USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 93
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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 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 shall exhume a human body and remove it froin a town, from one cenietery to another, or from one grave or tomb other than the receiving tomb to another In the same cemetery, until he has received a permit from the board of health or Its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to sucb board, agent or clerk, as the case inay he, a satisfactory written statement 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. or in lieu thereof a certificate as liereinafter 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- cisn who ia 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. tbe medi- cal examiner 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 early enough for the purpose, tbe certificate of desth made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, thst such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit In the usual form for the removal of such hody has been 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 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 transnilt It to the clerk of the town for registration, The person to whom the permit Is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces sary information which can be obtained as to the deceased. or as to the manner of cause of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 15, G. L., (Tercentenary Edition).
No undertaker 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 jæeruit so to do from the board of health or its agent appointed to Issue such permits, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have tbe care of the cemetery or burial ground in which ibe interment is made. .. . Chap. 114. Sec. 16. G. L., (Tercentenary Edition).
Medical examiners shall make 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 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 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 iliness from disease unrelated to any form of injury.
(2) Board of Health physiolans wili 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 phyaf- cian is 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 desthe caused directly or in- directiy by traumatism (including recuiting septicemla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, zınl deaths following abortion, but also deaths from diseass resulting from Injury or Infeotlon related to oosucation, the sudden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statement of Cause of Death. Cause of death meana the disease, or complication which causes death, not the mode of dylng. e. g., heart fallure, asphyxia, astbenia, etc. As principal cause name the disease caualng 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 Occupation .-- Precise statement of occupation la very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned an at school or at boine. For a woman whose 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 fanrily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
Suffolk
...
(County)
1
Winthrop
(City or Town)
No.
80 Somerset 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 itsAgent
Registered No.
S (If death occurred in a hospital or institution, St. [ give its NAME instead of street aud number)
2 FULL NAME
John William Simson
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
80 Somerset Ave .
(Usual place of abode)
Length of stay: In mesoltal or Institution
(Before death)
yeara
months
days.
(If nonresident, give city or town and State)
In this community37
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEMarried
DEATH
18 DATE OF December
(Month)
21
1943
(Day)
(Year)
Sa If married, widowed, or divorced Elizabeth Fullerton december 7 1943
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 years
> IF STILLBORN. enter that fact here.
8 ÅG65 YearsL 1
Months
10 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Grocer
Industry
Grocery Store
10 or Business :
None
11 Social Security No.
Grand Pre
12 BIRTHPLACE (City)
(State or country)
Noia Scotia
13 NAME OF
FATHER
James Simson
14 BIRTHPLACE OF
FATHER (City)
Grand Pre
(State or country) Novia Scotia
15 MAIDEN NAME
OF MOTHER
Hattie Raunsefell
Grand Pre
16 BIRTHPLACE OF
MOTHER (City)
(State or country) Novia Scotia
17 Elizabeth Simson
Relation, If any
Informant ( Address ) 80 Somerset Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the berist or frangit permit was issued : Nui. D. Childressx Signature of Astat of Board of Health or other)
Health Great
12/23/43
( Official Designation) ( Date of Trque of Permit)
19 i HEREBY CERTIFY,
That ! attended degaased from
I last saw h mal alive on
December 21, 1943 death is said to
have oocurred on the date stated above, a
7:45Pm.
Duration
Immediate oguse of death ....
acute Coronary Thrombosis 14 days
Due to
auguna Pectoris
6 mois
Due to.
Other conditions.
none
( Include pregnancy within 3 months of death)
Major finding
Of operations
none
Date of.
Of autopsy
none
What test confirmed diagnosis?
chincali let.
IMPORTANT Physician Underline the cause to which death should be charged sta- tistica)ly.
20 Was disease or injury in any way related to occupation of deceased 10
(Si
nonverb Chamo m. w
M. D.
(Address) 562 Hurley
Date 12/22/4/3
21
Winthrop
Misanthrop
Place of Burial, Creniation or Removal.
December 24
43
19
DATE OF BURIAL
22 NAME OF
Howard S arnaldo
FUNERAL DIRECTOR.
ADDRESS
within Mais
Received and Alad
NECZY IN.
19
( Registrar)
100M-G - 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 physiolans to Insert a recital to that effect. PARENTS
PLACE OF DEATH
(Specify whether)
St.
PHYSICIAN - IMPORTANT
U. S. War Veteran,
if so specify WAR)
(City or Town)
to.
