USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 67
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by section ten of chapter forty-six, that the deceased served in the or 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 giveu and the physiciau certifying the cause of death shall thereafter furnish for registration any other nece+ 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 .- 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 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 appointed to have the care of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examinera 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 boily lies aud take charge of the same; ... - General Lawa, Cbap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calle for the observance of the following rulea of practice :
(1) Attending phyalciana will certify to such deatha only aa those of persona to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Heelth physiolans will certify to such deaths 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 pbyal- cian ia ahsent from home when the certificate of death ia needed.
(3) Medloal Examinera will investigate end certify to all dlcatha sup- posebly due to injury. These include not only deaths caused directly or in- directly by traumatiam (Including resulting septicemia), and by the action of chemical (drugs or poisons), therinal, or electrical agents, aml deatbs following abortion, but also deatha from dlacasa resulting from injury or infeotion related to ocoupatlon, the sudden deatha of persons not disabled by recognized disease, and those of persons found deed.
Statement of Cause of Death .- Cause of death meana the disease, 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 causea, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principai cause.
Statement of Occupation .- Precise statement of occupation ia very im- portant, so that the relative bealthfulnesa 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 lilnese. If the deceased had retired from businesa, report the usual occupation prior to retirement. Children not gainfuily employed may be returned an at school or at boine. For a woman wbose only occupatiou was that of bone bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa housekeeper-private family, cook-hotei, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
PLACE OF DEATH -
Suffolk (County)
1
Winthrop
Town)
No.
441
Winthrop Street
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. 106
Registered No.
{ { If death occurred in a hospital or institution, give ita NAME instead of atreet and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Daniel J Cash
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
441 Winthrop St
St.
(If nonresident, give city or town and State)
Length of stay : In nnsoital or Institution.
(Before death)
(Sperify whether)
years
months days.
In this community17
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEDMarried
Sa If married, widowed,Against MacDonald
HUSBAND of
(or) WIFE of
( Husband's name in full)
58
years
> IF STILLBORN. enter that fact here.
8 AGE 59 Years - Months Days
If less than 1 day Hours Minutea
Usual
9 Occupation :
Retired Staamfitter
Industry
10 or Business :
Swift Co
11 Social Security No. ...
021-01-6057
12 BIRTHPLACE (City)
( State or country)
Nova Scotia
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Mary MacKimion
16 BIRTHPLACE OF
MOTHER (City)
(State or country) Nova Scotia
17 Margaret Cash
Rewife any
Informant
( Address)
441 Winthrop St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificata of death waa
filed with me BEFORE the burial og transit permit was Issued ?
Um L. Cebuldrero
HO
(Signature of Agegt, ofBoard of Afealth or other) Nepr 8/43.
..... (Official Dealgnation) (Date of Maue of Permit)
18 DATE OF
DEATH
Duft
6
1941
(Month)
(Day)
(Year)
19
HEREBY CERTIFY,
Amel, 1943.
107 6
19
43
I Just saw h
welive on
Just6, 1943 de
have oocurred on the date stated above, at.
8,15Pm
1: 5
Duration IMPORTANT
2ms
Due to
Due to
Other conditions
( Include pregnancy within 3 months of death)
.... IMPORTANT
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed diagnosla ?.
Underline the cause to which 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. 4Washington Cute 9-7-1963 (Address)
21
Winthrop ...
Winthrop (City or Town)
Place of Burial, Creniation or Removal. DATE OF BURIAL
September
9-1943.
19
22 NAME OF
John JO Valy
FUNERAL DIRECTOR
ADDRESS Winthrop, Massachusetts.
Racalved and flad.
SEP 9 1943
19
(Registrar)
A
St.
(Was deceased &
U. S. War Veteran,
if ao speolfy WAR)
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
That I attended deosased from
(Give maiden name of wife in full)
6 Age of husband or wife if alive
Immedlate cause of death
Physician
13 NAME OF
FATHER
Daniel Cash
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 whoin he has attended during his last Illness, at the request of an undertaker or other authorized person or of sns meniber of the family of the deceased, furnish for registration a standard certificate of desth, 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. wirre ssme was contracted. the duration of his last illness, when last seen slive by the physician or officer and the date of his death ... Geur. 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, shafl, if the decessed, 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. snd 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 sny provision of this section, such 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" shail Include the China relief ex- pedition and the Phillppine 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 sixtcen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hudy which has not been buried, until he has received a permit from the board of health, or ita agent appointed to lesue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a towit. from one 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 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 he returned sud 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 certificsie as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by It or by the selectinen for the purpose, shall upon application niake the certificate re- quired of the attending physician. If death is caused by violence, the medl- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within the cominouwealth cannot be obtained early enough for the purpose, the certificate of desth made as above provided and in the possession ot 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 hody 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. such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statenient and certificate, shall forthwith countersign it and transmit It to the clerk of the town for registration. The person to whom the permit Is so giveu and the physiciau certifying the cause of desth shall thereafter furnish for registration any other ueces sary information which can be 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).
