Town of Winthrop : Record of Deaths 1943, Part 77

Author: Winthrop (Mass.)
Publication date: 1943
Publisher:
Number of Pages: 594


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 77


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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20 Was disease or injury in any way relatad to occupation of deceasad ?.


If so, spaolty


de Puerto Chamus m. W


M. D.


(Si


(Address) 562 Stanley


Datallet 11/1943


21 lleve


Winthrop, Maso Everest


Place of Burial, Cremation or Kemof the City .... ..


(City or Town)


DATE OF BURIAL


October 12,


1943


I HEREBY CERTIFY that a satisfactory standard certificats of death was / filed with me BEFORE the gurigfor Wanglt parmit was Issued ? Wm. D. Chil Meget .. ADDRESS ToWashington the Door-


Health office 10/12/43


Comelal Designation) ( Date of Isque of Vermit)


18 DATE OF


DEATH


October


1943


( Month )


(Day)


(Year)


19 /1 HEREBY CERTIFY.


That I attended deosesed from


September 110 43


October 11


1943


I last saw her


alive on


October 11, 1943


Is said to


heve occurred on tha data stated above, at 6:30 Pm.


Immediete cause of death.


Carcinoma left freasx


* operation therefore


Due


Several Carcinomatesis


Due to Carcinoma leftlung


Other conditions.


none


( Include pregnancy within 3 months of death)


Major findings:


Of operetions


Carcinoma left


breast


Data


, Jak. 1936


Of autopsy


What test confirmed diagnosis ?


no


100M- { · 2·42-8855


extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that offoot. PARENTS


are


St.


Win


(Was deceased a


U. S. War Veteran,


it so apeoify WAR)


81.


( If nonresident, give city or town and State)


58


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physloian or registered hospital medical officer shail forthwith, after the desth of a person whoin he has attended during bis 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 atandard 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 ssme wss contracteil. the duration of his last Iliness, when last seen alive by the physician or officer and the date of hia death ... Gen. Lsws, 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 decessed, 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. sud shall also certify in such certificate both the primary and the secondary or immediate csuse of death as nearly as be can state the saine. For neglect to comply with any provision of this section, such physician or officer sball forfeit ten dollars. For the purposes of thla sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bumlred and fourteen, the word "war" sball include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, 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 bury or otherwise dispose of a buman body in a town, or remove tilerefrom a human body which has not been buried, until be haa 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 otber person ahall exbume a human body and remove it from a town. from one cemetery to another, or from oue 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 shsil be Issued until there shall bave been delivered to sucb 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 physiclan, 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, bis certificate cannot be obtained early enough for the purpose, or is insufficient, a pbysi- clan who is a member of the board of health, or employed by it or by the selectinen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examluer ahall make such certificate. If such a permit for the removal of a iruman body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, tbe certificate of death made as above provided and in the possession ot the undertaker desiring to make such removal shsil constitute a permit for such removal; provided, that such body shali 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 certifcate 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 neces Bary information which can be obtained as to the deceased, or ss to the manner or cause of the death, which the clerk or registrar uray require .- Chap. 114. Sec. 45, G. L., (Tercenteuary 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, 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 interneut is made. ... Cbap. 114. Sec. 46. C. L., (Tercentenary Editiou).


Medical examiners sball mske examination upon the view of the dead bodies of only such persons ss 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 wirere 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 lawa calls for the observance of the following rules of practice :


(1) Attending phyalclana 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 physlolans 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 attendance or whose pbyaf- cian is absent from home when the certificate of death is needed.


(3) Medloal Examiners will Investigate and certify to ali dicatha 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, snd deatbs following abortion, but also deaths from dlacase resulting from Injury or Infection related to ocoupatlon, the audden 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 ilylug, e. g., heart failure, asphyxia, asthenla, etc. Aa principal cause name the disease caualng death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important compilcation of the principal cause.


Statement of Oooupatlon .- 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 ou account of the disease 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 home. 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 by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


-301 A


1


No.


(City of Town) 34 Tapt Queve


St .?


S ( If death occurred in a hospital or institution,


give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


(Wes deceased a


U. S. Wer Veteren,


if so speolfy WAR)


(a) Residence. No.


34 Taft ave


St.


(Usual place of abode)


Length of stay : In hosoltal or Institution


(Before death)


(Specify whether)


years


months days.


