USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 27
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by section ten of chapter forty-six, that the deccased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such 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 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 may require .- Chap. 114, Scc. 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 sucb 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 cemetcry 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 dicd 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 forin 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 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 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, aspbyxia, asthenia, etc. As principal causc 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
-
·
RM R-301 1
1 PLACE OF DEATH 3 SEX female 8 80 Usual PARENTS Informant. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of is very important. See instructions and extracts from the laws on back of certificate. 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 10 or Business: 200m-10-'39. No. 8427-d
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
82
Registered No.
(If death occurred in a hospital or institution,
No Winthrop Community Hospital St. give its NAME instead of street and number)
2 FULL NAME.
Mary E. McCarthy
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No ...
3.16
Pleasant .... s.t
St.
(Usual place of abode)
1.ength of stay : In hospital or institution
(Specify whether)
years
months
I
days.
In this community IO
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
AGE
Years
Months.
Days
If less than I day
Hours.
Minutos
9 Occupation:
Retired
Industry
Dressmaker
11 Social Security No.
12 BIRTHPLACE (City)
Boston
(State or country)
Masg
13 NAME OF
FATHER
Timothy McCarthy
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Katherine Crowley
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Geraldine Halligan
Relation, if any Niece
(Address)
316 Pleasant st
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued; Wa. S. Childress 8
(Signature of Agent of Board of Health or other)
/health Officer 4/13/44 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
12
1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY, That I attended deceased from
19.5 .. 5., to .............
192.x.
I last saw ha ... alive on ....
19.5.5 .. , death is said
to have occurred on the date stated above, at .... 3.124.m.
Immediate cause of death Separation
ritiene
Duration 6 mg
....
...
....
Due to .....
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
...
Of autopsy
What test confirmed diagnosis?
Chemical
20 Was disease or Injury in any way related to occupation af deceased ? 200
If so, specify.
M. D.
(Signed).
(Address) 148 h-UtpSt.
Date ..
4/12 19 44
Malden
21
Holy Cross
Place of Burial, Cremation
DATE OF BURIAL
Afrin
or Removal. (City or Town)
19
22 NAME OF
FUNERAL DIRECTOR
Tobe JTE maler
Winthrop
ADDRESS
Received and filed.
...........
APR 17-1944
19
A TRUE COPY ATTEST:
(Registrar)
...
Due to
Cmstrophic Lateral Salen
Date of.
......-
Underline the cause to which death should be charged sta- tistically.
...
War Veteran.
specify WAR)
(If nonresident, give city or town and state)
.....
12
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 undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No 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 canuot 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 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.)
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 deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .-- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .-- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits 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 none.
SPACE FOR ADDITIONAL INFORMATION
RM R-302
1
PLACE OF DEATH
( SUFFOLK (County) BOSTON
1
(City or Town)
Mass. Eye & Ear Infirmary
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BONTON
(City or town making return) 83
Registered No.
3693
(If death occurred in a hospital or institution,
St.
¿ give its NAME instead of street and number)
John L. Gleason
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
2.2 .... Loring ... Rd
St. ... Winthrop
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
years
month&
days.
In this community
yrs.
mos.
2
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
April 13, 1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
4/12/44
19
to.
4/13/44
19
....
I last saw h.
im
.alive on.
4/13/44
19.
death Is sald to
have occurred on the date stated above, at
9:45 p.
m.
Duration
Immediate cause of death
Post-hemorrhagic shock
3 days
Due to
Nasal hemorrhago
3 days
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations.
Date of
should be
·
charged sta-
tistically.
What test confirmed diagnosis ?.
20 Was disease or Injury in any way related to oooupation of deceased ?. n.Q.
If so, specify
A. Roopenian
(Signed)
(Address)
Mass. Eye & Ear Inf.
Date
4/14/1
21 PLACE OF BURIAL, Evergreen, Boston, Mass.
CREMATION OR REMOVAL.
49/17 /24
DATE OF BURIAL
(City or Town)
19
22 NAME OF
H. S. Reynolds
FUNERAL DIRECTOR
ADDRESS
Winthrop Mass.
Received and filed
MAY 1 0 1944
19
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased PARENTS
2 FULL NAME
3 SEX
M
(or) WIFE of
14 BIRTHPLACE OF
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk
(State or country)
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Agnes Davis
(Husband's name in full)
6 Age of husband or wife if alive
55
years
7 IF STILLBORN, enter that fact here.
8 AGE ... 7.2 ..... Years .. .. 2. Months. .9 .... Days
If less than 1 day Hours. ...... Minutes
Usual
9 Occupation :
Electrical .... engineer.
