USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 90
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(If outside city or town limits, write RURAL)
(c) Name of hospital or institution:
(If not in hospital or institution, write street number or location)
(d) Length of stay: In hospital or institution
In this community
15 days
(Specify whather
years, months or daya)
(e) If foreign born, how long in U. S. A .? years.
lung day 10
year L27 3 hour
minute
19. to
19
6. (b) Name of husband or wife Same Hall Pagere alive - years Immediate cause of death acute myocarditis
If less than one day ue to Generalized arterio!
·
11. Industry or business Real Cetate renauranch Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
14. Maiden name Cela 1. Ludwig 15. Birthplace Maldiodoro nie (City, town. orlcounty) (Stato or foreign country)
Of autopsy
(b) Address_
17. (a)
(Mb) (Daf) (Your)
-302
Suffolk
(County)
1
Chelsea
(City or Town)
No. Soldiers! Done Hospital
5
(If death occurred in a hospital or institution,
St.
{ give its NAME instead of street and number)
2 FULL NAME
Leo J.Gallant
(If deceased is a married, widowed or divorced woman, give also maiden name.)
132 Main
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution.
hospital
„Onths
26.
days.
In this community
yrs.
mos.
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
M
4 COLOR OR RACEJ
W
MARRIED
WIDOWED
or DIVORCED
Married
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Aug.23
19
43
Nov. 19
That I attended deceased from
to
19
43
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
53
years
7 IF STILLBORN, enter that fact here.
8 AGE. 55Years 7 Months. 4 Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
Clerk
Industry
City of Boston
10 or Business :
Il Social Security No .. none
12 BIRTHPLACE (City)
(State or country)
P.E.I. Ganada
13 NAME OF FATHER Francis
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
P.E.I.Canada
15 MAIDEN NAME
OF MOTHER
Catherine McKenna
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
P.E.I.Canada
17 Informant ( Address)
Hospital Records
Relation, if any
A TRUE COPY.
ATTEST :
DATE FILED
(Registr Nov. 19,1943
19
occurred) ADDRESS
John F. O Muley
22 NAME OF
UNERAL
79 "Atlantic St. Winthrop
Received and filed
11. 1943
19
(Registrar of City or Town where deceased resided)
?
Generalized arterio-
Due to
sclerosis.
?
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of ..
Physician Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?
clinical
20 Was disease or Injury In any way related to oooupation of deceased ?
If so, speolfy
(Signed)
Min . Planchard
M. D.
(Address)
Soldierge Home Date
11/19
43
21 PLACE SABURDON 's Cem. ".orcester , Mass. CREMATION OR REMOVAL (Hovy22, 1943 (City or Town) 19
DATE OF BURIAL
50m (e)-1-41-4667
PLACE OF DEATH -
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Chelsea (City or town making return) 260732
Registered No.
(If U. S.
War Veteran,
specify WAR)
V.V.
1
(a) Residence. No.
(Usual place of abode)
5 SINGLE
(write the word)
18 DATE OF
DEATH
Nov. 19, 1943
I last saw h.
fralive on
Nov ... 29 .. , 19 ... 43death is sald to
have occurred on the date stated above, at
6.140 ml Duraion
Immediate cause of death Cerebralaccident
5 .... hr.s .
Due to.
Hypertensive heart dis.
5a If married, widowed,
HUSBAND of
(Give maiden name of wife in full)
Winthrop,
lass.
1 R-305
2 FULL NAME
3 SEX
male
(or) WIFE of
8
74
9 Occupation :
Industry
10 or Business :
PARENTS
of the city or town in which the deceased resided as soon as possible after the close of the month in which the death
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-805 to the clerk
(State or country)
occurred. (See Chap. 46, Sec. 12, G. L.)
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If alive years
7 IF STILLBORN, enter that fact here.
AGE Years Months. Days
If less than 1 day
Hours.
Minutes
Usual
retired leather worker
11 Social Security No.
none
12 BIRTHPLACE (City)
Malden
13 NAME OFWilliamH. Mortelle FATHER
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Anna Thorton
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Mary K. McPhillips
Relation, if any
Informant
(Address)
DSH)
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
11/29/43
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Nov. 24, 1943
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Bronchopneumonia; arteriosclerotic heart disease
20 Acoldent, sulolde, or homicide (specify)
Date of occurrence.
19
Where did Injury ooour ? (City or town and State)
Did injury occur in or about the home, on farm, In Industrial place, or in publio piace? (Specify type of place)
Manner of Injury
Nature of
Injury
While at work?
Was there an autopsy?
