USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 56
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ue uch 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- on 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.
... ]Ie 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 discase unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only aa those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physi- eian 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 hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), therinal, 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
Medical Examiners in certifying to & 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 circumstances unknown."
If discase or injury was related to occupation, specify. If investigstion 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)." "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
BOSTON NOTIFIED 9/9/1/3
Suffolk
(County)
Winthrop
(City or Town) Winthrop Community Hospital
The Commontoralil 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 i Agent.
Registered No.
S ( If death occurred in a hospital or institution, St. [ give its NAME Instead of street aud number)
2 FULL NAME
Male ... Nalen
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
274 Princeton
St.
Fast Boston
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before desth)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Single
18 DATE OF
DEATH
aug
6,1949
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
19
19
to
I last saw h ............
.allve on.
19
., death Is sald to
have occurred on the date stated abova, a
10:12 p.
6 Age of husband or wife if alive years
IF STILLBORN. enter That fact here. Stillborn
8 AGE Years Months - Days
-
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
None
Industry
10 or Business :
None
11 Social Security No.
None
'2 BIRTHPLACE (City)
( Siate or country)
Mass
Winthrop
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country) Mass
Northhampton
15 MAIDEN NAME
OF MOTHER
Gertrude Marshall
16 BIRTHPLACE OF
MOTHER (City)
East Boston
( State or country) Mags.
17 Informant ( Address)
Anthony Nalen 274 Princeton St E. Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was
fled with me BEFORE the budsi or transit permit was Issued :
William & Childres
(Signature of Agent of Board of Health or other)
agent
aug 10/43
(Omcial pesignation) ( Date of fame of Permit)
20 Was disease or injury in ony way related to occupation of deceased ?............. If so, spoolfy. ....
('Signed)
M. D. 01
(Address)
1960
Cantonale, 61949
....
21
St. Michaels, Boston
l'lace of Burial, Crenistion or Removal.
(City or Town)
DATE OF BURIAL ...
August 10,1943
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Boston
Received and Aled.
AUG 12 2049
19
( Registrar)
100M-6 -2-42-8855
PLACE OF DEATH
1
13 NAME OF
FATHER
Anthony Nalen
Major findIngs :
Of operations
IMPORTANT Physician Underline the cause to which death should be
Of eutopsy
-100 định
What test confirmed diagnosis?
Camera Section chargedits.
tistically.
Duration
IMPORTANT
Immediate cause of death .......
Stillban
.
Due to Premature Separation &
Due to
Placenta
Placenta
Other conditions.
( Include pregnancy within 3 months of death)
Date of.
That I attended deosased from
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife In full)
(or) WIFE of
( Husband's name in full)
years - months - days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran NTO.
if so speolfy WAR):
No.
1 A
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physloian 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, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one, where same was contracted. the duration of his last illneaa, when last seen alive by the physician or officer aud the date of bis death ... Gen. Laws, Chap. 46, Sec. 9.
A' physician or officer furnishing a certificate of death aa required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, served In the army. navy or marine corps of the I'nited States in auy war in which it has been engaged, insert in the certificate a recital to that edect, 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 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 bundred and fourteen, the word "war" shall inchide the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetwcen February fourteenth, eigliteen 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. Cliap. 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 lasue 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 froin a town. from one cemetery to another, or from one grave or 10mb other thau tbe 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 ahall be Issued until tbere aball bave been delivered to sucb board, agent or clerk, as the case inay be, a satisfactory written atatenient containing the facta required by law to be returned and recorded, which shall be accompanied, in case of an original Interneut, by a satisfactory certificate of the attending physician, if any. aa required by law. 01 in lieu thereof a certificate aa hereinafter provided. If there ia no attending physician, or if, for sufficient reasona, hia certificate cannot be obtained early enough for the purpose, or ia insufficient, a physl- cian who ia a meniber of the board of health. or employed by it or by tbe selectinen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death ia caused by violence, tbe medi- cal examiner shall make sucb certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within tbe connnonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the posaesaion 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, unlesa a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate containa 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 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 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 uece+ sary information which can be obtained as to the deceased, or as to the manter or cause 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 from the hoard of health or its agent appointed to issue such permits, or if there is no such board, front the clerk of the town where the boily is to be buried or the funeral is to he held, or from a person appointed to have tbe care of the cemetery or burial ground in which the internient ia made. .. . Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examinera shall_make examination upon the view of the dead bodies of ouly such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the hody lles aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calla for the observance of the following rulea of practice :
(1) Attending physicians will certify to such deatha only aa those of persona to whom they have given bedside care during a last illuesa from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deatha only aa those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbyat- cian ia absent from home when the certificate of death la needed.
(3) Medloal Examiners will investigate and certify to all dlcatba 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 ahortion, but also deatha from diseass 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 dlaease, or complication which causea 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 earlier morbid conditiona, if any, related to the principal cause and any important complication of the principal cause.
Statement of Oooupation .- Precise statement of occupation ia very 1m- portant, so that the relative healthfulnesa of various pursuits can be known. Make aome 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 discase causing death, report the usual occupation prior to Illness. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at hoine. For a woman whose only occupatiou waa that of home housework. write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, as bousekeeper-private faniily, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-302
Essex
(County)
Newburyport
(City or Town)
Anna Jaques Hospital
The Commonfocalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Newburyport
(City or town making return)
Registered No.
