USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 85
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No undertaker or other person shail hury a human hody 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 heid, 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 Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy violence. If a medical examiner hss 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 lawa calls for the observance of the following rules of practice :
(1) Attending physiciana will certify to such deatha 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 physicians will certify to such deaths only aa 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 is absent from home when the certificate of death is needed.
(8) Medioal Examiners will investigate and certify to all deatha sup- poasbly 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 diacasa resulting from injury or infection related to oooupation, the audden deatha of persona not disabled by recognized disease, and those of persons found desd.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death. not the mode of dying, 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 persou 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 businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at hoine. For a woman whose only occupatiou was that of home housework, write housework. 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
R-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
507 Pleasant St.
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, St. [ give its NAME instead of otreet and number)
2 FULL NAME
Frances Mable Winne
or Winnie
(Ford)
(War dedbased
- IMPORTANT
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
...
507 Pleasant St.
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
yearo
months
days.
In this community30
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Widow
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
( Give maidencima fried" fol) Winne
( Husband's name in full)
6 Age of husband or wife if alive
years
> IF STILLBORN. enter that fact here.
8
92
10
AGE
Years
Months
12 Days
Days
If less than 1 day Hours. Minutes
Usual
9 Dccupation :
Housewife
Industry
Own Home
11 Social Security No.
None
12 BIRTHPLACE (City)
(Siate or country)
Illinois
13 NAME OF
FATHER
Ford
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Illinois
15 MAIDEN NAME
OF MOTHER
Unable to Obtain
16 BIRTHPLACE OF
MOTHER (Clty)
(State or country)
Virgina
21
winthrop
l'lace of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
November 9
143
22 NAME DF
Howard S ynolds
FUNERAL DIRECTOR
ADDRESS
Winthrop iness
/ Le altre pfizer
(Omcial Dosignation) ( Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month )
71943
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deosased from
19
43 to.
19
I last saw h .. ........... allve on.
200. 7.29 % Sdeath Is sold to
have oocurred on the date stated above, at.
m.
Immediate cause of death
"IMPORTANT
Due to
arturo Meno
Due to
1 0 hs
Other conditions.
( Include pregnancy within 3 months of death)
Major findings:
Df operations
Date of
Of autopsy
What test confirmed diagnosts?
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ?......... If so, spaolfy .................
.(Signed).
(Addrass)
M. D.
The the Date 11-8- 1942 Winthrop
17 Informant ( Address)
Mrs Julia Murphy
Relation, if any 85 Newbury St Boston
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed, with me BEFORE the burst or transit permit was Issued :
(Signature of Agent of Board of Health or other) 11/9/43
Raoalvad and Ated. 19
( Registrar)
1
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
100M-6 -2-42-8855
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
No.
(Specify whether)
U. S. War Veteran,
if so speolfy WAR)
Duration
IMPORTANT Physician
10 or Business :
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or regiatered hospital mediosi 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 anthorizeni person or ol ans member of the lamily ol 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 asme was contractei. the duration of his last illness, 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 helief, merved 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 immediate csuse of death as nearly as he can state the saine. For neglect to comply with any provision ol this section, sucb physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-Alve, forty-six and forty-seven of said chapter one bumired and fourteen, the word "war" shall inchule the China relief ex- pedition and the Philippine insurrection, which shall, for sail purposea, he deemed to have taken place hetwcen February fourteenth, eighteen hundred and ninety- eight and July lourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen bundred and seventeen. G. L. Clisp. 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 issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertsker or other person shall exhume a human body and remove it froin a town, from one cemetery to another, or from one grave or tomb other thau the receiving tonib 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 shail be issued until there shall have been delivered to sucb board, agent or clerk, as the case may be, a 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 certifleste of the attending physician, if any. as required by law. 01 in lieu thereof a certificate as hereinafter provided. If there la 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 is a meniber of the board of health, or employed by it or by the selectmen lor the purpose, shali upon application niske the certificate re- quired of the attending physician. If death Is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, 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 ot tbe undertaker desiring to make such removsi sliali 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 removai, 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 heen engaged, sucb recitai 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 nece+ sary information which can be obtained as to the deceased, or wa to the manner or canse of the death, which the clerk or registrar thay 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 fruni the hoard of health or its agent appointed to issue such permits, or if there is no such hoard, Irom 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 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 ol such a person, he shall forthwith go to the place where the hody lies and 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 physicians 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 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 pbyal- cian is ahsent from home when the certificate of death is needed.
(3) Medioal Examiners will investigate and certify to all dicatba sup- posably due to injury. These include not only desths caused directly or in- directiy by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, all deaths following abortion, but also deaths from dlaease resulting from injury or Infection related to occupation, the audden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of deathi meana the disease, or complication which causes death, not the movie of dying, e. g., heart failure, asphyxia, astbenia, etc. Aa principal cause name tbe disease caualng death. As related causes, name earlier morbid conditiona, if any, related to the principal cause and any important compliestion of the principal cause.