No undertaker or other person shall bury a hunian hody or the ashea 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 bosrd, 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 is made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall mske examinstion upon the view of the dead bodies of ouly such persons as are supposed to have died hy violence. If a medical exsminer has notice that there is within his county the body of such a person, he shall forthwith go to the place where the luxly liea aud 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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deaths only as those of persons who, though disahled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose phyaf- cian ia ahsent from home when the certificate of death is needed.
(3) Medloal 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 chenilcai (drugs or poisons), thermal, or electrical agents, aml deaths following abortion, but also deaths from diseass 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 fallure, 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 Oooupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing 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 he returned as at school or at hoine. 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 terme, as housekeeper-private faniily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
PLACE OF DEATH -
Suffolk (County)
Winthrop
No.
(City or Town)
59 Cottage Park Rd.
Une Commontocall of Hassarcinisetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agentury
Registered No.
{ ( If death occurred in a hospital or Institution, give Ita NAME Instead of street and number) St.
2 FULL NAME
Elmer Lake Porter
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
59 Cottage Park Rd,
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
years
months
days.
In this community 22 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 DIVORCED Married
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
74
6 Age of husband or wife if alive years
" IF STILLBORN. enter that fact here.
8
AGE
6.9Years
1 Months
3 Days
If less than 1 dey
Hours
Minutes
Usual
9 Occupation :
Agent
(Retired)
Industry
Railroad Station
10 or Business :
11 Social Security No. .
023-10-6723
Wenham
12 BIRTHPLACE (City)
(State or country)
Magg
13 NAME OF
FATHER
Sylbanus Porter
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Hamilton
(State or country)
Mass.
15 MAIDEN NAME
ยท OF MOTHER
Marv
***
-
20 Was disease or injury in any way related to occupation of deceased? 200
If so, spaoify
(Signed) ..
(Address) Winthrop,
Date : Sep/81943
21 . Swampscott Swampscott
l'lace of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL.
Sept. .. 9
1943
22 NAME OF
FUNERAL DIRECTOR
Howard S Finaldo
ADDRESS
Winches
In dias.
.....
Raoeivad end fled ...
SEP 9 1943
19
.......
Hia.
att Sept. 4/43
.... (Official Designation)
(Date of Issue of Pormi)
18 DATE OF
DEATH
September 7, 1943
(Month)
(Day)
(Year)
That I attended deosased from
19 L HEREBY CERTIFY,
Sept 5
1943, to ..
Sept ?
1943
I last saw het alive on ..
Sept 6,, 1943 death Is said to
have occurred on tha date stated above, at ..
4.300
m.
Duration
"AV.PORTANT
Due to
Senile 14 40 carditis
Due to
Other conditions.
200ml
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Underline the cause to which death should ba
Of eutopsy
zone
What test confirmed diagno
Clinical Signs
charged sta- tistically.
16 BIRTHPLACE OF
MOTHER (City)
Hamilton
(State or country )
Mass.
Informent.
( Address)
Addie Porter
59 Cottage Park Ra!"
Relation, If any Wife
I HEREBY CERTIFY that a satisfactory standerd certificate of death was filed with me BEFORE tha burlafor transit parmit was Issued : Delchildress
(Signature of Arentoy Board of Health, or other
( Registrar)
....
5 years
IMPORTANT Physician
M. D.
1
PHYSICIAN - IMPORTANT
(Was dedeased
U. S. War Veteran,
if so speolfy WAR)
(Usual place of abode)
(Specify whether)
Addie Blaney
Immediate oouse of death.
Coronary
Thrombosis
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A. physiolan or registered hospital medlosi offioer 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 ol ans meniber of the family of the deceased, furnish for registration a standard certificate of desth, 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 slive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing $ 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, aerved 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 immeiliate 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 aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall inclindle 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 seventeen. G. L. Chiap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in s town, or remove therefrom a human body which has not been burled, 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 fromn a town, from one cenietery 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 inay be, & satisfactory written atatenient containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, 01 in lieu thereof a certificate as 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 s meniber of the board of health, or employed by It or by the aelectinen for the purpose, shall upon application niake the certificste re- quired of the attending physician. If death is caused by violence, tbe med !- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within the commonwealth 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, thst 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 obtalned hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-bit, that we uctcescu otryto su w 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 counter-ign 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 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 front the board 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 body 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 interment is made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as sre 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 aud 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 Hesith physlolsns will certify to such deaths 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 phyaf- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only desths caused directly or in- directly by traumatism (including resulting septicemia), and by the actlon of clientical (drugs or poisons), thermal, or electrical agents, aml deatbs following abortion, but also deaths from diseass resulting from Injury or Infection related to occupation, the sudden deaths of persons not disablad 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 ilylug, e. g., heart failure, 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 Oooupation .- 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 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 business, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at hoine. For a woman wbose only occupatiou was that of honie housework, write bousework. 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.
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