USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 50
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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 huried, until he has received a permit from the board of health, or its agent appointed to Issue such perinits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhumc 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 buricd. No such permit shall be issued until there shall have been de- Ilvered to such hoard, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, hy a satisfactory certificate of the attending physiclan, 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 cnough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body. not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such 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- alx hours after such removal, nnless 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 transmlt It to the clerk of the town for registration. The person to whom the permit is so given and the physician certifylng 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 elerk or registrar may require .- Chap. 114, See. 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 hurled 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 fer the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those ef persons to whom they have given bedside care during a last ill- ness from dlsease 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 an- 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) Medieal 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 septlce- 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 fallure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditlons. If any, related to the principal cause and any important complloation of the prinelpal cause.
Statement of Occupation .- Precise statement of occupation is very Important, so that the relative healthfulness of various pursults 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 occupatlen 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
A
301 A
1
PLACE OF DEATH
- Winthrop (City of town) Cammina Hosp No.
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 Many I Daud
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
1st Myrtle Do Que.
St.
(If nonresident, give elty or town and State)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months 5 days.
In this communtt
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH
3 SEX Le
4 COLOR OR RACEĮ
( write the word) \
5 SINGLE
MARRIED
WIDOWED
OL DIVORCED
18 DATE OF
DEATH
August 7 ,1944
(Month)
( Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deosased from
Aug ..... 2, ....... 1944 ..... , Ło ...
.Aug. ... 7,
19
4
I last saw he.x ...
.. allve on
Aug. 7 , 1944
death is sald to
have occurred on tha date stated above, at.
8:00 ₽
6 Age of husband or wife if aliva
72 yaars
7 IF STILLBORN, enter that fact here.
AGE
Years Months
Days
If less than 1 day
Hours
Minutes
Disease
Usual
9 Occupation :
at home
Industry 10 or Business :
11 Social Security No. none
12 BIRTHPLACE (City)
( State or country)
C. Autor
13 NAME OF
FATHER
Dennis Mahoney
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Laland
15 MAIDEN NAME
OF MOTHER
Many Sweeney
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 21.86 Daund
Informant ..
( Address )
15 Muelle Sine
I HEREBY CERTIFY that asatisfactory standard certificata of death was filed with me BEFORE the batlar or transit permit was Issued :
Health Officer (Signature of Agent of Board of Health or other) protes/9/44
.... ('Official Designation) (Date of Issue of Permity
20 Was disease or injury in ony way related to occupation of deceased ? If so, spaoify ...
( Signed)
(Address) Winthrop . Mass.
Date
Aug. 9. 1944
. M. D.
1 Wenche ......
trênduas.
Place of Burial, Cren
tion or Removal.
(City or Town)
DATE OF BURIAL.
1944
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
19
IMPORTANT 4 years
Due to
Due to
Other conditions.
Pulmonary .... Asthma
( Include pregnancy within 3 months of death)
Major findings:
Of operations
No ne
Date of
Of autopsy
Notdone
What test confirmed diagnosis? Clinical
4years IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
100m(i).1-44-13634
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physiofans to insert a reoltal to that effeot. PARENTS
Duration
Immediate cause of death Hypertensive Cardio-Vascular
8 70 ars
5a If married, wid bred, or divorced
HUSBAND of
...
The neide me Dowie
(or) WIFE of
( Husband's name in full)
(a) Residence. No.
(Usual place of abode)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Recalved and filed AUG 1 0 1944(i)
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 helief the name of the deceased, his supposed age, 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 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 hy 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 iu the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate hoth 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 expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican horder service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human hody in a town, or remove therefrom a human hody 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 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 shall be issued until there shall have been delivered to such hoard, agent or clerk, as the case may 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 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 physi- cian who is a member of the board of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such hody shall he 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 been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten or 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 aud 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, Sec. 45, 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 hy 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.
No undertaker or other person shall hury a human hody 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 he 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 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 hedside 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 hy recognized disease unrelated to any forin 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 hy traumatism (including resulting septicemia), and hy 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 hy 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 he 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 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
M R-301
PLACE OF DEATH No
9/7/4+
Suffolk (County) Winthrop. (City or Town) Community Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
S
(If death occurred in a hospital or institution,
St. ¿
give its NAME instead of street and number)
2 FULL NAME
ElleEn K. Jones net
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
188
Bellingham Ave
.St.
(Usual place of abode)
Length of stay: In hospital or institution (Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
HEmale
4 COLOR OR RACE
what
5 SINGLE
(write the word)
MARRIED
WIDOWED
plucarried
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
ALBERT
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
AGE .Years. .Months. Days
If less than 1 day
Hours ..............
.. Minutes
9 Occupation:
houseunta
10 or Business:
at have
11 Social Security No.
Med Ford
12 BIRTHPLACE (City)
(State or country)
Man
13 NAME OF
FATHER
Albert Lavery
14 BIRTHPLACE OF
FATHER (City)
Barra
(State or country)
Man.
15 MAIDEN NAME
OF MOTHER
Ellen MEGEE
Peabody
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
mass.
17 Albert Jones Relation, if any
Informant
188 Bellingham For every
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burdel or transit permit was issued: Han D. Children
Signature of Agent of Board of Health or other) Health Office 8/8/44
(Date of Issue of Permit) /
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
august
Month)
(Day)
19
august 6
HEREBY CERTIFY. That I attended deceased from
44, to Que 7
1944
I last sam h. fr alive on.
aug 70, 1944, death is said
to have occurred on the date stated above, at.
3.15P.
.. m.
Duration
Streptococcus Setticarina
Due to
...
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Petrocalcal affund
Petrovestirte Date of milk 26un
Of autopsy
What test confirmed diagnosis ?
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease or Injury In any way related to occupatiaa at deceased ? 20
If so, specify
Fred Dillegan
(Signed)
M. D.
(Addre
670 Saratoga U. F.B
Dato.
8/7
1944
21
Place of Burial, Cremation, or Removal.
(City or Town)
DATE OF BURIAL.
Aha, 10
1944
22 NAME OF
FUNERAL DIRECTOR
Murray, murray
ADDRESS
Received and filed ..
AUG 1 0 1944
......... 19
........
A TRUE COPY ATTEST: COP
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
1 8 21 Usual PARENTS (Address) 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 Industry
200m-10-'39. No. 8427-d
(Official Designation)
LAvery
Lavery
(H U. S.
War Veteran.
specify WAR)
-
Reveja
(If nonresident, give city or town and state)
7 1944
( Year)
22 years Immediate cause of death.
...
1 Day
pushand V
Malden
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 undortaker 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 huried, 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 huried. 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 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 physician who is a member of the board of health, or employed hy 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 medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal ; provided, that such body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required 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, such recital shall appear upon the permit. The hoard 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
ohtalned 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 to to do from the hoard of health or it.s agent appointed to Issue such permits, or if there is no such board, from the clerk of the town where the hody Is to he buried or the funeral Is to be held, or fromn 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 thesc laws calls for the ohserv- ance of the following rules of practice :
(1) Attonding 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 hy recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is ahsent 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 hy traumatism (including resulting septice- mia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut 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.
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