USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 51
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obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chup. 114, Seo. 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 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 discasc 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 orcupa- 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 death, not the mode of dying, ., 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 whosc 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
303-A
1
PLACE OF DEATH
Suffalte County) Clintlash (City or Town) EPRES Homme
The Commonturalth of Massachusetts 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.
Show Drive 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.)
Short Llave
St.
(If nonresident, ghe city or town and State)
Length of stay : In hospital or Institution .... ( Before death:)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4 COLOR, OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word) Single
5a If married, widowed, or divorced HUSBAND of
(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
56 .Years. Months. Days
If less than 1 day Hours ............ Minutes
Usual 9 Occupation :
General work
Industry
10 or Business :
Harbor Defense
11 Social Security No ...
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City) Unknown
(State or country)
15 MAIDEN NAME
OF MOTHER
Unknown
16 BIRTHPLACE OF MOTHER (City) (Stat
17 Fred Baumiestus
Relation, if Winthrop
i HEREBY CERTIFY that satisfactory standard certificate of death was filed with me BEFORE theburial or transit permit was issued :
(Signature of Agent de'Board of Health or other)
72613 1000
(Official Designationy (Date of Issue of Permit)
(Registrar)
V
18 DATE OF DEATH July 22
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER therecf are as follows: (If an injury was involved, state fully.)
Chronic Cardio-Vascular DuEnAz 1777
20 Accident, sulclde, or homlolde (specify) Date of ocourrenoe. 19
Where did Injury occur ?
(City or town and State)
Did Injury oocur In or about home, on farm, In Industrial place, or In publlo
place ?
(Specify type of place)
Manner of
Injury
Nature of
Injury
While at work? Was there an autopsy?
21 Was disease or Injury In any way related to occupation of deceased ?
If so, specify.
(Signed)
ES 8 Relativa
M. D.
(Address)
May 24 19 43
22
mt. Hoper
Place of Burial, Cremation / Remoyal. (City or Town)
DATE OF BURIAL
July 26
1943
23 NAME OF
FUNERAL DIRECTOR
Richard C./July
ADDRESS
Bratr
Received and filed
JUL 2 8 1943
19
vailuis vin ine ws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to insert a recital to that effect
50m (g)-1-41-4667
=
..... ......
Winthro
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, If so specify WAR)
(a) Residence. No.
(Usual place of abode)
years
months
days.
In this community 20 yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
1943
(Give maiden name of wife in full)
PARENTS
Date ...
Boston
Informant ( Aldress)
No.
George W Prescott
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 standard certificate of deatlı, 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 physician or officer and the date of his death . .. Gen. 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 United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate canse of death. as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of 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-cight 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 boily 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 exliume a liunian body and remove it from a town, froin 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 perinit from 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 obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attenuling 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 such body shall be returned to the town from which it was removed within thirty-six hours after such re- inoval, unless a perinit 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 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 otber necessary information which can be obtained as to the decease.l, 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 sueli permits, or if there is no such board, from the clerk of the town where the body is to be buricd or the funeral is to be held, or from a per- son appointed to have tbe 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 calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose pliysi- cian is absent from home when the certificate of death is neededl.
(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 DEATII
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) under manner, the mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circunistances 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 presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basal ganglia) (found dead in bed)." "Ileart 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, Scc. 14: *
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
PLACE OF DEATH
Suffolk (County)
1
Winthrop
(City or Town)
No. 205 Cliff Ave.
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.
Registered No.
§ ( If death occurred in a hospital or institution, give its NAME Instead of street aud nuniber)
PHYSICIAN - IMPORTANT
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
205 Cliff Ave
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
years
months
days.
In this community
20
20
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE|
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
DIVORCED
Widowed
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE
Robert(dite maiNernebife In full)
( Husband's name in full)
6 Age of husband or wife if alive
years
> IF STILLBORN. enter that fact here.
8
AGE
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
Own Home
11 Social Security No. .
Liverpool
12 BIRTHPLACE (City)
...
(Siate or country)
England
PARENTS
100M-6 - 2-42-8855
I HEREBY CERTIFY that a satisfactory standard certificate of deeth was filed with ma BEFORE the burial or transit permit was Issued?
(Signature of Arout of Board of Thatth ero
Health officee 4/26/43
(Omcial Designation) ( Date of Freue of Permit)/
18 DATE OF
DEATH
July
24
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
famman
19/5 de Jul, 24
That I attended deceased from
I last saw h
anfallve on
July 23/ 1943.
death Is sald to
have occurred on the date stated above, at.
5 A
m.
Immediate osuse of death.
Duration IMPORTANT days
10 kms
Due to
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT
Major findIngs:
Of operations
Physician
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupstion of deceased ?
If so, specify. ('Signed)
vous
M. D.
(Address) Corren Ze
Date
July 24/19 43
21
winthrop Winthrop
l'Isce of Burisi, Cremation or Remeral. 27 DATE OF BURIAL Jüly
(ForTown)
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
olm of@maly. Winthrop
19
Reoelvsd and Aled
JUL 2 6 1943
( Registrar)
-
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Hughes
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Edith Wilson
Informant
-205-Cliff Ave
(
Relation, if any
( Address)
Date of
Of autopsy.
What test confirmed diagnosis ?.
MEDICAL CERTIFICATE OF DEATH
1943
194-3
78
Due to.
Vejo candelas
13 NAME OF
FATHER
Martin J. Walsh
St.
Margaret G. Walsh Neilson
(Was deceased a
U. S. War Veteren,
if so specify WAR)
(Specify whether)
1 A
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or regiatered hospital medioal offioer 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, 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 oue. where same was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physiclan or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the I'nited 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 saine. 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" 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 bundred and seventeen. G. L. Chiap. 46, Sec. 10.
No undertakar 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 burled, 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 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 than 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 such board, agent or clerk, as the case may be, a satisfactory written statement containing the facta required by law to be returued and 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 reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physl- 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, tbe medi- cal examluer ahall 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 ot 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 removal, unless a permit In the usual form for the removal of such hody has been sooner obtalned hereunder. If the death certificate contains a recitai, 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 heen engaged. sucb 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 transnrit it to the clerk of the town for registration. The person to whom the permit Is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces sary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No 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 from the board 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 apminted to have the care of the cemetery or burial ground in which the interment is made. .. . Chap. 114. Sec. 46. C. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within hils county the body of such a person, he shall forthwith go to the place where the body lles aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these iawa cails for the observance of the following rules of practice :
(1) Attending phyalciana will certify to such deatha only as those of persons to whout 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 ahsent from home when the certificate of death Is neededi.
(3) Medloal Examiners will Investigate and certify to all deaths sup- posably due to injury. These include not only deaths canned directly or in- directly by traumatiam (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from dlaeasa resulting from injury or Infeotlon related to occupation, the audden 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, asthenla, 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 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 yeara 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 businesa, report the usual occupation prior to retirement. Children not gainfully employed may he returned aa at school or at bome. For a woman whose only occupation waa that of hone bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, aa housekeeper-private fantily, cook-hotel, etc. For a person who had no occupation whatever write none.
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