USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 29
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No undertaker or other person shall bury a human body or the ashes thercof 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, Scc. 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 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 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
M R-305
SUFFOLK
(County) SOSTON
(City or Town)
Ma.s.s ..... Gen ..... Hospital
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
KOSTOK
(City or town making return)
Registered No.
3992
§ (If death occurred in a hospital or Institution, [ give its NAME instead of street and number)
John William Henderson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
(Usual place of abode)
39
Irvin ... S.t.
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ...
(Before death)
Hosp
years
months
7
days.
In this community
8 yrs.
mos.
days.
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
April 23 1944
(Month)
(Day)
(Year)
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.) Ruptured aneurisma basilar
Cerebralartery
Subdural hemorrhage
20 Accident, sulolde, or homlolde (specify)
Date of occurrence.
19
Where did Injury occur ?
(City or town and State)
Did Injury occur In or about the home, on farm, In Industrial place, or In publlo place ? (Specify type of place)
Manner of Found collapsed on street at
Injury
Nature of
Winthrop Apr 15, 1944
Injury
While at work ?.
Was there an autopsy?
Yes
21 Was dlsease or Injury In any way related to occupation of deceased ?
If so, specify.
(Signed)
Wm. J. Brickley , M. D.
M. D.
(Address)
Boston., .... Mas.a.
Date.
4/24/44
22
Fairview, Boston, Mass.
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
April 27, 1944
19
23 NAME OF
FUNERAL DIRECTOR
H S. Reynolds
ADDRESS
Winthrop, Mass.
Received and filed
MAY 1 0 1944
19
(Registrar of City or Town where deceased resided)
=
1 V
5 SINGLE
(write the word)
W
MARRIED
WIDOWED
or DIVORCEDSingle
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 40Years .... 3 ... Mon 15
Days
If less than 1 day Hours. Minutes
Industry
10 or Business :
none
11 Social Security No. 014-18-2619
12 BIRTHPLACE (City)
(State or country)
Now Haven, Conn.
13 NAME OF
FATHER
Robert Henderson
England
15 MAIDEN NAME
OF MOTHER
Mary Haveron
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informant. (Address)
Relation, if any
"Mother ..... )
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
April 28, 1944
V
No. 2 FULL NAME 3 SEX M Usual 9 Occupation : 14 BIRTHPLACE OF FATHER (City) PARENTS resided in another city or town at the time of death should be made forthwith and transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) Copies of Ieturis of deathis recorded during the previous Hotel WHICH OCCUIICH All youI CILy VI LOWII III COSE WIC UCUCEDCO (State or country)
25m (h)-1-41-4667
PLACE OF DEATH
1
St.
(If U. S.
War Veteran,
specify WAR)
no
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
None
e
R-301 A
1
PLACE OF DEATH No.
Suffolk (County)
Winthrop (Chy or Town) 151 Pleasant
The Commonturalth 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.
89
( ( If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
2 FULL NAME Adelaide Augusta (Weltsch) Murray
(If deceased is a married, widow or divorced woman, give also maiden name.)
(a) Residence.
No.
26 Billows
(Usual place of abode)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
days.
In this community 30 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
William Hen Murray
( Insband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN. enter that fact here.
AGE
8
77 Years.
700
Months
18
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
Own home
11 Social Security No.
None
Cambridge
12 BIRTHPLACE (City)
(State or country)
Mass
13 NAME OF
FATHER
Henry T. Weltsch
14 BIRTHPLACE OF
FATHER (City)
Cambridge
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Caroline A. Stevens
16 BIRTHPLACE OF
MOTHERP(City)
Cambridge
(State or country)
Mass,
(Signed)
M. D.
(Address) Winthrop Man Date April 21944
21 Cambridge Com, Cambridge, Mass
l'lace of Burial, Cremation of Removal.
(City or Town)
19/14
22 NAME OF
Laville - Kimball
FUNERAL DIRECTOR
ADDRESS
418 Mars ave Olangter mars
19
/(Official Designation ) (Date of Issue of PermitY
18 DATE OF
(Month )
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
august 15
19 42 to.
April 25
...
1944
I last saw h ... e ........... alive on
April25
., 19 ..
.. , death Is sald to
have occurred on the date stated above, at.
1.37P.
m.
Duration
Immediate cause of death.
Rheumatic Heart Disease
IMPORTANT
(Endocarditis ) (Chronic)
......... 5 years
Que to
Due to.
Other conditions.
-
20000
(Include preguancy within 3 months of death)
IMPORTANT
Physician
Major findings :
Of operations
-20000
Date of.
l'inderline the cause to which death -livull be
Of autopsy.
200ml
What test confirmed diagnosis ?.
