USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 21
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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 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).
Medical examiners shall make examination upon the view of the dcad bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . - Gencral 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 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 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 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
PLACE OF DEATH
Suffolk (County)
1
1
Winthrop
(City or Town)
No. 34 Sunnyside Ave
St.
§ (If death occurred in a hospital or institution,
give its NAME instead of street and number)
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a)
Residence. No.
34 Sunnyside Ave
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
days.
In this community 54 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED idowed
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of Joseph J. Cyr
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
8 AGE82 Years Months. Days
If less than 1 day
Hours ._._.
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business:
Own Home
11 Social Security No. .
Lowell
12 BIRTHPLACE (City)
(State or country)
Massachusetts
13 NAME OF
FATHER
Cyprian Paquette
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
15 MAIDEN NAME
OF MOTHER
Assisian Gregoire
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
17
Francis Cyr
Relation, if any Son
Informant (Address) 54 Sunnyside Ave Winthrop
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death
(Signature of Agent of Board of Health or other)
13/16/44
7(Official Designation) (Date of Issue of Permit;
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March
15 1944 (Year)
19
HEREBY CERTIFY
That I attended deceased from
September 1, 1942.
to
March 14, 1944
I last saw h.
alive on March 14, 1944 death is said to
have occurred on the date stated above, at 12 mont
Immediate cause of death
Codice Decompensation
Duration IMPORTANT 1943
1925
1900
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 ? ho If so, specify.
(Signed)
Thomas S. Wallace
., M. D.
(Address) 234 Back Dt. Recuerdate Mendo15 19665
21 Winthrop Cem Winthrop
Place of Burial, Cremation or Removal.
March 18
(City or Town)
44
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop Mass.
Yohow to Oulaley
Received and filed RAP 27 1341 19
(Registrar)
50m-(e)-3-43-11574
Due to __
Chovice Myocarditis
Due to
Bhumstudent
Disease
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
PARENTS
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filled for burial permit with Board of Health or its Agent.
Registrar's No. 61
2 FULL NAME
Rosanna Paquette Cyr
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Month)
(Day)
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 belicf the nainc of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, whcre same was contracted, the duration of his last illness, when last scen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deccased, to the best of his knowledge and helief, 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 onc 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 seventeen. G. L. Chap. 46, See. 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 permits, or if there is no such hoard, 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 hody is buried. No such permit shall be issued until there shall have heen 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 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 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, 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 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 cansc 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 or cause of the death, which the clerk or registrar inay 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 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).
Medical examiners shall makc examination upon the view of the dead hodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body 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 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 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 ahortion, 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 discase, or complication which causes deatlı, not the mode of dying, e. g., heart failure, asphyxia, asthenia, ctc. 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 he 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 deatlı, 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
Suffolk. (County)
Weiterap (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
62
(If death occurred in a hospital or institution, No Muntherap Community Corpo
St. 1 give its NAME instead of street and number)
2 FULL NAME
Mary E. Hallow
(If U. S. War Veteran. specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.) No. 235 Share Drive
(a) Residence.
(Usual place of abode)
Length of stay: In hospital or institution (Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OF RAGE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divorced
(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, onter that fact here.
8 70 ÅGE Years. Months. Days
If less than I day
Hours.
Minutes
touse work.
at home
II Social Security No. none
12 BIRTHPLACE (City)
Brookline
(State or country)
Omar
13 NAME OF
FATHER
John Jeallon
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Campbel
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Dreland.
17 Mrs Whatifany In Relation, if any (Address) .... )
Informant (Address) 110 Ground St Broohome
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Reall Spice
(Signature of Agent ef Board of Health with or other 3/12/44 (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
(Month)
22
(Day)
19471
(Year)
19 | HEREBY CERTIFY, That I attended deceased from mar 17 1944, ... mar 22 19 ......
I last saw h ........ alive on ..... Bez 22 19 ...... , death is said to have occurred on the date stated above, at 9:50Am. Immediate cause of death ... hamna
Duration 5 days
Due to
Ch. Hypotenuse Heart Quem
Due to
Cartório activação.
Other conditions
.....
(Include pregnancy within 3 months of death)
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? 220
If so, specify.
M. D.
(Signed)
148 mity of phy Date 0/22
19 4%
Dinge 21 Holywood Cemetery Brookline Place of Burial, Cremation or Removal DATE OF BURIAL a march 2057 () 1944 or Town)
22 NAME OF FUNERAL DIRECTOR ADDRESS 27 Harvard HiBrooklin
Received and filed. MAR 27 1944
....
1.19
A TRUE COPY ATTEST:
(Registrar)
200m-10-'39. No. 8427-d
(Official Designationy
Major findings :
Of operations
Date of ..
Of autopsy
What test confirmed diagnosis? Chemical
1 PLACE OF DEATH 3 SEX Female HUSBAND of Usual 9 Occupation: PARENTS 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. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry IO or Business:
(write the word)
18 DATE OF
DEATH
mar
mg
St. Ninthrap
(If nonresident, give city or town and state)
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- tration 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 officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No nndertaker 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 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 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 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 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 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 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 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 heaith 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 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 the observ- 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 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.
(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 septice- mia), 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 deathis of persons not disabled by recognized disease, and those of persons found doad.
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 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 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, etc. For a person who had no occupation whatever write nons.
SPACE FOR ADDITIONAL INFORMATION
IR-305
Middlesex
(County)
Melrose
(City or Town)
Melrose Hospital
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Melrose (City or town making return)
Registered No.
63
No. St. (If death occurred in a hospital or institution, give its NAME instead of street and number) /
2 FULL NAME
Nellie F. Klagge
(Mallows)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe.
No.
Winthrop Arms
St.
inthrop
(If nonresident, give city or town and State)
(Usual place of abode)
Hospital
years
months
days.
In this community
yrs.
mos.
daye.
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE)
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Henry Frederi
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If alive yearsı
7 IF STILLBORN, enter that faot here.
8 AGE.72 .Years ....
Months.
6
Days
If less than 1 day Hours. ........ Minutes
Usual
9 Oocupatlon :
At home
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
East Boston, Mass.
13 NAME OF
FATHER
Samuel Mallows
PARENTS
14 BIRTHPLACE OF
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