21 Was disease or Injury In any way related to occupation of deceased?
no
If so, specify
J. W. P. Murphy
(Signed)
M. D.
(Address)
Peabody
Dato
12/24/43
22 Arlington Nat'l Arlington, Va.
Place of Burial, Cremation or Remoral.
(City or Town)
DATE OF BURIAL
11/30/43
19
23 NAME OF
Owen P. Doonan Sons
FUNERAL DIRECTOR
Malden
ADDRESS
Received and filed
DEC LC 1543
19
(Registrar of City or Town where deceased resided)
25m (h)-1-41-4667
PLACE OF DEATH -
Essex (County)
Danvers
(City or Town) Danvers State Hospital No.
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No.
261
St. (If death occurred in a hospital or institution, give its NAME instead of street and number)
James F. Mortelle
(If deceased ia a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
41 Temple Ave.
(Usual place of abode)
years10
months 25
days.
In this community
yra.
mos.
daya.
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
St.
(If U. S.
Spanish
War Veteran,
specify WAR) .World .... I
Winthrop
(If nonresident, give city or town and State)
PERSONAL AND STATISTICAL PARTICULARS
1
RECEIVED
ONA
11 12. 1
GLL
9
-5
8
RCP
DEC111943 AM
-301 A
PLACE OF DEATH
(County)
(City or Town) "ITYTHROP COMITATI I FOST. No.
The Commonwealth 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. 262
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
St.
2 FULL NAME
JOFT FITY TINY
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX male
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5If married, widowed, or divorced ~ ~ ~~~~
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here.
8 AGE
Years - Months. - Days
Hours.
Minutes
Usual 9 Occupation:
Industry 10 or Business:
مسة
Il Social Security No.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City) (State or country)
15 MAIDEN NAME OF MOTHER
16 BIRTHPLACE OF MOTHER (City) (State or country)
Relation, if any
1
17 Informant (Address) 103 Bay View Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed win me BEFORE the berigY or transiy permit was issued: Www. X. Children.r. (Algnature of Ageny of Board of Health or other) Healthe Officer 12/2/43
(Official Designation) (Date of Issue of Perint)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEÁTH
(Month)
(Day)
-
1943 (Year)
19 LHEREBY CERTIFY SOFT 15, 1943, to ..
That I attended deceased from
1943
I last saw h .......... alive on. UN30, 1993., death is said to have occurred on the date stated above, at2 :..... A .. m. Immed
Duration IMPORTANT
Due to
Ipulito
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
Date of.
.......
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to occupation of deceased?
If so, spocity
......
1
M. D.
(Signed) ....
(Address)
Enpat
Date 142
1947
21
Place of Burial, Cremation or Removal. DATE OF BURIAL ... .
(City or Town)
19
22 NAME OF
FUNERAL DIRECTOR
T
ADDRESS
... +
Received and filed DEL 2 1943
(Registrar) 19
Y
......
.St.
(If nonresident, give city or town and state)
years
T
months
"+ days.
In this community
yrs.
mos.
days.
is very important. See instructions and extracts from the laws on back of certificate. PARENTS
100m-10-'39. No. 8427-e '
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
If less than 1 day
Years
I
(If U. S.
War Veteran,
specify WAR)
r
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tratlon a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or offieer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
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 sueh permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 physiclan, or if, for sufficient reasons, his certificate eannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such 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 carly enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal ; provided, that such body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deccased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such reeital shall appcar upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith eountersign 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 fur- nish 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 elerk or registrar may require .- 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 untli he has received 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 elerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burlal ground in which the interment is made. ... Chap. 114, Sec. 46, G. L., (T'ercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to sueh deaths only as those of persons to whom they have given bedside care during a last ill- ness 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 un- related to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death Is needed.
(8) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupa- tion, 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 failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very Important, so that the relative healthfulness of various pursuits ean 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 cecupation prior to Illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, ete. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A
PLACE OF DEATH
Suffolk (County)
.....
Winthropl (City or Town) No. 223 Woodside AVE
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. 263
Registered No.
S ( If death occurred in a hospital or Institution, St. [ give its NAME instead of street aud nuniber)
2 FULL NAME
JANET I Clapk
( If deceased is a married, widowed or divorced woman, give aiso maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
39 Brooks St
St.
Madfond Mass.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
yeara
months days.
In this community
5 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Widowed
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Ch (Give maiden name of wife in full)
Clark.
( Husband's name in fuii)
6 Age of husband or wife if alive
years
IF STILLBORN. enter that fact here.
