USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 41
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yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
Female
White
MARRIED
WIDOWED
or DIVORCED
Single
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
IF STILLBORN. enter that fact here.
8 AGE 86 Years Months Days
If less than 1 day Hours Minutes
Usual 9 Occupation :
Industry 10 or Business :
11 Social Security No.
Boston
12 BIRTHPLACE (City)
( State or country)
Mass.
13 NAME OF
FATHER
Michael Rourke
Major findIngs:
Of operations
Of autopsy
What test confirmed diagnosis?
Climmal
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, specify H2
.....
('Signed) ....
(Address) 148hLL551
Date 6% ........ , M. D.
1944
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL ... June .. 20 1944
19 ..
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agept of Board of Health or, other)
Health Officer 6/19/44
(Official Designationy (Date of Issue of Permis)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June 17, 1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
1944
...
to ..
That I attended deosased from
1944
I last saw hallve on ...... Femme
17, 1944, death Is said to
have occurred on the date stated above, at 12.15 A.m.
Immediate cause of death
Duration 10 dias IMPORTANT
.........
Due to
Marcadel
Due to
auto delucia
1
...
Other conditions ...
Senelik
(Include pregnancy within 3 months of death)
....... ....... ....
IMPORTANT Physician
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Julia Murphy
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 John Jessop
Relation, If any .Nephew.
Informant ( Address) 37 Dolphin Ave., Winthrop
21
Dorchester
22 NAME OF
FUNERAL DIRECTOR Sichand Io phile
ADDRESS
147 Winthrop St.,
Winthro
Received and Aled
JUN 23 7944
19
( Registrar)
..
100M-6 · 2·42-8855
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.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PARENTS
Date of.
Underline the cause to which death should be charged sta- tistically.
1
PLACE OF DEATH
St.
PHYSICIAN - IMPORTANT
(was deceased a
U. S. War Veteran,
if so spoolfy WAR)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whoin he has attemuled during his last illness, at the request of an undertaker or other authorized person or of ans meoiber of the family of the deceased, furnish for registration a standard certifcate of death, stating to the best of his knowledge and heltef the name of the deceased, his supposed age, the disease of which he died. defued as re- quired by sectioo one. where same wes 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 koowledge and belief, served in the army. usvy or marine corps of the I'nited States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or inmeiliate cause of death as nearly as he can state the saine. 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 inchile the China relief ex- pedition and the Philippine insurrection, which shall. for said purposes. he deemed to have taken place hetween 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. Clisp. 46. Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human budy which has not been buried, until he has received a permit from the board of health, or ita agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the peraon dled; and no undertaker or other person ahall exhume a human body and remove it froin a town. from one cemetery to another, or from oue grave or tomh other thau the receiving tomh to another In the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit ahall he issued until there shall have been delivered to such board, agent or clerk, as the case inay he, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied. in case of an original internient, by a satisfactory certificate of the attending physician, if any, as required by law. on in lieu thereof a certificate as hiereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a 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, froin one town to another within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as above provided and in the possession ot 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 hody has heen sooner ohtaloed 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 stateoiot 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 veces 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 unay require .- Chap. 114. Sec. 45, G. L., ( Terceutenary Edition).
No undertaker or other person shall hury a hunian body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a jærniit 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 he held, or from a perduD appointed to have the care of the cemetery or burial ground in which the interment is made ... . Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
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 belly lies aud 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 deatha only as those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiolana will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose phyaf- cian is ahsent from home when the certificate of death is needed.
(3) Medioal Examiners will investigate and certify to all dcatha sup- posably due to injury. These include not only deaths caused directly or in- directly hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, ami deaths following abortion, but also deaths from disease resulting from Injury or infection related to occupation, the audden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Curse of deathi meana the disease, or complication which causes death. not the moile of ilying. e. g., heart fallure, asphyxia, asthenia, etc. Aa principal cause name the disease causing death. As related causes, name earlier Diorbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Oooupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some eutry in this section for every person aged 10 years or over. If the occupation had been given up or changed ou 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 he returned aa at school or at hoine. For a woman whose only occupatiou was that of honie housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private faniily, cook- hotel, etc. For a person who had no occupation whatever write DODe.
SPACE FOR ADDITIONAL INFORMATION
M R-301 |
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country) 200m-10-'39. No. 8427-d
1
PLACE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
20
Sa If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
7 IF STILLBORN, enter that fact here.
C
8
AGE
80
Years
6
.. Months
Days
9 Occupation:
10 or Business:
11 Social Security No.
Belfast
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
Belfast
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
Industry
Clothing Store
is very important. See instructions and extracts from the laws on back of certificate.
PARENTS
(write the word)
Single
If less than 1 day Hours. Minutes
Usual
Retired Salesman
15 MAIDEN NAME
OF MOTHER
Clara Russell
16 BIRTHPLACE OF
MOTHER (City)
Belfast
(State or country)
frame.
Beanie & Sleeker Sites Relation, if any
17
Informant.
