USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 12
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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 as to the manter or cause of the death, which the clerk or registrar uisy require .- Cbap. 114. Sec. 45, G. L., (Tercentenary Editiou).
No undertaker or other person shall bury a hunian body or the ashes thereof which have been brought into the conimonwealth until he has re- ceived s perniit so to do froni the board of health or it sgent appointed to Issue such permita, 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 appointed to have tbe care of the cemetery or burial ground in which tba interment is made .... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners ahall 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 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 laws calla for the observance of the following rules of practice :
(1) Attending phyalciana will certify to sucb deaths only as those of persons to whom they have given bedside care during a last liiness from disease unrelated to any form of injury.
(2) Board of Health phyalolana 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 ia absent from home when the certificate of death Is needed.
(3) Madloal Examiners will Investigate and certify to all dicstha sup- posably due to injury. These Include not only desths caused directly or in- directly hy traumatiam (including resulting septicemia), and hy tbe action of clientical (drugs or poisons), theriual, or electrical agents, aunt deaths following abortion, but also deatha from dlaeasa resulting from Injury or Infeotlon Falated to occupation, the sudden deatha of peraona not disabiad hy recognized dlaease, 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 dylug. e. g., heart fallure, asphyxia, astbenla, etc. As principal cause name tbe 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.
Statamant of Oooupation .- Precise statement of occupation is 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 discase 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 he returned as at school or at boine. For a woman wbose only occupstiou was that of bonie housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
. A
If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
50m-(e)-3-43-11574
was filed with me BEFORE the burial or transit permit was issued : I HEREBY CERTIFY that a satisfactory standard certificate of death Nau-D. Children 9
(Signature of Agent of Board of Health or other) Health Office 2/9/44
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
February
$7
1944
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEMingle
5a If 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. -years
7 IF STILLBORN, enter that fact here.
8
AGE 8
Years.
Months.
Days
If less than 1 day
_Hours.
Minutes
Usual
Occupatio
Electrician
Industry
10 or Business:
Fort Banks
11 Social Security No.
12 BIRTHPLACE (CityEast Boston
(State or country)
Magg
13 NAME OF
FATHER
Jameg Regan
14 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mass
15 MAIDEN NAME
OF MOTHER
Johanna Hurley
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Toledo
Ohio
17 Regan
Si'stop if any
Due to.
Other conditions
arterio Actuario
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Of autopsy
nil done
What test confirmed diagnosis?
Clinical
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify.
(Signed)
(Address) Winterto Mass Date
2/9
M. D.
19.
21
Holy Cross V/ Malden
Place of Burial, Cremation or Removal.
4
(City or Town)
DATE OF BURIAL .....
Feb/ 10/
1944,
/ ____ 19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Received and filed +LL 10 1014 19
(Registrar)
1
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No. 33 ....... Hutchinson St
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.
Registrar's No.
6
St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
William A.Regan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
33 Hutchinson St
St.
(Usual place of abode)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
days.
(If nonresident, give city or town and State)
In this community 8
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
(Month)
(Dayy
(Year)
19 I HEREBY CERTIFY,
That I attended deceased from
Feb. 87
19
44
last
in
„alive on
have occurred on the date stated above, at.
7.35 M.
Duration IMPORTANT
Immediate cause of death.
Coronary Thrombosis
Feb # 1944
Due to ..
arterios elespacio
about 3 yrs.
-
1944
to_
Feb. 87. 1944
d to
Date of.
Informant
(Address)
33 Hutchinson St
3 SEX
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 the name of the deceased, his supposed age, the discase of which he died, defined as re- quired hy 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, Scc. 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 army, navy or marine corps of the United 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 same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty five, forty six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventecn. 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 board of health, or its agent appointed to issue such perinits, 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 tomh to another in the same cemctery, until he has received a permit from the board of health or its agent aforcsaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a niember 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 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 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 deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The hoard 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 deccased, or as 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 perinits, 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 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 only such persons as are supposed to have died by violcucc. 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 deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deathis only as those of persons who, though disabled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatisin (including resulting septicemia), 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 occupation, 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 conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is 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 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, how- ever, designate the occupation hy the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
Suffolk
(County)
Winthrop
(City or Town)
No. 26 Bates Ave.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be Gled for burial permit with Board of Health or its Agent. 35
Registered No
§ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Joseph Couilliard
(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)
years
months
days.
