USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 53
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General Debility
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physioian or registered hospital medloal officer shall forthwith, after the death of a person whoin he has attemled 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 atandard certificate of death, ststing 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 same was coutracieil. 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 decessed, to the best of his knowledge and belief, served in the grmny, navy or marine corps of the I'nited States in any wer 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 immediate 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 thia 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 purposea, 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. Clisp. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or ita 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 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 its agent aforesaid or from the clerk of the town where the boily 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, & satisfactory written atatenient containing the facts required by law to be returned ail 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. o1 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 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 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 esrly enough for the purpose, the certificate of desth made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such renroval; 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, aa 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 shali appear upon the permit. The board of health, or its agent. upon receipt of such ststenient 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 other nece+ sary information which can be obtained as to the deceased, or aa to the manter of canse of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 45, G. L., (Tercentenary Edition ).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do fron 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 apointed to have the core of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons ss 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 and take charge of the same; ... - General Laws, Chap. 38, Suc. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calia for the observance of the following rules of practice :
(1) Attending physicians will certify to such deatha only aa those of persons to whom they have given bedside care during a fast illness from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deaths only aa those of persons who, though disshled by recognized disease unrelated to any form of injury. have died without recent medical attemiance or whose pbyaf- cian is absent from home when the certificate of death is needed.
(3) Medloai Examiners will investigate and certify to all dicatbe sup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatism (including resulting septicemia), and by the actlon of clientical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseasa resulting from injury or Infeotlon 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. not the moile of ilying, e. g., heart failure, asphyxia, asthenla, etc. Aa principai 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 healthfulneas 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 ou 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 borne. For a woman wbose only occupatiou was that of home housework, write housework. For s person engaged in domestic service for wages, however, designate the occupation hy the appropriate terma, an housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A Suffolk (County) Winthrop 1 (City or Łowa 188 Woodside Que 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.
Registered No. f ( If death occurred in a hospital or institutinn, St. [ give its NAME instead of street aud number)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No.
(Usual place of abode)
188 Woodside Live
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
3 SEX 7
4 COLOR OR RACE|
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
Sa If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Fred , adame of in full )
( Ilushand's name in fill)
6 Age of husband or wife if alive 74 years
7 IF STILLBORN. enter that fact here.
8 AGE 75 ve Months Days
If less than 1 day Hours Minutes
Usual
9 Oocupation :
Housewife
Industry
10 or Business :
at home
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Charles Sweeney
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
ME Mary O.Donald
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informar ( Address)
Full Track
18 Woodside Con, Which
I HEREBY CERTIFY that a satisfactory standard oertifloate of death was filed with me BEFORE the barhun or transit permit was Issued : Na. D. Chil dress x
(Signature of Agent of Board nf ffealth of other)
seattle
Office
7/29/X3
('Official Designation) (Date of Ismue/ot Permits
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH July 28, 1943
(Month)
(Day)/
(Year)
19 1 HEREBY CERTIFY,
July 24
That I attended deceased from
1943, to .. July 28 19 ....... 3
1 last sawh of allve on
July 28 ,19 43,
death Is sald to
have occurred on the date stated above, at /0. A.m.
Immediate causa of death
Central Humanleague
Duration IMPORTANT 3 days
10 yrs
Other conditions.
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Of autopsy.
What test confirmed diagnosis? clinical
t'ilerline the cause to which death should be charged sta- tistically.
20 Was disease or injury In any way related to ocoupation of deceased ?. ).10. If so, speolfy.
M. D.
(Sig
(Address) 26 Wane Way Que for Pate 7/28 1945
21 l'face of Burial, Creniation or Rentoral. (Clty or Town)
DATE OF BURIAL
July 31
19
x3
22 NAME OF
FUNER
Daniel Je Nuceny
ADDRESS
350 Body, Everett Years
Received and filed
JUL 3 0 1943
19
( Registrar)
100m (d)-1-41-4667
PLACE OF DEATH
2 FULL NAME Ellen M. Track
( If deceased is a married, widowed or divorced woman, give also maiden name.)
extracts from the lawe an Lasl. ir deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
Due
Due to.
