USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 63
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Medical examiners shall make examination upon the view of the dead bodies of ouly 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 liea 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 those of persons who, thengh 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 include not only deaths cansell directly or in- directly by traumatism (including resulting aepticenda), and by the action of chemical ( drugs or poisons). theriaal, 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 ot 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 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 terins, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
A
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
26 Pleasant St
The Commontoralth of Massacipisetts 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.
S
( If death occurred in a hospital or institution, give its NAME instead of street aud auniber)
PHYSICIAN - IMPORTANT
2 FULL NAME
Josephine V. Ryan Kneeland
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
26 ..... PleasantSt
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
yeara
months days.
In this community 16
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
≤
3 SEX
Female
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVOMarried
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
Dafia theeraria 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.
AGE
8 .58 Years Months .. Days
if less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
Own Home
11 Social Security No.
Boston
12 BIRTHPLACE (City)
(State or country)
Mass
13 NAME OF
FATHER
John Ryan
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Bridget Flannery
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 David
Informant
( Address)
Kneeland 26 Pleasant St ( Husband
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with ma BEFORE the burjal ot framlt permit was Issued :
(Signature of Arrot of Board of Health or other) ..... Health prices 8/24/43
(Official DesignationY (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.
(Address) ON Mulino
Date .....!
Cure 26 1943
21
Winthrop
Winthrop
(City or Town)
l'iace of Buriai, Crenistion or Removai.
DATE OF BURIAL
1928
1943
19
...
22 NAME OF
FUNERAL DIRECTOR
Www The Maxey
ADDRESS
Winthrop
Rsosived and flad
19
( Registrar)
.
0
Due to
Due to.
Other conditions
( Include pregnancy within 3 months of death)
.... IMPORTANT
Major findings:
Of operations.
Cancer
Que 11 1942 Date of
Of autopsy ...
What test confirmed diagnosis? partilogical
Physician U'uderiine the cause to which death shouldi ba charged sta- tistically.
PARENTS
18 DATE OF
DEATH
Cinqust
25
1943
19 | HEREBY CERTIFY,
That I attended deceased from
que 8
19943
to
aug 25
19
i last saw h or alive on
Que 25 , 1943
death is sald to
43
have occurred on tha date stated above, at.
5.30pm.
62
Immediate cause of death.
Concu Fill Color
Duration IMPORTANT
(Sperify whether)
......
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
Registered No.
1
No.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medioai officer shall forthwith, after the death of a person whoin he has attended during his last illuesa, at the request of an undertaker or other authorized person or of ans meniber of tbe 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 one. where ssme was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of his deatb ... Cen. Laws, Chap. 16, 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 helief, 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 shail also certify in such certificate both the primary and the secondary or iinmediate cause of death as nearly as be 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 humilred and fourteen, the word "war" shall Include the China relief ex- pedition and the Phillppine 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 aud sixtcen and nineteen bundred and seventeen. G. L. Chap. 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 permita, or if there is no such board, from the clerk of the town where the person died; and no undertaker or otber person ahall exhume a human body and remove it froin a town. from one cenietery 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 aforexaid or from the clerk of the town where the body is buried. No such permit shall be Issued until there aball have been delivered to sucb board, agent or clerk, as the case inay be, a satisfactory written statement containing the facts required by law to be returued andi recorded, which shall be accompanied, in case of an original internieut, 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, hls 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 selectinen for the purpose, shall upon application niake the certificate re- quired of the attending physician. If death is caused by violence, tbe medi- cal examhier ahall make such certificate. If such a permit for the removal of a human body, not previously Interred, froin one town to another within the cominonwealth cannot be obtained early enough for the purpose, the certificate of desth made as above provided and in the possession of the undertaker desiring to make such renioval 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 aerved in the army, navy or marine corps of the United States in any war in which it has been 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 manner of 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 huard 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 be held, or from a person appointed to have tbe care of the cemetery or burial ground in which ibe interment is made. ... Cbap. 114. Sec. 46. C. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died lly 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 aud take charge of the same; ... - General Laws, Cbap. 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 physlelans will certify to sucb 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 physicians will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attenelance or whose pbyat- cian ia ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will Investigate and certify to all deatbe sup- posabiy due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemla). and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseasa resulting from injury or infection related to occupation, the sudden deaths of persons not disabied by recognized disease, and those of persons found desd.
Statement of Cause of Death .- Cause of deathi means the disease, or complication which causes death, not the moile of dying, e. g., heart failure, asphyxia, astbenia, etc. Aa principal cause name tbe disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any Important compliestion of the principal cause.