(If nonresident, give city or town and state)
In this community 36 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
OF DIVORCED Divorced
Sa If married, widowed, or divorced ude Barteaux
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
7 IF STILLBORN, enter that fact here.
8 80
AGE
Years
5. Months.
16 Days
If less than 1 day
Hours
.Minutes
9 Occupation :
Eléctricali
Inspector
Industry
Fire Insurance Co. (Retire
10 or Business :.
None
11 Social Security No.
12 BIRTHPLACE (City).
Newburyport
(State or country) Mas's .
Corrected PARENTS
13 NAME OF
FATHER
John H Couilliard
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Unable to obtain
15 MAIDEN NAME
OF MOTHER
Cora ( Unknown)
16 BIRTHPLACE OF
Unable to Obtain
MOTHER (City) ..... (State or country)
17
Cora Couilliard
Relation, If any Daughter)
Informant. (Address) 26 Bates Ave. Winthrop
I HEREBY CERTIFY that a satisfactory etandard certificate of death was filed with me BEFORE the burial or traneit permit was issued: Nm. D. Clubduer
(Signature of Agent of Board of Health or other)
realiti Ativer 2/12/44
(Official Designation) V (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
February
89 1944
(Month)
(Day) /
(Year)
19 OI HEREBY CERTIFY. prime 10, 1941 to
That I attended deceased from
1944
last saw h m alive on
6
19.44, death is said to
have occurred on the date stated above, at. Immediate cause of death.
645Am.
Duration
Dansto.
Brancho - pneumonia
3 des
7
Other conditions Cerebral Hemorrhage (Include pregnancy within 3 months of death)
2 yrs 8 mm IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- [tistically.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify ... .......
(Signed) Louis 7. Valerio
M. D.
(Address)
175 Plansmy Pt
Date 2/9
19.9.4
21 Waterside
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL ..
Febuary
12
19.
22 NAME OF FUNERAL DIRECTOR. Howard S Rumolds
ADDRESS.
Winthrop Mars
Received and filed 19
(Registrar)
100m-2-'40-D-729-a
CAUSE OF DEATH in plain terins, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificato.
1
PLACE OF DEATH
5/24/44
6 Age of husband or wife if alive.
Ueual
Due to.
Major findings: Of operations.
Date of.
Of autopsy.
What test confirmed diagnosis ?.
Marblehead
44
(If U. S.
War Veteran,
specify WAR)
......
26
Bates Ave .
St
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shail forthwitb, after the death of a person whom he lias 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 the name of the deceased, bis supposed age, the disease of which be died, defined as required by section one, where same was contracted, the duration of his last illness, wben last seen alive by the physician or officer and the date of bis deatb . . . 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 buman 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 anotber, or from one grave or tomb other than the receiv- ing tomb to another in the same cemetery, until be 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 sball be issued until there sball 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, 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 tbe attending physician. If death is caused by violence, the medical examiner shall make sucb certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enougb for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removai 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 bours after such removal, unless a permit in the usual form for the re- moval of such body has been sooner obtained hereunder. If the deatb certificate contains a recital, as required by section ten of chapter forty- six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital sball 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 shail 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 ashes thereof which have been brought into the commonwealth until 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 clerk of the town wbere 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 burial ground in which 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 tbe observance of tbe following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is aosent from home when the certificate of death is needed.
(3) 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 septicemia), and by the action of chemical (drugs or poisons), thermai, 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 discase, 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 conditions, if any, related to the principal cause and any important complication of the principai cause.
Statement of Occupation .- Precise statement of occupation is very important, 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 cbanged 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 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, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
PLACE OF DEATH
Suffolk (County)
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.
Registered No
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
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