USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 73
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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 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 remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or 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 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 selectmen for the purpose, shall upon application make the certificate re- quired 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 body, not previously interred, from one town to an- other within the commonwealth cannot be obtained carly enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make sueh removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such re- moval, 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 United States in any war in which
it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for regis- tration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary 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 re- quire .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a per- son 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.
... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose 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 caused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseass resulting from injury or Infection related to oocupation, ths sudden deaths of persons not disabled by recognized dissase, and those of persons found dsad.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basal ganglia) (found dead in bed)." "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
M R-301 A
-:---- Suny suppued. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain ...
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to insert a reoltal to that offoot. extracts from the laws on back of certificate. terms, so that it: may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
1
Winthrop
(City or Town)
No.
57 Paine St
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be tiled for burial permit with Board of Health or its Agent. 210
Registerad No.
( If death occurred in a hospital or institution, St.
give ita NAME instead of street and nuniber) PHYSICIAN · IMPORTANT
2 FULL NAME
Alfred J.St anwood
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
5.7 Paine St
(Usuxi place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Sperify whether)
years
months
days.
in this community 20 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCEMarried
18 DATE OF
DEATH
Jest
29
1943
.....
(šfonth)
(Day)
(Year)
19 | HEREBY CERTIFY.
sept. 2043.
That | attanded deceased from
19.
I last saw h ............... alive on.
Wr 27 19 43, death Is said to
have occurred on tha date stated abova,
at
1.45 pm
Immadlate gause of death.
Duration
IMPORTANT
8
AGE63
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Retired Installer
Industry
NewEng TelCo
10 or Business :
IP Social Security No.
011.07 4053
12 BIRTHPLACE (City)
(State of country)
So. Boston
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Major findIngs : Of operations
Physician
Underline the cause to which death should b . charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, specify ..
(Signed)
0 thandany
. M. D.
(Address) Y WithanyTime
on Date
9-10-1943
21
Winthrop ,"Winthrop
Place of Buriai, Cremation or Removal. DATE OF BURIAL.
(City or Town) 1943.
John AO mally
Winthrop
Received and Alad .... OCT-1-1943
19
....... (Omcial Designation)
( Date/of Issue of Permit)
( Registrar)
100M-6 - 2-42-8855
PARENTS
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Sweeden
15 MAIDEN NAME
OF MOTHER
Catherine Burke
16 BIRTHPLACE OF
MOTHER (City)
( State or country)
Ireland
MI Yeon, If any
17 InformAnna Stanwood 57 Paine st ( Address)
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with ma BEFORE the burlal or transit permit was Isused : Ihad Jeheldress
(Signature of Agent of Board of Health or other)
tepl 30/43
(write tbe word)
5a If married,
HUSBAND of
(Give maiden name of wife in full)
Afina Revello
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive 54
years
> IF STILLBORN. enter that fact here.
Due to
1
1
Due to
Date of
Of autopsy
What test confirmed diagnosis ?.
PLACE OF DEATH
Suffolk (County)
*
13 NAME OF
FATHER
Charles Stanwood
MEDICAL CERTIFICATE OF DEATH
(Was deceased
U. S. War Veteran,
if so specify WAR)
.......
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
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 any meniber of tbe 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, bis supposed age, the disease of which he died. defined as re- quired by section one, where same was contracied. the duration of his last illness, when last seen alive by the physician or omcer and the date of his deatb ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa required hy 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 effect, speci. fylng the war. sud shall also certify in such certificate both the primary and the secondary or inmediate 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 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 deenicd 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 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 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 uo such board, from the clerk of the town where the person dled; and no undertaker or otber pervon ahall 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 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 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 he 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 cammot 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 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 the commonwealth 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 removal shall constitute a permit for ruch 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 heen sooner ohtalned 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. 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 giveu and the physician certifying the cause of death shall thereafter furnish for registration any other veces 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 unay require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a hunisn body or the ashes thereof which have been brought luto the commonwealth until he has re- ceived a permit so to do from the board of health or its agent apminted 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 tbe care of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the hody lies aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such 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 phyalolana 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 pbyaf- cian ia ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to all deatba sup- posably due to Injury. These include not only deaths cansed directly or in- directly hy traumatism ( including resulting septicemla), and hy the action of clientical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from dlacasa resulting from injury or Infeotlon related to oooupation, the audden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statemant of Cause of Death .- Cause of deathi meana the disease, or complication which causes death. not the mode of dying, e. g., heart fallure, asphyxia, astbenia, 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 tbe principai cause.
Statemant of Occupation .- Precise statement of occupation ia very im- portant, 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 illness. If the deceased hsd retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he returned aa at school or at boine. For a woman wbose only occupatiou was that of home housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook- hotei, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
FORM R-302
1
PLACE OF DEATH
NORFOLK (County)
BROOKLINE (City or Town) BROOKS HOSPITAL
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BROOKLINE (City or town making return)
Registered No.
494
5 (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
ARTHUR H. SMITH
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
61 WASHINGTON AVENUE
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
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
September
30
1943
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY, That I attended deceased from
September 2719 43 to . September 30 19 43 last saw h .. im. .. alive on Soptember 30, 19 43 death is said to have occurred on the date stated above, at 6.37 P ... m.
Duration
Immediate cause of death. Cerebral .... haemorrhage Arteriosclerosis.
Due to.
Age
Due to
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis ?
Phys . Exam.
20 Was disease or injury in any way related to oooupation of deceased ?.... NO If so, specify
(Signed)
Albert A. Hornor
M. D.
5
(Address) 319 .... Longwood ... A.v ... Bostante ...
10/1.19 43
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Cambridge
Cambridge
(Cemetery}
October 3,
(City or Town).