IMPORTANT Physician
Mardin
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 death, stating to the best of his knowledge and behef the name of the deceased, bis supposed age, the disease of which he died. defined as re- quired hy section Que, where same was contraeteil. 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 deceaseil, to the best of his knowledge and belief, served in the army. navy or marine corps of the United States in auy 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 aml the sceomlary or immediate cause of death as early 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 inchide the China relief ex- pedition and the l'hilippine insurrection, which shall, for said purposes, he 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, 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, froin the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it froin a town, from one cemetery to another, or from one grave or tomb other than the receiving tonib 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 boily is huried. No such permit shall he issued until there shall have been delivered to such board, agent or clerk, as the case inay be, a satisfactory written statement containing the facts required by law to he returned 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. o1 in lieu thereof a certificate as Irereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate carmot 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 selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence, the meili- cal examiner 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 eamiot be obtained carly 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 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 l'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 sueb statement aml certificate, shall forthwith countersign it aml transmit it to the clerk of the town for registration. The person to whom the perinit 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 decrased, or as to the manner or cad-e 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 re- ceived a permis 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 he buried or the funeral is to he held, or from a person apointed 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 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 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 thoae of persons who, though disabled hy 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 inelnde not only deaths eaused directly or in- directly by traumatism (including reaulting septicemia), and by the action of chemical-(drugs or poisons). thermal, or electrical agents, aml deaths following abortion, hut 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 conmplication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause naine the disease cansing 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 heen given up or changed ou 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 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
I A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No.
45 Coral ... Ave ....
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Nep. 33 Books
To be filed for burial permit with Board of Health or its Agent. 160
( If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Catherine .... Smith ..... "No.11.1
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
45 Coral Ave
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
( Before death)
years
months
days.
In this community 40 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE!
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Widowedg
Sa if married, widowed, or divoroed
HUSBAND of
Michaelmio Ne il Ite 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
95
Years
Months
Days
If less than 1 day
Hours ...
Minutes
Usual
9 Occuoalsousewife
Industry
10 or Business :
Own Home
11 Social Security No.
Fre land
12 BIRTHPLACE (City)
( State or country)
manuela nfed
13 NAME OF
FATHER
John Smith
PARENTS
100M-6 - 2-42-8855
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with me BEFORE the Burjei op tranalt germit was Issued :
( Signature of Agent of Board of Health of other ) Health Officer 8/9/43
(Omefal Designation) ( Date of Issue of Permit)/
20 Was disease or injury in any way related to oooupation of deceased ? 200
If so, spsolfy ...
............
(Signed)
..............
. M. D.
Winthrop muss
.........
Date Le311943
St. Mary's Jacksonville l'lace of Burial, Cremation or Removal. (City or Town) DATE OF BURIAL .. ALL& .. 3 1943 / 19
22 NAME OF
FUNERAL DIRECTOR
Form W Maler
ADDRESS
Winthrop
19
(Registrar)
Duration IMPORTANT
Immediate oayse of death .. hugocarditis
Due to
devlet
........
95 years
Due to.
Other conditions
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed diagnosis
Clinical Signs
Physician Underline the cause to which death should be charged sta- tistically.
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Alice Walsh
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant
( Address)
45 Coral Avel.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
30
1943
(&fonth )
(Day)
(Year)
That I attended deceased from July 1
A last saw h.e.l .....
alive on .......
July 29,, 19 43 death is said to
Have occurred on the date stated above, at ....
2ªP
m.
HEREBY CERTIFY,
1943, to.
30
1943
(Specify whether)
St.
(Was deceased a
U. S. War Veteran,
if so specify WAR).
Registered No.
1
Maril Kenny
Received and fied AUG .... 4
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physlolan or registered hospital medical officer shall forthwith, after the death of a person whoin he has atteruled during his last Illuesa, at the request of an undertaker or other authorized person or of any meniber of the family of the deceased, furnisb 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 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 ... Cet. 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 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, sucb phyelcian or officer shall forfeit ten dollars. For the purposes of thla aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one buitred and fourteen, the word "war" shall lucinde the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetween February fourteenth, eigliteen hundred and ninety- eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen bundred and seventeen. G. L. Chap. 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 buried, until he has received a permit from the board of health, or ita agent appointed to lesue sucb permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person ahall 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 be hae received a permit from the board of health or Its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to sucb board, agent or clerk. as the case inay be, a satisfactory written statement containing the 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, 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 ie insufficient, a physl- cian who is a member of the board of health, or employed by it or by the selectinen for the purpose, shall upon application niake the certificate re- quired of the attending physician. If deatb is caused by violence, tbe medi- cal examiner chall 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, tbe 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 body has been sooner obtained hereunder. If the death certificate containa a recital, ao required
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