(Add
94 Bay View Que Withro
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Wmp. Children
(Signature of Agent of Board of Health or other)
Vealthe Offices
6/18/44
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June
17
1944
(Month)
(Day)
( Year)
19 | HEREBY CERTIFY. That I attended deceased from
14
1944
7., to ...
June 17
19.44
Vlast saw but alive on June (1)
.....
19 .. 7.5, death is said
to have occurred on the date stated above, at.
8:40Am
Duration
4 days
Due to
Chronic Myocardial
Due to
Uremia
Other conditions
Senility
(Include pregnancy within 3 months of death)
Major findings :
Of operations
none
Date of
Of autopsy
une
What test confirmed diagnosis
clinical lat.
20 Was disease or Injury In any way related to occupation of deceased ? 40
If so, specify ...
(Signed)Geok @haus M.D.
(Address) 562 Sely St Withige
M. D.
June1 344
21 it auburn Cambridge Place of Burial, Cremation or Removal. (City ) Town)
DATE OF BURIAL
22 NAME OF FUNERAL DIRECTOR David Funde 480 Highland Que Somerville.
ADDRESS
Received and filed 19
J.U.N .... 2.3 1944
A TRUE COPY ATTEST:
(Registrar)
2 FULL NAME
Charles Sleeper
(If deceased is a married, widowed or divorced woman, give also maiden name.)
94 Bay View Line Withusps:
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
years
months
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
125
(If death occurred in a hospital or institution, No Winchholo Commento Hospital St.
give its NAME instead of street and number)
(If U. S.
War Veteran.
specify WAR)
no.
(If nonresident, give city or town and state)
days.
In this community
yrs.
nios.
days.
....
Immediate cause of death .. Cerebral Hemontage
6 mos. 2 days
1 year
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
1.19 1944
Suffek (County) Winthrop (City or Town)
6 Age of husband or wife if alive. years
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 hy section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been 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 tomh 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, hy a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the hoard 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 hy violence, the inedical exain- 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, Sco. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall hury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the 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 interinent is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillinent 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 fromn 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 husi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
1
PLACE OF DEATH
Suffolk &coghty ) Winthrop
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. 126
Registered No.
( { If death occurred In a hospital or lustitutlon, Ì give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR)
(If nouresident, give city or town and State)
Length of stay: In hosoltal or Motitution (Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX female
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the wurd)
widerd
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Daniel@maily nam@f wifein full
( Ihusband's name in full)
6 Age of husband or wife if alive
7 IF STILLBORN. enter that fact here.
8 AGE
11
Months
26 Da
Jays
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Retired Sabedoria
Industry
10 or Business :
Jordan march Co Boston
11 Social Security No. 022-01-2516
12 BIRTHPLACE (City)
(State or country)
England
13 NAME OF
FATHER
John. P. Gillespie
PARENTS
15 MAIDEN NAME
OF MOTHER
mary) unable to obtain
Flat Brush
16 BIRTHPLACE OF
MOTHER (City)
(State or country )
new york
17 Informant Clyabsel.Fr. Marsboul ( Address)
Kelation, if any
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued: Childrens
(Signature of Agent of Board of Health or other)
/flatter / flickr 6/20/44
(Official Designation) (Date of Issue of/ Permit) (
18 DATE OF
DEATH
17
1144
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
to
it cares 17
1944
I last saw h 57
... allve on
June
4:36 A
m.
Duration
IMPORTANT .... Aaus.
Due to
Due to.
Other conditions.
Fracture ofunding
12
8$145
(Include pregnancy within 3 months of death) ? ar Fractured Feiner
IMPORTANT
Major findings :
Of operations
Date of.
Of autopsy.
What test confirmed dlagnosis?
+ 7-24
20 Was disease or injury in any way related to ocoupation of deceased ?... NO
If so, specify ..
(Signed) - Laura, 1. manager
M. D.
(Address)
200 Una Chinader In Date JUNE 17 19
(City or Town)
Place of Burial, Cremation or Romount!
BURIAL June 1186
19 ×4
22 NAME OF
Ски.л. Венник
ADDRESS
Received and filed
JUN 2-3-1944
19
( Registrar)
100m (d)-1-41-4667
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 If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to Insert a recital to that effect.
2 FULL NAME
Winthrop, Community Hospital No. Mary Granes, Emerson Gillespie
(If deceased is a married widowed or divorced woman, give . also maiden name?) 61 Sea View ave Winkler
(a) Residence. NO.
(Usual place of abode)
-2 months years 8 days.
In this community @yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
17
19.4445
death Is sald to
have occurred on the date stated above, at ...
years Immediate cause of death Broncho Personalen
Physician
U'nderline the cause to which death -lwould be charged sta- tistically.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
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 attemled during his last illness, at the request of an undertaker or other authorized person or ol any member of the family of the deceased, furnish for registration ae standard certificate of desth, stating to the best of his knowledge and behef the name of the deceased, his supposed agc, the disease of which he died. defined as re- quired hy section one, where same was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Cen. 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 l'united States in any war in which it has heen 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 one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetween 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.
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