USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 15
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(2) Board of Health physicians will certify to sueh 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 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 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 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 eause 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 .- Precisc statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this scetion for every person aged 10 years or over. If the occupation had heen given up or changed on account of the discase 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 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
Suffolk
............
(County) Winthrop
(City or Town) /
No. 86
Thuson Michael + Kelly
2 FULL NAME
( if deceased is a married, widowed, or divorced woman, give zloo' maiden name.)
86 Arhuson Ave
(a) Residence. No.
(Usual place of abode)
no.
years
months
days.
(if nonresident, give city or town and State)
In this community 5 yrs.
m08.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
male white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
Widowed
Sa If married, widowed, or divorced ME to theart HUSBAND of
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive ·leccese years
> IF STILLBORN. enter that fact here.
8
AGE D
Years
9
Months
5
Days
If less than 1 day Hours Minutes Due to
Undertaker & Funeral Director
Funeral Service
11 Social Security No.
12 BIRTHPLACE (City)
(Siate or country)
Maine
13 NAME OF
FATHER
Film A. Kelly
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Deland
15 MAIDEN NAME
OF MOTHER
Matilda Doyle
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 John C. Kelly Relation, if any
1st Andrews Pil, 4, 15.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with ma BEFORE the burlai or transit permit was Issued : Wm Alehelden
(Signature of CECT
for Board of Health or other) 2/18/44
(Omcial Designation) (Date of Issue of Permic)
18 DATE OF
DEATH
(Month)
16 1944
(Day)
(Year)
19 | HEREBY CERTIFY,
1943.
Ło ..
Feb 16
1988
I last saw h. brand alive on
Feb 16, 1944.
death Is said to
have occurred on tha date stated above, a
8P
m.
Duration .
Immediate oause of death. Prancha. Precisponia
IMPORTANT
5 days
Due to.
arteriosclerosis
Other conditions.
( include pregnancy within 3 months of death)
IMPORTANT
Major findIngs:
Of operations.
Date of
Of autopsy
What test confirmed diagnosis ?
Physician Underline the cause to which death should ba charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased? OFC
If so, specify.
theles, o' Regan
(Signed)
.... M. D.
(Address) 670 La
Jucatogas Date 2/17 1944
21
Place of Burial, Cremation or Removal.
DATE OF BURIAL february
19
1944
John G. Kelly
22 NAME OF
FUNERAL DIRECTOR.
ADDRESS
11 Meclilian St., 2013.
Reoaived and Aled FER 19 1914 19
( Registrar)
100M-€ - 2-42-8855
1 3 SEX Usual 9 Occupation : PARENTS Informant. ( Address} If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a recital to that effsot. terms, so that it may be property classified. Exact statement of decorATION is very important. See instructions and Industry 10 or Business : extracts from the laws on back of certificate.
PLACE OF DEATH
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. 42
Registered No.
( If death occurred in a hospital or Institution, St. [ give its NAME instead of street and auniber)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
no.
if so spoolfy WAR)
"Winthe
St.
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
That i attended deceased from
(Give maiden name of wife in full)
....
(City or Town)
.....
Are
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whoin he has attewled during his last illnesa, 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 disease of which he died. defined as re- quired by section one. where same was contracted. the duration of his last Illness, when faat seen alive by the physician or officer and the date of bis death ... Gen. Lawa, Chap. 46, Sec. 9.
A' physician or officer furnishing a certificate of death ae required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served In the ariny. 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, and shall also certify in such certificate both the primary and the secondary or iinmediate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this eection, such physician or officer shall forfeit ten dollars. For the purposes of thia sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one huwired 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-eiglit and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chiap. 46, Sec. 10.
No undertakar 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 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 ahalf 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 fn 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 internient, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate as hiereinafter 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 physl- 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 examfier chall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within the conunonwealth 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 fiermit 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-eix, 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 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 la so given and the physician certifying the cause of death shall thereafter furnish for registration any other veces sary information which can be obtained as to the deceased, or as to the mauler 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 hoard of health or its agem appointed to issue such permite, or if there is no such hoard, from the clerk of the town where the boxly is to be buried or the funeral is to he held, or from a person apointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114. Sec. 46. C. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of oply 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 hody lies aud take charge of the same; ... - General Laws, Chap. 38, Suc. 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 Illness from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deathe 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 phyaf- cfan is ahsent from home when the certificate of death la needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism (Including resulting septfcemfa), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseasa resulting from injury or Infeotlon 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 causea death, not the mole of dying, e. g., hrart failure, asphyxia, sethenla, etc. Aa principal cause name the disease caualng death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any Important complication of the principal cause.
Statement of Oooupatlon .- Precise statement of occupation ia very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 yeara 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 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 waa that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301
Suffolk
(County)
Winthrop
1
....
PLACE OF DEATH
3 SEX
4 COLOR OR RACE
White
Male
5a If married, widowedy or divorced.
(or) WIFE of
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
8
Usual
9 Occupation:
Machinist
10 or Business:
Dover
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
Unknown
15 MAIDEN NAME
OF MOTHER
Alta (?)
