USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 3
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What test confirmed diagnosis?
Duration
1
(If U. S.
War Veteran.
specify WAR)
(a) Residence. No ....
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
S
No. Winthrop Community Hospital
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwitb, after the death of a person whom be has attended during his last illness, at the request of an undertaker or otber authorized person or of any member of the family of the deceased, furnish for regis- tratlon a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, bis supposed age, the disease of which he died, defined as required hy section one, wbere same was contracted, the duration of bis last illness, wben last seen alive by the physician or officer and the date of bis deatb ... Gen. Lawe, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove therefrom a human hody wbicb bas not been buried, until be has received a permit from the board of bealth or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person dicd ; and no undertaker or other person shall exhume a buman body and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving tomb to another in the same cemetery, until be has received a permit from the board of bealth 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 sucb 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 npon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- incr sball 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 he obtained early cnough for the purpose, the certificate of death made as above provided and in the possession of the undertaker deslring to make such a removal shall constitute a permit for sucb 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 bas been sooner ohtained bereunder. If tbe 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 it has been engaged, sucb recital shall appcar upon the permit. The hoard of bealth, or its agent, upon receipt of such statement and certificatc, 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- nisb 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 .- Chop. 114, Sec. 45. G. L., (Tercentenary Edition.)
No undertaker or other person shall bury a bumnan 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 cler' of the town where the body is to he huried 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 tbose of persons to whom they have given hedside care during a last ill- ness from discase unrelated to any form of injury.
(2) Board of llealth physicians will certify to sucb deaths only as those of persons who, though disabled hy recognized disease un- related to any form of injury, have died without recent medical attendance or wbose physician is ahsent from bome when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths Anpposably 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 deatbs from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized discase, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., beart failure, aspbyxia, 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 .- Precisc statement of occupation is very important, so that the relative bealthfulness 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 bad 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 bome housework, write housework. For a person engaged in domestic service for wages, bowcver, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
1
Winthrop
(City or Town)
(Usual place of abode )
3 SEX
Female
6 Age of husband or wife if alive
Usual
9 Occupation :
W.A.C.
10 or Business :
(State or country)
16 BIRTHPLACE OF
MOTHER (City)
(Stale or country)
17
U. S. Army
Informant.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a reoital to that effect.
PARENTS
should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain
Industry
U.S.Army
extracts from the laws on back of certificate.
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
Sa If married, widowed, or divorced
HUSBAND of
-
(Give maiden name of wife in full)
(or) WIFE of
(Ihishand's name in full)
year‹
7 IF STILLBORN. enter that fact here.
8
AGE 22 Years
7 Months
18 Days
-
If less than 1 day
Hours
Minutes
11 Social Security No.
Unknown
12 BIRTHPLACE (City)
Cambridge
( State or country)
Massachusetts
13 NAME OF
FATHER
John J. Quinn
14 BIRTHPLACE OF
FATHER (City)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Lahiff
Ireland
Relation, if any
--
( Address) Station Hospital, Ft Banks, Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : Man.D . Childrenk
(Signature of Agent of Board of Health or other)
Health Officer 1/17/44
(Date of Issue of Permit)?
(Official Designation)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January
15
( Month)
(Day)
(Year)
44
19 | HEREBY CERTIFY,
That I attended deceased from
11 January
19
to
44
15 January
19
......
I last saw h.S.r .......
.alive on
15 January
19 .. /h44 death Is sald to
nave occurred on the date stated above, at
9:45
p.m.
Immediate cause of death.
Peritonitis, acute
diffuse suppurative extreme
cause undetermined.
Due to Rupture of infected cyst, left
ovary ...
.....
.No .... operations ..
Due to.
-
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations.
Date of.
I'nderline the cause to which death
Of autopsy
Findings as above
What test confirmed dlagnosis?
None
charged sta. Iistically.
20 Was disease or injury in any reeled to occupation of deceased ? If so, specify.
( Sıgred)
R. el Keys,
Capt, MC,
M., D.
( Address)
Fort Banks, Mass.
16 Jan 1944
Mt. Pleasant On Cirlington
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BUF
Mil Petar
1/19 / 4 3/19
22 NAME OF
FUNERAL DIRECTOR ...
Manuel G. Diprien
ADDRESS
90% Masostoro Camilo, Dass.
Received and filed JAN 1 % 1944
19
(Registrar)
100m (d)-1-41-4667
PLACE OF DEATH
Suffolk (County)
2/8/44
The Commonmoralth ot Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
[{ If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
MARY T. QUINN
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
TI. Beacon Street
xs Arlington,
Ma.s.s.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
years
- months
2 days.
In this community -
yTs.