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
Charles ... B ..... Watson
ADDRESS
Cambridge
Reoelved and filed OCT 8 1943
{ Registrar
deceased resided)
19
DATE FILED
5 SINGLE
(write the word)
Widowed
MARRIED
WIDOWED
or DIVORCED
Addie Downing
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive years
8 AGE .. 83 Years 1 Months. 21 Days
If less than 1 day Hours. .Minutes
Usual
9 Occupation :
Treasurer -- Gen. Manager
Provision Co.
11 Social Security No. 012-14-6586
13 NAME OF
FATHER
Charles Smith
15 MAIDEN NAME
OF MOTHER
Cannot be learned
50m (e)-1-41-4667
17 InformantMir. C. Wesley Smith
Relation, if any
Son
(Address) 718 Concord Turnpike Lexington
A TRUE COP
ATTEST :
(Registrar of city of town where death occurred)
October 1,
19 43
19
should be charged sta- tistically.
Date of
4 days
No.
2 FULL NAME
(Usual place of abode)
3 SEX
4 COLOR OR RACE
White
Male
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
7 IF STILLBORN, enter that fact here.
Industry
10 or Business :
12 BIRTHPLACE (City)
London
(State or country)
England
14 BIRTHPLACE OF
FATHER (City)
London
16 BIRTHPLACE OF
PARENTS
Lond on
England
MOTHER (City)
(State or country)
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
of the city or town in which the deceased resided. (See Chap. 46, See. 12, G. L.)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk
(State or country)
Eng land
(If U. S.
War Veteran,
specify WAR)
WINTHROP
MASS.
بلدي
ORM R-302
2 FULL NAME
(a) Residence. No.
(Usual place of abode)
hosp.
Length of stay : In hospital or Institution.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
F
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
(Husband's name in full)
7 IF STILLBORN, enter that fact here.
8
I
AGE.
Years.
Months
Days
Industry
10 or Business :
11 Social Security No ..
Chelsea, Mass:
12 BIRTHPLACE (City)
(State or country)
La Roy
13 NAME OF
FATHER
Natick, Mass.
14 BIRTHPLACE OF
FATHER (City)
15 MAIDEN NAME
OF MOTHER
PARENTS
17
Informant
(Address)
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk
(State or country)
Charlotte Peaslee
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Aug.2, 1943
(Month)
(Day)
(Year)
19
1
HEREBY
lug.1
CERTIFY,
That I attended deceased from
Aug.c
1943
1 last saw h
Ctive on
have occurred on the date stated above, at.
2:45 p
n.
Duration
Immediate a ondata 1 pulmonary
atelectasis (both lungs).
2 .... d.a.s.
Due to.
Congenital undevelopment
Due to
Other conditions
(Include pregnancy within 3 months of death)
Physician
Underline the cause to
Major findings : Of operations
Date of
should be
Symptoms
charged sta-
tistically.
What test confirmed diagnosis ?.
20 Was disease or Injury in any way related to oooupation of deceased ?
If so, speolfy.
Goo.Roinherz
(Signed)
270 Chestnut St. 8/2. M. D.
(Address)
Winthrop, Wa99.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop, (Comcting . 4 , 194(ity or Town)
DATE OF BURIAL
.19
22 NAME OF
FUNERAL DIRECTOR
Winthrop, Mass.
ADDRESS
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 8/3/43
19
Received end filed
19
ULI,3
(Registrar of City of Town where Alyceased resided)
50m (e)-1-41-4667
Copies of returns of deaths recorded during the previous month which occurred In your city or town in case the deceased 4) WIIN UNFADING BLACK INK - THIS IS A PERMANENT RECORD Usual 9 Oooupation :
Suffolk
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
Chelsea
(City or town making return)
1
- PLACE OF DEATH
(County) Chelsea
(City or Tempelsea memorial Hospital No.
Baby Girl Whidden
(If deceased is a married, widowed or divorced woman, give also maiden name.)
49 Bartlott Rd.
St.
(If nonresident, give city or town and State)
2
months
days.
In this community
yrs.
mos.
days.
years
(write the word)
Single
6 Age of husband or wife If alive years
If less than 1 day Hours. Minutes
Lowell, Mass.
16 BIRTHPLACE OF
MOTHER (City)
(State or coule Roy Whidden
father
49 Bartlett Rd . Mothipp.
A TRUE COPY.
Josephe a. Vierill
CERTIFICATE OF DEATH
Registered No.
21.2554
(If death occurred in a hospital or institution, St. give its NAME instead of street and number)
(If U. S. War Veteran,
specify WAR)
Winthrop, Mass.
19
to
Aug.2
19 ......... weath Is sald to
which death
Of autopsy
19
43
DEPARTMENT OF COMMERCE BUREAU OF THE CENSUS
State of.
STANDARD CERTIFICATE OF DEATH NEW HAMPSHIRE
State File No.
Registrar's No.
161210
1. PLACE OF DEATH: (a) County Grafton
2. USUAL RESIDENCE OF DECEASED:
(a) State Massachusetts (b) County
(b) City or townBristol
(c) City or town
Winthrop
(If outside city or town limita, write RURAL)
(d) Street No.
144 Court Road
(If rural, give location)
(d) Length of stay: In hospital or institution
In this community
years, months or days)
(Specify whether
(i Hf foreign born, how long in U. S. A .? years.
3. (a) FULL NAME
Floyd E.Rich
MEDICAL CERTIFICATION
20. Date of death: Month _August.
day
4
ear
1943
hour
exact time unknown
21! I hereby certify that I attended the deceased from
Medical Refere
5. Color or
4. Sex Male
race
White
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