such permita, or if there is no auch board, from the clerk of the town where the body ia 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).
Medical examiners ahall 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 lles and take charge of the aame; ... - General Lawa, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the observance of the following rulea 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 disahled by recognized disease unrelated to any form of injury, have died without recent medieal attendance or whose physi- cian is absent from home when the certificate of death is necded.
(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 chemieal (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 disabied 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, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the discase 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 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 hiomc. 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 had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301
Suffolk (County)
Winthrop
REVERE NOTIFIRE 5/10/4/3
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,
No.
(Wheeler)
2 FULL NAME
alice Bird
(If deceased is a married, widowed or divorced woman, give also maiden name.)
356 Beach St., Revere
St.
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED Married
or DIVORCED
5a If married, widowed, or divorced falter H. Bird HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
59
6 Age of husband or wife if alive
.years
7 IF STILLBORN, enter that fact her ..
AGE Years .. Months ............
........ Days
If less than 1 day
Hours
Minutes
Usual
Housewife
Industry
At home
11 Social Security No.
none
12 BIRTHPLACE (City)
Scituate
(State or country)
...... Mass
13 NAME OF
FATHER
Wheeler
14 BIRTHPLACE OF
FATHER (City)
...
(State or country)
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 Mr. Walter Bird
Relation, if any Cadores 35o Beach st. Revere dass Informanty. V
I HEREBY CERTIFY thal a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Win. D. Chil dress (Signature of Agent of Board of Health of other) Health Officie 4/17/43 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
(write the word)
DEATH
april
18 DATE OF
14 1943
(Month)
(Day)
(Ycar)
19 | HEREBY CERTIFY. That I attended deceased from
4/9
1943, to 4/14
I last saw hmmm.alive on .....
7/12
19.6 3, death is said
to have occurred on the date stated above, at. f104m.
Immediate cause of death ............
acute chole cystitis
abdominal carcinomatos is
Due to
Cancer of the maries
3 yrs.
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
acente chileantitis
CHOLECYSTITIS
abdominal caranormatifis
Date of 4/12/43
Of autopsy
..
What test confirmed diagnosis ? Lar, 9 Mp.
Underline the cause to which death should be charged sta- tistically.
20 Was disease or lojury In any way related to occopation ol deceased ?
If so, specify
Franx 78undli
....
(Signed)
M. D.
(Address) Keny Man
Dale 4/14
1943
21
Place of Burial, Cremation of Removal. 17, Lig 43
rTown)
DATE OF BURIAL
15
22 NAME OF
FUNERAL DIRECTOR
Edith M. Merwin
ADDRESS
305 Beach St. , Revere, Mass
Received and filed ..
APR 2 2 1943
19
A TRUE COPY ATTEST:
(Registrar)
St.
give its NAME instead of street and number)
(If U. S.
War Veteran.
specify WAR)
(a) Residence. No ...
(Usual place of abode)
hospital
ength of stay : In hospital or institution
(Specify whether)
years
months
7
days .
In this community
yrs.
1 PLACE OF DEATH 3 SEX Female (or) WIFE of 46 9 Occupation: CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. PARENTS 200m-10-'39. No. 8427-d NN. D .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 10 or Business:
(City or Town) Winthrop Community Hospital
5
19 43
Duration
...
..........
7 days
Edgewood Cemetery , Nashua,
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 regis- tration 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 dicd, 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 such 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 he 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 who 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 caused by violence, the medical cxain- 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 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 certificatc, 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 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 human hody or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be 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 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 who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is absent 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 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 porsons not disabled by recognized discase, 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 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 who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 1
County)
Winthrop
1
PLACE OF DEATH
2 FULL NAME ..
(a) Residence. No.
(Usual place of abode)
ength of stay : In hospital or institution
PERSONAL AND STATISTICAL PARTICULARS
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)
40
7 IF STILLBORN, onler that fact here.
8
43.
A.GE
Years
- Months
Days
Usual
Truckman
9 Occupation:
10 or Business:
Il Social Security No.
029-10-7279
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
David Glass
(State or country)
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
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
Transportation
If less than 1 day Hours ... Minutes
Boston was
14 BIRTHPLACE OF
FATHER (City)
Russia
15 MAIDEN NAME
OF MOTHER
Etta Rabinowitz
Russia
17 Charlotte Glass Relation
Informant (Address) 14 addison St Chelsea
I HEREBY CERTIFY that a satisfactory slandard cerllficale of death was filed with me BEFORE the burial or transit permit was issued
Um. Diglechildress
YSignature of Agent hl ward of Health or offer) april 16/43
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
(write the word)
DEATH
april 16 /1
13 DATE OF
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