* mos.
- days.
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
red
7
No. Station Hospital Fort Banks, Mass.
PHYSICIAN - IMPORTANT
World
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Mar II
1944
Duration IMPORTANT
7
IMPORTANT
Physician
21
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 attrialed during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased. furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the decrasel. bis 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 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. wavy 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 alot the secotolary 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 atal forty-seven of said chapter one hundred and fourteen, the word "war" shall inchide 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 aml 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 theretrom a human body which has not been buried, until he has received a permit from the board of health, ur 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 tuwn. 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 huried. 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 he returned ai 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. of 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 medli- 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 forin 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 ['nited States in any war In which It has been engaged, such recital shall appear upon the permilt. The 'board of health, or its agent. upon receipt of such statement and certificate, shall forthwith counter-ign 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 needs- sary information which can be obtained as to the deceased, or as tu the mauber or canse of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
Nu undertaker or other person shall bury a human body or the ashea thereof which have been hronght into the cummonwealth outit 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. 16. 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 liea and take charge of the same; ... - General Laws, Chap. 38, Scc. 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 persuns who, though disabled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pliysi- cian 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 in. directly ly 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 .-- Callse of ileath means the disease, or complication which causes death, not the more of dying, e. g. heart failure, asphyxia. asthenia, etc. As principal cause name the discase causing death. As related causes, name carlier morbid conditions, if any. related tu the principal cause and any inmortant complication of the principal cause.
Statement of Occupation .- l'recise 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 uver. If the occupation had been given up or changed un account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupatiun 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 occupatiou whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
§ (If death occurred in a hospital or institution, St. give its NAME instead of street and number)
2 FULL NAME
Sigrid (Arnoldgon) Carlson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
45 Shore Drive
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution ...
Hospital
years
months
1 Odays.
In this community
yrs.
mog.
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widow
Sa If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
EmilCarlson
(Husband's name in full)
6 Age of husband or wife if alive. years
7 IF STILLBORN. enter that fact here.
8 85
AGE
Years
.Months.
Days
If less than 1 day Hours. Minutes
9 Occupation :
Housewife
Industry
At Home
10 or Business:
11 Social Security No ...
None
12 BIRTHPLACE (City) ..
(State or country)
Swedenn
13 NAME OF
FATHER
Anderes Arnoldson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Sweden n
15 MAIDEN NAME
OF MOTHER
Unable to obtain
16 BIRTHPLACE OF MOTHER (City). (State or country) Swedenn
17 Frank Arnoldson
Brother
... )
Informant
(Address)
9 Marion Rd. Belmont Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. L. Children
(Signature of Agent of Board of Health or other) Realiz Mucz 1/19/44
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH ..
fammary
16
1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
march 10
1940 to January 16 19. 44 I last saw her alive on January 16, 1945 16:10 P! m. have occurred on the date stated above, at .... Immediate cause of death Broncho- Pneumonia
Duration IMPORTANT
2 weeks ....
Congestive Failure
1 year
Due to ....
arteriosclerosis
Other conditions senility (Include pregnancy within 3 months of death)
5 years 2 years IMPORTANT
PHYSICIAN
Major findings:
Of operations.
none
Of autopsy
none
What test confirmed diagnosis? Clinical × laboratory
20 Was disease or injury in any way related to occupation of deceased? no
If so, specify ..... (Signed)verb Chamo M. D (Address) 562 Stanley St
M. D.
Date : /17/404.
21.
(City or Town)
Forrest Hills untaux Boston
Place of Burial, Cremation or Removal.
DATE OF BURIAL.
January
19
144
....
22 NAME OF
FUNERAL DIRECTOR
Howard
S Plusmoldo
ADDRESS
Winthrop Toho.
Received and filed JAN-2-6-1944 ............ 19.
(Registrar) 4
1 PARENTS 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 Usual
100m-2-'40-D-729-a
Relation, if any
Underline the cause to which death should be charged sta- etistically.
Date of.
death is said to
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
No. Winthrop Community Hospital
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 wbom be has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death. stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, tbe duration of his last illness, wben 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 buman body which has not been buried, until he has received a permit froin 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 person died; and no undertaker or otber 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 receiv- ing tomb to another in the same cemetery, until he has received a permit from the board of bealth 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for tbe removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enougb for the purpose, tbe certificate of death made as above provided and in the possession of the undertaker desiring to make such removal sball constitute a permit for such removal; provided, that sucb body shall be returned to the town from which it was removed witbin thirty-six hours after such removal, unless a permit in the usual form for the re- moval 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 tbe 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 sucb statement and certificate, sball forthwitb 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 deatb shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which tbe clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
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