In this community 50


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR,OR RACE|


5 SINGLE


(write the word)


Quaid


5a If married, widowed, or divorced HUSBAND of


(or) WIFE of


Gave maiden name Drode (i) che


( Husband's name in full)


6 Age of husband or wife if alive 68 years


> IF STILLBORN. enter that fact here.


8


7/


AGE


Years


Months


Days


If less than 1 day Hours Minutes


Usual


9 Occupation :


Hausenje


Industry


at Stime


11 Social Security No. NONe


12 BIRTHPLACE (City)


(State or country)


Charleston maso.


13 NAME OF


FATHER


Charla ma muller


14 BIRTHPLACE OF


FATHER (City)


(State or country)


15 MAIDEN NAME


OF MOTHER


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


17


( Address)


I HEREBY CERTIFY that a satisfactory standerd certificata of teeth wes filed with ma BEFORE the burjal or transit permit was Issued ? Www. D. Juldelas &


( Signature of Agent of Board of Imalth or other ) He atthe Office 10/12/43


(oficial Designation) ( Date of Issue of Permits


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


October


12


(Month)


(Day)


(Year)


19/ | HEREBY CERTIFY,


Thatal attended deosased from


19.


September 2


43


October 12


943


Ło


....


i last saw h.


en


alive on


October /1, 1943 death is said to


have occurred on the date stated above,


at.


12:35 A.m.


Immedlate ooyse of death ..


Cerebral Hemorrhage


Due to.


arteriosclerosis


3 years


Due to.


Uremia


.... 2 days


Other conditions.


none


(Include pregnancy within 3 months of death)


IMPORTANT


Physician Underline the cause to which death should be charged sta- tistieatty.


20 Was disease or injury in any wey related to oooupation of deoeesed 3/1.2. if so, specify ... (Signed partiallyrays M./ (Address) 562 Playray


M. D.


yourway Dite ct/219 43


l'lace of Burial Cremation or Removal. (City or Town) DATE OF BURIAL Detben 14 19


22 NAME OF


FUNERAL DIRECTOR


ADDRESS 9.07


Que Conlinje


Daniel Bien


Raoalved and Alad.


UVI 13 1943


19


( Registrar)


100M-6 - 2-42-8855


extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G L. Chap. 46, Section 10, requires physicians to insert a recital to that offoot. PARENTS


PLACE OF DEATH


(County)


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. 208


Registered No.


1


2 FULL NAME


( If deceesed is a married, widowed or divorced woman, give also maiden name.)


Buitend we Canthey (he mullen)


(If nonresident, give city or town and State)


1943


Duration


Major findings :


Of operations


none


Dete of


Of eutopsy.


none


What test confirmed dlegnosis ?


Clinical + labi


21


RJNyy IL yny


Ireland


10 or Business :


MARRIED


WIDOWED


or DIVORCED


NO


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 illuesa, at the request of an undertaker or other authorizeil person or of any meniber of the 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 same was contracted. the duration of his last illnesa, when Isst seen alive by the physician or officer and the date of bia 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 helief. 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 wsr. and shall also certify in such certificate both the primary and the secondary or immediste csuse 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 bumlred and fourteen. the word "war" shall incinde the China relief ex- pedition and the Philippine insurrection, which shall. for said purposes. be deemed to have taken place hetween February fourteenth, eigliteen hundred and winety-eight and July fourth. nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen bundred and seventeen. C. L. Chap. 46. Sec. 10.


Na undertaker ar other person shall bury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or ita agent appointed to Issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or otber person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other thau the receiving tomb to another In the same cemetery, until he has received a permit from the board of health or Its agent aforexaid or from the clerk of the town where the boily is buried. No such permit ahall be issued until there shall have been delivered to sucb 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 pbysi- cian who ia a member of the bosrd 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. tbe medi- cal examiner ahall make such certificate. If such a permit for the removal of a liumsur 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 tbe undertaker desiring to make such rentoval 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 obtalued hereunder. If the death certificate contains a recital. aa required


by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States In any war in which It has been engaged. 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 transnrit it to the clerk of the town for registration, The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other nece+ aary information which can be obtained as to the deceased, or us to the manner or canse of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 45. G. L., ( Tercentenary Edition).


No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until Ire 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, 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 the care of the cemetery or burial ground in which ibe interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).


Medical examiners shall mske examination upon the view of the dead bodies of only such persons ss are supposed to have died hy violence. If a medical examiner has notice that there is within lils county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.