8
AGE
60 Years
4 Months
9
7 Days
if less than 1 day
Hours
Minutes
Usual
9 Occupation :
At 1
HOMA
Industry
10 or Business :
Housework
11 Social Security No.
NONE
*2 BIRTHPLACE (City)
( Siate or country)
N. S.
13 NAME OF
FATHER
JANiEl MAC JUFFIE
14 BIRTHPLACE OF
FATHER (City)
(State or country)
N.S.
15 MAIDEN NAME
OF MOTHER
ANNin Smith
16 BIRTHPLACE OF
MOTHER (City )
(State or country)
IY.S.
17 Dunia E Clarke,
Reiation, if any (Address) 29 Brooks St. Mediagyshte
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE the burial or transit permit was Issued :
(Signature of Agoat of Board of flealth or other) Realthe prices 12/8/43
Tomclai Designationy (Date of Issue of Permit)
18 DATE OF
DEATH
Dacon Gon
7
1943
( Month )
(Day)
(Year)
19 | HEREBY CERTIFY,
nov 16
1943
...
That i attended deceased from
12/7/47
19
......
I last saw hay alive on
12/7/43, 19.
...... death is said to
have occurred on the date stated above, at
7.45P
m.
Duration
Immediate oause of death Carmin Richtig with Delene
Chrom mocarchitects Cordier
IMPORTANT 943
Due to
Diabete mellito
Due to.
Other conditions.
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to occupation of deceased ? if so, spacify.
(Signed)
M. D.
(Address) LY Harenh HT- Creme Date 12/7/1543
21
String Grove
AndOVER MA
Piace of Burial/Cremation or Removai.
(City or Town)
...
DATE OF BURIAL.
December 9,
1943
22 NAME OF
Edward grafy stars.
FUNERAL DIRECTOR
ADDRESS
MedFond MASS
Received and Alad
DES 8 1943
19
( Registrar)
100M-G - 2-42-8855
1
-
r
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 effect. PARENTS
1943 1941
IMPORTANT Physician
Undieriine the cause to which death should ba charged sta- tistically.
to
(Usual place of abode)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medloel offioer shall forthwith, after the death of a person whom he has attemied during his last illness, at the request of an undertsker or other authorized person or of sns 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 contracteil. the duration of his Isst ilinesa, when last seen alive hy the physician or officer and the date of bis death ... Gen. Lawa, Chiap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa 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 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 hoth the primary and the secondary or immediate cause of death as nearly as he can state the ssine. For neglect to comply with any provision of this section, auch 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 cimapter one hundred and fourteen, the word "war" shall inclinle the Chius relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deencd to have taken place hetwcen February fourteenth, eighteen hundred and ninety-eiglit and July fourth, nineteen hundred and two, and the Mexi- can horder service of nineteen hundred and sixtcen and nineteen bundred 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 hody which has not been huried, until he haa 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 humen hody and remove it fromn a town, from one cemetery to another, or from one grave or tomh other thau the receiving tomb to another in tile same cemetery, until he haa received a permit from the board of health or ita agent aforesaid or from the clerk of the town where the body is buried. No such permit shall he issued until there shail have been delivered to such hoard, agent or clerk, as the cose inay be, a aatisfactory written statement containing the facta required by law to be returned and recorded, which shaii he accompanied. in case of an original interment, by a satisfactory certificate of the attending physician, if any, aa required by law. 01 in lieu thereof a certificate aa hereinafter provided. If there is no attending physician, or if, for sufficient reasons, hia certificate camnot be obtained early enough for the purpose, or ia insufficient, a physi- cian who ia a member of the board of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. if death ia caused by violence. the medl- cai examiner shaii 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 es ahove provided and in the possession of the undertaker desiring to make such 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 removal, unlesa a permit In the usuai form for the removal of such hody haa been sooner obtained hereunder. If the death certificate containa a recitai, 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. such recitai shali appear upon the permit. The hosrd of health, or its agent. upon receipt of such statenient and certificate, shall forthwith countersign it and transniit 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 as to the manner or cause of the death, which the clerk or registrar uray require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition ).
No undertaker or other person shall bury a hunian hody 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 sgent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the boily is to be buried or the funeral is to he held, or frum a person appointed to have the care of the cemetery or burial ground in which the internient 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 e 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 hody lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfliiment of the purpose of these laws cails for the obaervance of the following rulea of practice :
(1) Attending physiciens wili certify to such deatha only as those of persona to whoin they have given hedside care during a last illneas from disease unrelated to any form of injury.
(2) Board of Health physlolens wili certify to such deaths oniy aa those of persons who, though disshled 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 ia needed.
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