December 21
19 43
65
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or regiatered 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 member of the family of the deceased, furniab 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 wss contracteil. the duration of his last illnesa, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Cliap. 16, 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 helief, served in the army, usvy 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 cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, sucb physician or officer shall forfeit ten dollars. For the purposes of thia aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bundred 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 hetween February fourteenth, eighteen hundred and ninety.eiglit and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen bundred and seventeen. G. L. Chiap. 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 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 exhume a hunan body and remove it froin 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 haa 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 shall be issued until there shall bave been delivered to sucb board, agent or clerk, as the case inay 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. 01 in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a pbysi- cian who is a meniber of the board of health, or employed by It or by the selectmen for the purpose, shall upon application niske the certificate re- quired of the attending physician. If death Is caused by violence. tbe medl- cal examluer shall make such certificate. If such a permit for the removal of a human body. not previously interred, froin one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of desth made as above provided and in the possession ot tbe undertaker desiring to make such renioval shall constitute a permit for such removal; provided, that such body shall be returned to the town from wbich it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has been sooner obtalued 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 given 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 ma to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No undertaker or other person shall bury a 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 he held, or from a person apointed to have tbe care of the cemetery or burial ground in which the interment is made .... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
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 has notice that there is within his county the body of such a person, he shall forthwith go to the place where the lucly lles and 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 phyalcians will certify to sucb deuthu 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 physlolans will certify to such deaths only as those of persons who, though disshled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phyef- cian is ahsent from home when the certificate of death is needed.
(8) Medloal Examiners will investigate and certify to all dratbe aup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatiam (Including resulting septicemla), and by the action of chemical (drugs or poisons), thermal. or electrical agents, all deaths following abortion, but also deatha from dlacasa resulting from injury or lafeotlon related to oooupation, the audden deatha of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death meana the disease, or complication which causes death. not the moile of dylug. e. g., heart failure, asphyxia, astbenla, etc. Aa principal cause name tbe disease caualng 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 Occupation .- Precise statement of occupation la very im- portant, so that the relative bealthfulness 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 had retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at boine. For a woman whose only occupatiou was that of home bousework, write bousework. 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 had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A Suffolk (County)
1
(City or Town)
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. 270
Registered No.
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAMES
Jeorge Cheever Juices
E 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)
years
months days.
In this community
6 yrs. 8
mos. - days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
Volete
5 SINGLE
(write the word)
MARRIED
WIDOWED Marned
or DIVORCED
5a If married, widowed, or
HUSBAND of
......
Luck Preston Sinclan
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive .....
.. years
7 1F STILLBORN, enter that fact here.
6 5
AGE Years 4 Months 17 Days
If less than 1 day Hours Minutes
Usual Inderrita
9 Occupation :
Industry
Surchy Bonda
11 Social Security No ....
025-03-9641
12 BIRTHPLACE (City) Semanece (State or country) mais
13 NAME OF
FATHER
alfred Palmerston Sinclair
14 BIRTHPLACE OF
unable toblair
FATHER (City)
(State or country)
15 MAIDEN NAME.
Emma. J. Gress
16 BIRTHPLACE OF MOTHER (State or country) "
.17 Informant Auch. . Sinclan (wigh
Relation, If any
80 washington are Wucher
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burialor transit permit was issued : Www. D. Childrens 0
(Signature of Agent of Board of Health or other)
Healthe Office 12/13/43 / (Officlal Designatlon) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
December
21,
1943
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY
That I attended deceased from
Dec 20,
1943 to
Dec
21, 1943
I last saw h (or alive on
Dec
21
1,38 death is said to
have occurred on the date stated above, at.
... m.
Immediate cause of death
Duration
IMPORTANT
Due to.
Lobar Premoni
Due to.
Other conditions.
Diabetes
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings:
Of operations.
2200g
Date of ..
Of autopsy.
What test confirmed diagnosis? Clinical Signs
20 Was disease or injury in any way related to occupation of deceased ?.......
If so, specify .... >
D.J.OBrien M.D.
(Signed) ....
M. D.
) Winthrop, mass Date Dec 21,1943
2
Place of Burt, Cremation or Removal. (City or Towny
DATE OF BURIAL.
Dec 23 h autocon Panna +3
22 NAME OF FUNERAL DIRECTOR Ches. R. Descrición ADDRESS
Received and .~ 371043 19
(Registrar)
100m-2-'40-D-729-a
is very important. See instructions and extracts from the laws on back of certificate. PARENTS
PLACE OF DEATH
No 86- Washington avenue
St.
.......
....
(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
days
Underline the cause to which death should be charged sta- w+ tIstically.
10 or Business :.
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 registration a standard certificate of death, stating to the best of his knowledge and belief tbe 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 officer 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 buman body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing 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 tbe 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, bis certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required 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 another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body sball be returned to the town from which it was removed witbin tbirty-six hours after such removal, unless a permit in the usual form for the re- moval 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, 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 necessary information which can be obtained as to the deceased, or as to the manner or cause of the deatb, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the asbes thereof which have been brought into the commonwealth until he bas 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 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 wbich the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
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 Heaith physicians will certify to such deatbs 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 physician is absent from home when the certificate of death is needed.
(3) Medicai Examiners will investigate and certify to all deaths supposabiy due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia). and by tbe 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 occupation, the sudden deaths of persons not disabied by recognized disease, and those of persons found dead.
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