Clinical Sigas
charged sta- istically.
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify.
tamil 1O Brien
17 Mrs Wyman Smart Relation if any DATE OF BURIAL Apr. 26
Informant
27 Kembyto Rd, Andingthe Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : Neu: D. Audrey
Health Muck
(Signature of Agent of Board of Herth or other) 14/26/44
Received and filed.
MAY 2 1944
(Registrar)
100m (d)-1-41-4667
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS extracts from the laws on back of certificate.
Registered No.
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
St.
(If nonresident, give city or town and State)
(write the word) DEATH april 25 1944
MEDICAL CERTIFICATE OF DEATH
...
10 or Business :
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness. at the renoesi of an undertaker or other authorized person or of anv mirother of the fancily of the deceased, furnish for registration a standard certificate of death. stating to the best of his knowledge aml belief the name of the deceased, hi- supposed age, the disease of which he died. defined as re- quired by sretion 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.
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 foor- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army. navy or toarine 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 all 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 iuclmle 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.eight and .luly fourth. nineteen hundred and two, and the Mexi- can horder 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 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 Que 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 he issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statentent containing the facts required by law to he 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 niake the certificate re- quired of the attending physiciao. If death is caused by violence, the me li- 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 ahove 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 forin for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
hy section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the I'nited States in any war In which It has hren engaged. such recital shall appear upon the permit. The board of health, or its agent. upon receipt of soch 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 manber or canse of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bory a human hody or the ashes thereof which have been brought into the coolmonwealth ontil 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 person apointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114. Src. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only sneh 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 physiclans 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 physi- cian is alsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate aod certify to all deatha sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical ( drugs or poisons), thermal, or electrical agents, aml deatha 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 .- Callse 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 naine 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- portaut, 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. teport 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 honce 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-303-A
1
PLACE OF DEATH
Salluck (County )
The Somnantucalth 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.
90
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, gives also maiden name.)
(a) Residence. No.
31 Buckavon St. Wwatters St.
(Usual place of abode)
(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
уга.
5
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE|
male Mate
5 SINGLE
(write the word)
MARRIED)
WIDOWED
DIVORCED dound
If marrie HUSBAND of
2. divortul E. Berner
(Give maiden game of wife in full)
(or) WIFE of
( Ilusband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 63 Years Months. Days
If less than 1 day Hours ...... Minutes
Usual 9 Occupation :
Industry
Bertin & maine R. R.
10 or Business :
11 Social Security
Comme te Leturned
12 BIRTHPLACE (City)
(State or country)
masa
13 NAME OF
FATHER
Frank . Backer
14 BIRTHPLACE OF
Portland
FATHER (City)
(State or country)
maine
......
15 MAIDEN NAME
OF MOTHER
minima Hayes
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Baterb
masa
17 Dorothy Salipenses
( Address) 163 mangel 1 2
I HEREBY CERTIFY, that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : WMED.Childrlexx (Signature of Agent of Board of Health or other)
Wealth Offices 5/1/44
(Official Designation) (Date of Issue of Permit)'
20 Acoldent, suicide, or homlolde (specify)
Date of ocourrenoe.
19
Where did
Injury occur ?
(City or town and State)
Did Injury ooour In or about home, on farm, in industrial place, or in publio
place ?
(Specify type of place)
Manner of
Injury'
der Supertivation
Nature of Injury
While at work ?.
Was there an autopsy ?.
yes
21 Was disease or Injury in any way related to ocoupation of deceased ?
If so, specify.
IK Sueckler
M. D.
(Signed)
aespañ 24-1914
22
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
may
2
19 44
23 NAME OF
FUNERAL DIRECTOR
Frederick Smugnach
ADDRESS
Eat
Bot
Received and filed
MAY 2
1944
19
(Registrar)
so that it may be properly classified under the International Classification of Causes of Death. Sce reverse side for
extracts from the laws relative to the return of certificates of death.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect
50m (g)-1-41-4667
No.
(City of Town ) 71 Buchanon St. 111 Charles arthur Backer
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
none
18 DATE OF
DEATH
abril - 29 -1944
(Mfonth )
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER. thereof .
Kruhses & helt Caroled Gestern
Several arterio Perosis
Supervisor
PARENTS
(Address)
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 naine 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 hy 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 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 prinmary 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 ex- pedition 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 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 hody which has not been buried, until he lias 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 front one grave or tomh other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of healthi or its agent aforesaid or from the clerk of the town where the body is buried. No such perinit 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 he 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 pliysician, 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 hy 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 hody. 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 a permit for such removal; provided, that such body shall he 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 tlie removal of such hody has heen sooner obtained hereunder. If the death certificate contains a recital, as required hy 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
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