Statement of Oooupation .- Precise statement of occupation ia very im- portant, so that the relative beaithfulness 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 bsd retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned an at school or at boine. For a woman wbose only occupation was that of bone bousework, write bousework. For s person engaged in domestic service lor wages, however, designate the occupation by the appropriate terms, aa bousekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A
¿Suffolk
(County)
Winthrop
(City or Town)
No.
III .... Main ..... S.t
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 Ägent. 249
Registered No.
f ( If deeth occurred in a hospital or institution, ( give ite NAME instead of street aud number) St.
2 FULL NAME
Mary V. Beause jour Bennett
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
III Main St
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
( Before death)
years
months
days.
In this community26
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
Or DIVORCEDIdowed
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Michae raideBerinie teun full)
( Husband's name În full)
6 Age of husband or wife if alive years
> IF STILLBORN. enter that fact here.
AGE
8
70
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry 10 or Business : Own Home
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Nova Scotia
13 NAME OF
FATHER
Elias Beause jour
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Ursula King
16 BIRTHPLACE OF
MOTHER (Clty)
(State or country)
Nova Scotia
17 Informant Margaret ....... MacLuchlan
( Address)
I Maind gt1 !!!
I HEREBY CERTIFY that a satisfactory standard certificate of death. was filled with me BEFORE the burial or trahalt permit was Issued : -Was. Children ( Signature of Agent of Board of health or other )
Shealth Officer 11/10/43
(Omcial Dealgnation) (Date of Issue of Pørmit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
( Month)
8
(Day)
(Year)
19 | HEREBY CERTIFY,
mv.5
1943
to ..
19
That I attended deceased from
I last saw h.
allve on
6, 19 43
S death is sald to
have occurred on the date stated above, at.
ID
m.
Immedlete gause of death.
Duration IMPORTANT
...
Due to
Due to,
..... 3 das
Other conditions.
(Include pregnancy within 3 months of death)
....... IMPORTANT
Major findings: Of operations
Date of
Of autopsy.
What test confirmed diagnosia ?.
20 Was disease or injury in any way related to oooupation of deocasad ?..
If so, apsolfy
(Signed)
(Address)
. .
M. D.
21 ...
HoTy
Cross Maiden
DATE OF BURIAL.
Nov
11
194g
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Reoalvad and fled
1 ............. 1943
19
( Registrar)
V
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a reoltal to that effeot. PARENTS
100M-6 -2-42-8855
PLACE OF DEATH
1
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if ao epeolfy WAR).
(Usual place of abode)
(Sperify whether)
1943
Physician
Underline the cause to which death should be charged sta- tistically.
196
Relat Daughter Plece of Burial, Crematinn or Removal.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physiolan or registered hospital medioel officer shall forthwith, after the death of a person whoin he has attemled during his last Illuesa, at the request of sn undertsker or other authorizeil person or of any 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. wlivre same was contracted. the duration of his lest illness, 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 helief, served in the army, navy or marine corps of the I'nited Ststes In any war In which it has been engaged, insert in the certificate s recital to that edect, speci- fylng the wsr. sud shall also certify in such certificate both the primary and the secondary or inmeiliate cause of desth as nearly as he can state the saine. For neglect to comply with any provision of this section, such physician or officer shell forfeit ten dollars. For the purposes of this sec- tlou 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 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 sixteen and nineteen hundred and seventeen. G. L. 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 buried, until he has received a permit from the bosrd of health, or ita agent appointed to lasue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it froin a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another In the same cemetery, until he has received a permit from the board of health or ita agent sforesaid or from the clerk of the town where the boily is buried. No such permit shall be Issued until there aball bave been delivered to such board, agent or clerk, as the case inay be, a satisfactory written atatement containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original Internient, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate as liereinafter provided. If there is no attending physicien, 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 medl- cal examiner 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 connnonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession ot 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 obtained 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 heen engaged. sucb recital shall appear upon the permit. The bosrd of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit Is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manber or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No undertsker or other person shall bury a human body 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 ajwinted 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 s 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 make examination upon the view of the dead bodies of ouly such persons ss are supposed to have died by violence. If a medical examiner has notice that there is within hils county the body of such a person, he shall forthwith go to the place where the body lles aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calle 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 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 pbsaf- 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 desths cansed directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, aml deaths following chortion, but also deatha from diseasa resulting from injury or Infeotion raleted to occupation, the sudden deaths 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 causes death. not the mode of ilylug, e. g., heart fallure, asphyxia, astbenia, etc. As principal cause name the disease caualug 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 Oooupatlon .- Precise statement of occupation ia very im- portant, so that the relative bealthfulness of various pursuits can be known. Make some entry in this section for every persou 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 hsd retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned an at school or at hoine. For a woman whose only occupation was that of honie bousework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa bousekeeper-private family. cook-hotel, etc. For a person who bad no occupation whatever write none.
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