Industry
10 or Business :
Mfg ..... Electrical ... Equip.
Il Social Security No ..... 022-12-8388
12 BIRTHPLACE (City)
(State or country)
Plymouth, Mass.
13 NAME OF
FATHER
John G. Gleason
FATHER (City)
Plymouth, Mas's.
15 MAIDEN NAME
OF MOTHER
Unable to obtain
3
17 D. Gleason
Relation, if any
Informant
(Address)
Lexington, Mass.
Son
A TRUE COPY.
ATTEST:
(Registrar of city or towy where death occurred)
DATE FILED
4/20/44
......... 19
Underline the cause to which death
Of autopsy
That
¿ attended deceased from
(If U. S.
War Veteran,
specify WAR)
no
(Usual place of abode)
No.
R-303-A
7 Sulfitt (County)
notified 5/10/14
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 84
Registered No.
St. { ( If death occurred in a hospital or Institution, { give its NAME instead of street and number) 7
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
69 Cooledan St. Brookline
(Usual place of abode)
Length of stay : In hospital or Institution ...
( Before death)
(Specify whether)
years
4
months
days.
In this community 6 0 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE!
00
5 SINGLE
(write the word)
wichen
MARRIED
WIDOWED
or DIVORCED
Sa If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
Jim de maiden name of wie in fully
(Husband's name in full)
6 Age of husband or wife If alive years
7 IF STILLBORN, enter that fact here.
8 AGE. 83 Years. Months. Days
If less than 1 day
Hours.
Minutes
at Home
none
11 Social Security No.
pane
12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
Cornelis Buckley
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ruland
15 MAIDEN NAME
OF MOTHER
Elizabeth Innehan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Leland
17 mem latter.
Informant
( tildress) 69 ecolidye St. Bienkline
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : APR 1 6 1944
(Signature of Agent of Board of Health or other) 5/91
MATH DEPL.
(Official Designation) (Date of Issue of Permit)
1
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april
-14 -
1944
(Month)
(Day)
(Weaf)
19 | HEREBY CERTIFY that i have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Broncho neu nunca. Fractures MORE Tibia & RT Fibula: Fract. Delvis 1
20 Accident, sulolde, or homlolde (specify).
accidental
Date of ooourrenoe.
Dec-23-
1943
Where did
Brookline
Injury occur ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In pubilo
place?
Street
(Specify type of place)
Manner of Said To have been injured Gy an
Injury
Nature of
auto at Brookline Des-23-1943
Injury
While at work?
Was there an autopsy ?.
200
21 Was disease or Injury in any way related to ocoupation of deceased ? 2
if so, specify
(Signed)
M. D.
(Address)
22
St. Joseph's Cemetery Baston
Place of (Burial, Cremation or Removal.
(City or Town)
-
day matter if any
DATE OF BURIAL
april 17- 44
19
23 NAME OF
Mary 4 mº manue
FUNERAL DIRECTOR.
54 Harvard st. Brookline
Received and filed. APR 2-0-1944 19
(Registrar)
1
11
50m (g)-1-41-4667
1
3 SEX
7
Usual
9 Occupation :
PARENTS
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effeot
extracts from the laws relative to the return of certificates of death.
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for
Industry
10 or Business :
r PLACE OF DEATH
(City or Town) Northrop Community Hospital
No. mary Howard
PHYSICIAN-IMPORTANT (was deceased a U. S. War Veteran, If so specify WAR)
St.
(If nonresident, give city or town and State)
ADDRESS
email-14
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 otter authorized person or of any meinber of the family of the deceased, furnish for registration a standard certificate of deatlı, 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 saine 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.
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 inarine 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 iminediate 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 ex- pedition and the l'hilippine insurrection, which shall, for said purposes, be deemed to liave taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. 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 perinit 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 exhumne a human body and remove it from a town, from one cemetery to another, or from oue 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 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 hoard 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 medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such removal shall constitute & 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 re- moval, 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 certlocate, shall forthwith countersign it and transmit It to the clerk of the town for regla- tration. The person to whom the permit Is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceasedl, or as to the manner or cause of the death, which the clerk or reglatrar may re- quire .- 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 hoard, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a per- son appointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
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