USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 33
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by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The hoard of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifyiug the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human hody or the ashes thereof which have been brought into the commonwealth until lie has re- ceived a permit so to do from the board of health or its ageut appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to he held, or fromn a person appointed to have the care of the cemetery or burial ground iu which the interment is made ... . Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physiclans 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 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 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., 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 disease causing deatlı, 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 had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
1
-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) Winthrop Community Hospital
The Commontoralth of MassacInisetts 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.
91
S ( If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
TEMALE
SHEEHAN
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
43 TEWKSBURY ST
(Usual place of abode)
Length of stay: In hospital or Institution Hospital
( Before death)
(Specify whether)
years
months
1
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE1
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Single
Sa 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
IF STILLBORN. enter that fact here.
8 AGE Yeers
Months Days
If less than 1 day
7 Hours
.... Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
Winthrop
12 BIRTHPLACE {City)
( State or country )
Massachusetts
13 NAME OF
FATHER
Michael J Sheehan
14 BIRTHPLACE OF
FATHER (City)
Taunton
(State or country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Christine Winters
16 BIRTHPLACE OF
MOTHER (City)
South Boston
(State or country)
Massachusetts
17 Michael J. Sheehan
rathery
Informant ( Address) 43 Tewksbury St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificats of death was filled with me BEFORE the) burlai of transit permit was Issued :
(Signature of front of Board ny Health or other) Healthe article 4/30/43
(Omciai Designation)
( Date of Immue of Permit).
MEDICAL CERTIFICATE OF DEATH
18 DATE
DEATH
Cerril 28 ES
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
9 mil 27
1943,
That i attended deosased from
Ło.
April27
19 4×3
1 last saw her
alive on ...
April27, 1943, death Is said to
have occurred on the date stated abova, at
830
.m.
Immedlate cause of death.
......
8:15 a.m
Duration &-
IMPORTANT
Due to Premature delivery 3months factur)
Due to acute infection (pyelitis) of Mother
1 week
Other conditions.
( Include pregnancy within 3 months of death)
Major findIngs :
Of operations
Date of
-
Of autopsy
none
.........
What test confirmed diagnosis?
Clinical Signs
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, specify
Daniel . 06 Jon
(Signed )
., M. D.
(Address) Winthrop, mass Date Mar1/291943
21
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
April
Film HO Males
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop Massachusetts
Reoalvsd and Alled
19
MAY 5 .1943
( Registrar)
per Dr. O' Brien
extracts trom the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10. requires physicians to insert a recital to that effect. PARENTS putropical
100M- 6 - 2-42-8855
1
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so speoffy WAR)
St.
(If nonresident, give city or town and State)
1943
...........
Winthrop
.........
Registered No.
No.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physicien 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 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 same was contracted. the duration of his last Illness, when last seen alive 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 belief, served In the army, navy or marine corps of the l'uited 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 iinmediate 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 aec- 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, he deemed to have taken place hetween 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. Cliap. 46, Sec. 10.
No underteker 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 lasue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or otber person shall exhume a huinan body and remove it froin a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another In the 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 aball bave been delivered to such board, egent 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 Interment, by a satisfactory certificate of the attending physician, if any, as required by law, 01 in lieu thereof a certificate as liereinafter 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 aelectmen 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 shall 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 early enough for the purpose, the certificate of death made as above provided and in the possession ot the undertaker desiring to make such rentoval 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 heen engaged. sucb recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statenient and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any usher nece+ sary information which can be obtained as to the deceased. ur us to the mauer or callse of the death, which the clerk or registrar may require .- Cbup. 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 he has re- ceived a permit so to do fram the haard 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 the internient is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as sre supposed to have died hy violence. If e 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 hody iies aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calle for the observance of the following rulea of practice :
(1) Attending physiciens 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 physiolans 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 attendutice or whose phyaf- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Exeminers will investigate end certify to all deatba sup- posably due to Injury. These include not only deaths caused directly un in- directly by traumatism (including resulting septicemla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deatbs following abortion, but also deaths from disease resulting from injury or Infection releted to occupation, the sudden deatha of persons not disabled hy recognized disease, and those of persons found deed.
Statement of Ceuse 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. Aa principal cause name the disease caualng death. As related causes, name eerlier 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 bealthfulness 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 gaiufully employed may he returned aa at school or at boine. For a woman whose only occupatiou was that of home housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terma, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for extracts from the laws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physiolans to Insert a recital to that effeot
1
PLACE OF DEATH
SuAttCK County)
Hauthorch (City or Town) 4 Highland are No.
Che Communauturalth ut fftassachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
...
St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number) 1
2 FULL NAME
(If deceased is a married, widowed or deforced woman, give elso maiden name.) 65 ave Hill Belfast Seland
(a) Residence. No. (Usual place of abode)
Length of stay : In hospital or Institution.
( Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
Sugle
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Ilusband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 AGE 20 Years
- Months ... Days
If less than 1 day Hours. Minutes
Usual
9 Occupation :
Sailor
Industry
10 or Business :
British S. S. Cheyenne
11 Social Security No ..
12 BIRTHPLACE (City)
(State or country )
Belfast Freland
13 NAME OF
FATHER
Mulknown
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Unknown.
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 James a. Brannen VICE Relation, if any DATE OF BURIAL may 1
Informant ( filerpas) British que Consul/ Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial ADRIAN E. CRAMPTOKensit permit was issued:
(Signature of Agent of Board of Ilealth or other) 1943 7115
(Official Designation)
ROSTON HEALTH DEplate of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april - 29-1943
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER theroof Flame Burns 1 /Books a extreme tid
20 Aocident, sulolde, or homiolde . (specify
Presumoty accidental
Date of ooourrenoe.
april-29-
1943
Where did
Injury oocur ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publio
place?
(Specify type of place)
Manner of
Injury
Found dead in a harming
Injury
Nature of
auto m a garage
While at work ?.
X
.Was there an autopsy ?.
yes
21 Was disease or Injury In any way related to ocoupation of deceased ?
If so, specify
(Signed)
Buten
and-30-19×3
(Address)
22 Woodlawn beenden
Place of Burial, Cremation or Removal.
194,
23 NAME OF
FUNERAL DIRECTOR
D.M. Samman x Som.
ADDRESS
376 mars. ave. arlington
19
Received and filed.
MAY 5
1943
(Registrar)
(Registrar of City or iown where deceased resided)
=
PARENTS
50m (g)-1-41-4667
Michael Joseph anglin
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(If nonresident, give city or town and State)
M. D.
I Everett hass (City or Town)
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 fantily of the decrased, furnislt 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 required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physiciau 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 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 arnty, 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 siso certify in such certificate both the primary and the secondary or innnediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" sltall include the China relief ex- pedition and the Philippine insurrection, which sltall, for said purposes. be deemed to have taken place between February fourteentlt, eighteen liundred 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 froin 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 towit, from one cemetery to another, or from one grave or tomb otlier than the receiving tomb to another in the same cemetery, until he has received a pertnit from the board of healthle or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall 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 selectinen for the purpose, sliall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death 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 suche body shall be returned to the town from which it was removed within thirty-six hours after such re- inoval, 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 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 physiciau cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may 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 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 per- son 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.
... Ile 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 certifiea the cause and manner of death to the best, of his kuowledge 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 whont they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiclans will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any forin of injury, have died withtout recent medical attendance or whose physi- cian is absent from home when the certificate of death is neededl.
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