Statement of Ocoupatlon .- Precise statement of occupation la 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 dixcase causing death, report the usual occupation prior to Illness. If the deceased bad retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at boine. For a woman wbose only occupation was that of home bousework. write bousework. For a person engaged in domestic service for wagen, however, designate the occupation by the appropriate terms, aa housekeeper -- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-301
Sniffall
(County)
Minthogy
(City or Town)
No.
I24
Cliff
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
....
{ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) PHYSICIAN-IMPORTANT (Was deceased a - U. S. War Veteran? If so. specify WAR)
(a) Residence. No
(Usual place of abode)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
St
months
days.
(If nonresident, give city or town and State)
In this community 3 3 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
nemul:
4 COLOR OR RACE
8 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)|
arric
Ba If married, widowed, or divorced HUSBAND of ...
(Give maiden name of wife In full)
(or) WIFE of.
(Husband's name in full)
years
6 Age of husband or wife if alive.
7 IF STILLBORN. enter that fact here.
8 AGE Years Months ..... .. Days
If less than 1 day Hours .Minutes
Usual
9 Occupation :
Industry
10 or Business:
+
11 Social Security No .....
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
. Belcher
14 BIRTHPLACE OF
FATHER (City) ..
(State or country)
18 MAIDEN NAME.
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City).
(State or country)
uine
17
Relation, If any
Informant (Address)
I HEREBY CERTIFY that . setiafectory standard certificate of death was filed with me BEFORE the burial/or transit permit was issued:
(Signature of Agent of Board of Heah't of other> Reality Office A/24/43
(Official Designation) X (Date of Issue of Permity
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Que
26
1943
(Month)
(Day)
(Year)
19
HEREBY CERTIFY,
19.
to
19
I last saw h
alive on
19 ........ ,
death is said to
have occurred on the date stated above, at.
7.45am.
Duration Important
Immediate cause of death,
Cancer d'autre colare about one
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Important
PHYSICIAN
Major findings:
Of operations
Care
wer
Of autopay
What test confirmed diagnosis?
Clinical
Date of Grief 19, Jwhich death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased?
If so. specify.
(Signed),
M. D.
BP) Brand Of Health De to aug 2) 19 43
21.
Place of Burial, Cremation or Removal. (City or Town)
10+
DATE OF BURIAL.
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
AUG 21 1949
19 ..
Received and filed
A TRUE COPY ATTEST: (Registrar)
OFAll in plain terme
100m(h)-1-41-4695
PLACE OF DEATH
1
2 FULL NAME
amnes " (elcher) Terer
(If deceased Is a married, widowed or divorced woman, give also maiden name.)
years
......... vis anu extract from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physician to insert a recital to that effect. PARENTS
D
Underilne the cause to
3
That I attended deceased from
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 hls last iliness, at the request of an undertaker or other authorized person or of any member of the famliy 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 required by section one, where same was contracted, the duration of his last iliness, 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 hy section forty-five of chapter one hundred and fourteen, shali, If the deceased, to the best of his knowledge and helief, served In the army, navy or marine corps of the United States in any war in which it has heen engaged, Insert in the certificate a recital to that effect, specifying 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 pro- vision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this section 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 expedition 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 Mexican horder service of nineteen bundred and sixteen and nineteen hundred and seventeen .- General Laws, 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 huried, until he has received a permit from the hoard of heaith, or its agent appointed to issue auch permits, or if there is no such hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- Ing 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 hody is huried. No such permit shail he issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required hy law to he returned and recorded. which shall he 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 he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the hoard of health, or em- ployed by it or hy the selectmen for the purpose, shall upon application make the certificate required 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 hody, not previously interred, from one town to another within the commonwealth cannot he 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 shail he 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 re- moval of such hody has heen sooner obtained hereunder. If the death certificate contains a recitai, as required hy 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 shail appear upon the permit. The hoard of health, or its agent, upon receipt of such statement and certificate, shail forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit 18 80 given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can he ohtained 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).
Medical examiners shali make examination upon the view of the dead bodies of oniy such persons as are supposed to have died by violence. If a medical examiner has notice that there Is within hla county the hody 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.
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 auch 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 from a person appointed to have the care of the cemetery or burial ground In which the interment la made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws cails 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 wili certify to sucb 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 physician 18 ahsent from home when the certificate of death is needed.
(3) Medical Examiners will Investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and by the actlon of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut aiso 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 iallure, asphyxia, asthenia, etc. Aa 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 important, so that the relative healthfulness of various pursuits can he 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 iliness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he 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 hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
The Commontoralth 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 ite NAME instead of atreet aud nuniber) PHYSICIAN - IMPORTANT
2 FULL NAME
Dorothea Bergin Lucey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(0) Residence. No. 3.0 ..... Plummer .... A.ve
(Usual plece of abode)
.......
St.
(If nonresident, give city or town end State)
Length of stay : in hospital or institution
(Before death)
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