RULES OF PRACTICE


The fulfillment of the purpose of these laws calla for the observance of the following rules of practice :


(1) Attending phyalciana will certify to sucb deatha only aa 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 dissbled by recognized disease unrelated to any form of Injury, have died without recent medical attendance or whose pbsof- cian ia ahsent from home when the certificate of death is needed.


(8) Medloal Examinera will investigate and certify to all deatbe sup- posably due to Injury. These Include not only deaths canned directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons). thermal. or electrical agents, aml deatbs following abortion, but also deaths from dlacasa resulting from injury or Infeotlon related to occupation. the sudden deatha of persona nat disabled by recognized dlaease, and those of persons found dead.


Statement of Cause of Death .- Cause of death meana the disease, or complication which causes death. not the mode of dying. e. g., heart failure, asphyxia. asthenla, 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 Ocoupation .- Precise statement of occupation ia very im- portant, so that the relative healtbfulness of various pursuits can be known. Make some 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 disease causing desth. 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 home. For a woman wbose only occupatiou waa that of bone 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 wbo bad no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


01 A


Suffolk


(County)


Winthrop


(City or Town)


Na.


I.75 .... MainSt


St.


S ( If death occurred in a hospital or institution, { give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME


Emil A.


Mansfield


( If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Rasidenco. No.


175 Main


st


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In hospital or Institution


(Before death)


(Specify whether)


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACEĮ


( write the word)


Male White


5 SINGLE


MARRIED


WIOOWEO


or DIVORCEOWidowed


5a If married, widowed. or divorged


Lovell


HUSBANO of


(Give maiden name of wife in full)


(or) WIFE of


( Husband's name in full)


6 Age of husband or wife if allva years


> IF STILLBORN. enter that fact here.


76 Years Months Days


If less than 1 day


Hours


Minutas


Usual


9 Occupation:


Retired Master Mariner


Industry


10 or Business :


Sea Captain


11 Social Security No. Riga


12 BIRTHPLACE (City)


(State or country)


Latinia


13 NAME OF


FATHER


Emil


Mansfield


14 BIRTHPLACE OF


FATHER (Clty)


Riga


(State or country)


Latinia


15 MAŁOEN NAME


OF MOTHERCannot be Learned


16 BIRTHPLACE OF


MOTHER (City)


Riga


(State or country)


Latinia


21 Winthrop


Winthrop


17


DATE OF BURIAL Informan Katherine O'Connor Step Daughterace of Burial, Cremation or Removal. ( Address ) 175 Main St


O.c.t


I7


(City or Town)


194.3


19


-


(Signature of Agent af Board nf Health or other) IHearta Officer 10/16/43


(omcial Designation) (Date of Issue of Permit)


18 OATE OF


DEATH


( Month)


15


1943


(Day)


(Year)


19 | HEREBY CERTIFY,


19


, to.


That I attended deocasad from


I last saw h


.. allva on


, 19


daath is said to


have occurred on tha date stated above, at


m.


Immediata oausa of daath ... Well n.55


Pitn.


Duration


IMPORTANT


Que to


Due to


Other conditions.


( Include pregnancy within 3 months of death)


IMPORTANT


Major findings :


Of operations


Physician


Underlina the cause to which death should be charged sta- tistically.


20 Was drseasa or injury in any way ralatad to occupation of deceased ?.


If so, spoolty


(Signed)


(Address master en


Data 13-16194


3


. M. D.


I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE tha burjal or transit permit was Issued : Www. D. Children. X.


22 NAME OF


FUNERAL DIRECTOR ..


ADDRESS


John MC Maler


Winthrop


Raosived and Aled OCT 18 1943


........ 19


( Registrar)


100M-G - 2-42-8855


If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physlolans to Insert a reoltal to that effeot. PARENTS


1


PLACE OF DEATH


The Commontoralth of Massacinisetts 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. 200


Ragtstered No.


(Was deceased a


U. S. War Veteran,


if so spaoify WAR)


St.


years


months


days.


In this community25 yrs.


mos.


days.


MEDICAL CERTIFICATE OF DEATH


19


...


Date of


Of autopsy


What test confirmed diagnosis?


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physioian 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 authorizeil person or of any member of the family of the deceased, furnisb for registration a standard certifcate of death, stating to the best of his knowledge and belief the hallle of the deceased, bis supposed age, the disease of which he died. defined as re- quired by section one. where same was contracteil. 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 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 ariny, navy or marine corps of the I'nited States In any war In which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, sucb physiclan 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 Inclinle the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety.eiglit 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. Cliap. 46, Sec. 10.




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