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
Unknown
(State or country)
Ireland
17
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
CAUSE OF DEATH in plain 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.
N. B .- WRITE PLAINLY, WITH UNTADING DLACH HA-PAID IN A PERMANENT RECORD. Every Item of
(State or country)
Ireland
200m-10-'39. No. 8427-d
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
HUSBAND of
ictoria ... McDonald
(Give maiden name of wife in full)
(Husband's name in full)
47
Years
AGE
5.6 .... Years
1
Months.1.2 ... Days
If less than I day
Hours
.. Minutes
Industry
W. P. Morse Co.
11 Social Security No.
021-05-6478
12 BIRTHPLACE (City)
(State or country)
New Hampshire
Martin Galligan
Informant.
Victoria ..... Galligan ... (
wife
(Address)
269 Lexington St., E. Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
William D. Children
(Signature of Agent of Board of Health or other)
agent
Freb 18/44
(Official Designation)
(Date of Issue of Dermit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
February
17
(Month)
(Day)
1944
(Year)
19
725.14
19 ........ ,
to.
CERTIFY , That I attended deceased from
I last saw h .......... alive on
244.17
to have occurred on the date stated above, at. 130 P. .בת .....
Duration
Immedime cause of death ..
Ceux Culum Elena
... 1 Day
Due to
Santral Hemmelige
5 Days
Due to
Kyperfusion
?
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?..
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to eccopation of deceased ?
If so, specify .......
Henry. H. Schwartz
(Address).
(Signed)
19 Ppunta St.
Date 717
M. D.
1984
21
Pine Hill
Dover New Hampshire
...
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL.
February/2,
19
4.4
22 NAME OF
FUNERAL DIRECTOR
ADDRESS 300 Meridian St. E. Boston
Received and filed. 19
(City or town making return)
Registered No
4.3
S
(If death occurred in a hospital or institution,
No St. give its NAME instead of street and number) -
2 FULL NAME
William Galligan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 269.Lexington .. Street ....... .St. East .. Boston, .. Mass.
(If nonresident, give city or town and state)
mos.
days.
(Usual place of abode)
.ength of stay: In hospital or institution
(Specify whether)
years
months
days.
In this community20
yrs.
PERSONAL AND STATISTICAL PARTICULARS
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or Town)
Winthrop Community Hospital
......
(If U. S.
war Veteran.
specify WAR)
£7.17
19.yy
.........
doath is said
A TRUE COPY ATTEST:D 1 9 1944
(Registrar)
Relation, if any
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered bospltal medleal 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- tration a standard certificate of death, stating to the best of his knowledge and belief the natne of the deceased, his supposed age, the disease of which he died, defined as required 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, Sec. 9.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been huried, 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 tomh other than the receiving tomh 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 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 he returned and recorded, which shall be accompanied, in case of an original interment, hy 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 physician who is a member of the board of health, or employed hy 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 hy 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 early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a 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 hody 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 arniy, 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 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 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 clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall hury 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 where the hody 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, Seo. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ohserv- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside 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.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septice- mia), and hy 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 ocenpa- tion, the sudden deathis 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 morhid 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 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 had retired from husi- 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 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
M R-301 1
1
PLACE OF DEATH
2 FULL NAME
3 SEX
F
4 COLOR OR RACE
White
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
64
AGE
Years.
3
Months.
15 Days
Usual
9 Occupation:
Teacher
Industry
10 or Business:
11 Social Security No.
NONE
12 BIRTHPLACE (City)
Boston
(State or country ganges.
13 NAME QF
albert
14 BIRTHPLACE OF
FATHER (City)
...
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
is very important. See instructions and extracts from the laws on back of certificate.
N. B .- WRITE PLAINLY, WITH UNTADING BLACK INA-THIS IS A PERMANENT RECORD. Every item of
(State or country)
England
200m-10-'39. No. 8427-d
5 SINGLE
MARRIED
WIDOWED
or DIVORCED4
(write the word)
DEATH
..
Divorced
5a If married, widowed, or divorced
HUSBAND of
allergie oiden to do mell
(or) WIFE of
Cuercon
(Husband's name in full)
65
years
If less than 1 day
.Hours ....
Minutes
FATHER
Mortimer Mardin
7
15 MAIDEN NAME
OF MOTHER
mary . Trazer
17 E allan Small
RGation, if any
Informant.
(Address) 78 Manchester Rd Newton highlands
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Www.D. Children
(Signature of Ment of Board of Health or other)
2/19/44
Realthe Office (Official Designation) (Date of Issue of Permix)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
(Month)
(Day)
18
1944
(Year)
19 | HEREBY CERTIFY. That I attended deceased from
19 44/ 10.
1944
I last saw haIn alive on ..
700-18
19 .. 6.44, death is said
to have occurred on the date stated above, at ..
7.15Pm
Duration
Immediate cause of death ...
Cholamin
3 ans
Due to
...
Subtured Gall bladder
Due to
Chalabichiamo
15 yrs
Other conditions
Hyper tensen + Ellosesta
(Include pregnancy within 3 months of death)
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