125
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
2 FULL NAME
Theodore W. Jennings
(If deceased is a married, widowed or divorced woman, give also maiden name.)
speolfy WAR)
(a) Residence. No.
39 .... Buokthorn ...
St.
Winthrop Lass
(Usual place of abode)
14days
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution bagnitel
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDmarried
5a If married, widowed, or divorced
HUSBAND of
( Give maiden name of Wie in ulisk
(or) WIFE of
(Husband's name in full)
70
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
AGE
8
71
Years
3
Months
3
Days
If less than 1 day Hours .Minutes
Usual
9 Occupation :
History Erringen
Industry
Boche Works
10 or Business :
11 Social Security No ..
none
12 BIRTHPLACE (City)
(State or country)
Chelsea , Mass.
13 NAME OF
FATHER
Stephen Jennings
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Chelsea.,Ma.s.s.
15 MAIDEN NAME
OF MOTHER
Alvin Lewis
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Chelsea, Mass.
17
Informanthony Jennings
fon
Relation, if any
(Address)
30 Buckthorn Terrace Winthe
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
Aug10, 1943
19
18 DATE OF
DEATH
August
7, 1943
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY, That i attended deceased from July 23, ... 1943 to August 7, 19.3 .... I last saw him alive on August 6 11943, death is sald to have occurred on the date stated above, at ... Duration 9:25 P
Immediate oause of death Intestinal Carcinoma
Due to.
Due to.
Other conditions Secondary angemia
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations.
Date of.
Underline the cause to which death should be charged sta- tistically.
What test confirmed dlagnosis?
20 Was disease or injury In any way related to ocoupation of deceased ?....... Q If so, specify
(Signed)
A. J. Peter
M. D.
(Address) 78 Iiidale St. Int. Date 8 /8/1943
21 PLACE OF BURIAL, CREMATION OR REMOVALVinthrop , Winthrop , Mass . (Cemetery ) (City or Town)
DATE OF BURIAL
August 10, 1943
19
22 NAME OF
FUNERAL DIRECTOR
Richard H.mite
ADDRESS
1.4.7.
inthrop
Received and filed
SEP 7 1943
19
(Registrar of City or Town where deceased resided)
od
of the city or town in which the deceased ina
1
PLACE OF DEATH
No.
...
(If U. S.
War Veteran,
none
Of autopsy
A
PLACE OF DEATH
Jufolk (County) Winthrop Mare
The Commonturalth 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.
{ ( If death occurred in a hospital or Institution, ¿ give its NAME instead of street and number)
frank Perry Webus Colby
(If deceased is a married, widowed or divorced woman, give also maiden name.
294-Bowdown Strat.
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
40 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
SEX
Male
4 COLOR OR RACE|
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
18 DATE OF
DEATH
august
10
1943
(Month)
(Day)
That 1 attended deoeased from
(Year)
Sa If married, HUSBAND of
Howed of divor dela Goodrich Golly September 5 1935
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8
AGE
35-
Years.
10
Months
13
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Retired. U.S. Calle Garin
Industry
10 or Business :
United States mail
11 Social Security No .... Charlestown
12 BIRTHPLACE (City)
( State or country )
13 NAME OF
FATHER
Ebenin bolly
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
mama
15 MAIDEN NAME
OF MOTHER
TE Eveline Hannaford
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
U.H.
17 annie E. G. Colby
Informant
( Address)
297 Bourdon St Wardluh mann
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued :
{Signature of Agept .of Board of Thealth or other) Health Malle 8/12/43
(Official Designation) (Date of lasue of Vermit)
20 Was disease or injury in any way related to occupation of deceased 200
If so, specify
(Signed Beef Chame 4:00)
(Address) 562 Stely Jt Caratteri
..... M. D.
aug 11/183.
21
Winthis Game lay Withegg
Place of Burial, Cremation or Renroval.
pos Town)
DATE OF BURIAL
august 13€
19 43
22 NAME OF
FUNERAL DIRECTOR.
Chw. R. Bennison
ADDRESS
Received and filed AUG 12 1849
( Registrar)
.... 5 yrs
Due to.
Uremia
Other conditions.
none
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
none
Date of
Of autopsy
none
What test confirmed diagnosis ?
Clinical + lah
Durarion
Immediate cause of Chuonic Steradilial Res replicates
Due to.
arteriosclerosis
2 week
IMPORTANT Physician
Underline the cause to which death should be charged sta- tistieatt !.
100m (d)-1-41-4667
1
297 Bowdown Street Winches No.
St.
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No.
(Usual place of abode)
(Give maiden name of wife in full )
19 HEREBY CERTIFY,
to
august 10
19
43
last saw him
allve on
august10 1943 death Is said to
have oocurred on the date stated above, at.
m.
19
Limerick
lencon
2 FULL NAME.
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 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 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 aud the date of bis 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 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 fourtcen, 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 seventecn. G. L. Cliap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a tuwn, 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 reniove 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 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 cannut 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 by violence, the medi- 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 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 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 forin 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 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 or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
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