USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 57
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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 .- 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 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 wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
01 A
BOSTON NOTITIEW 9/9/+4
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)
PHYSICIAN - IMPORTANT
2 FULL NAME Jessie H .Melling.
( If deceased is a married, widowed or divorced women, give itto meiden nome.)
(=) Residence. No.
76 West Newton St
St.
Boston
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
Home
......
years - months T4 days.
In this community
yrs.I
mos. I4 days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
-
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Single
Sa If married, widowed, or divoroed
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 fect here.
8
74
T
AGE
Yeers
Months
2.4 Days
If less than 1 day
Hours
Minutes
Usual
9 Ocouoation :
At .... Home
Industry
10 or Business :
None
11 Social Security No.
None
12 BIRTHPLACE (City)
( Siale or country)
England
13 NAME OF
FATHER
William Melling
14 BIRTHPLACE OF
FATHER (City)
England
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary A. Crowther
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
17 Informant ( Address) Willow St Box
( Bro ..
I HEREBY CERTIFY that a satisfactory standard certifiosta of death was filled with me BEFORE the Surlal or transit permit was Issued? -Wie. D. Childress.
(Signature of Agent { Board of Health or other) Realthe Officee 8/28/44
(Oficial Designation) (Date of Trque of Permit)/
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
( Mfp/h)
26
1944
(Day)
(Year)
19 | HEREBY CERTIFY,
19
, Ło
19
I lost saw h.
alive on.
19.
... death is said to
have occurred on the date stated ebova, at
81508
m.
Immediate cause of death ..... Naured by Medical Exammon
IMPORTANT
Due to
Coronary Thom Sons
3 mois .... 6 moet
....
IMPORTANT
Major findings :
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
disease or mijury in any way related to dooudation of degeased ?........... (Signed Upchande Inhalt
....
(Address)
148 W ml-0 5pt gate 134
. M. D. 19 5 9
21
Forest Hills Cem, Boston
Place of Burial, Cremetion or Removal.
DATE OF BURIAL.
Aug 29
1944
19
22 NAME OF
FUNERAL DIRECTORY . S. Waterman & Sons
Boston Mass
ADDRESS
Received and fled AUG 2 8 1944 19
( Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
100m(i).1-44-13634
-
(County)
1
PLACE OF DEATH
Winthrop (City or Town)
No.
I25 .... CliffAve ..
(Was deceased a
U. S. War Veteran,
if so specify WAR)
No
Female
White
That I attended deosased from
Duration
Due to
Cantina Scherono
Other conditions
( Include pregnancy within 3 months of death)
Physician Underline the cause to which death should be charged sta. tistically.
Emest H. Melling Relation, if any
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 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, 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 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 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 border service of nineteen hundred and sixteen and nine- teen 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 one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the 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, 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 form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten oi 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 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.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the 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
BOSTON NOTITILY
1/9/++
-301 A Suffolk. (County) Winthrop 1 1 (City ON Toy) WinthropCommunity Hospital No. -
The Commonforalth 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. okay
Registered No.
St. § (If death occurred in a hospital or institution, · give its NAME instead of street and number)
2 FULL NAME MatthewR. Dinhson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
335 Meridian
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death )
(Specify whether)
years
months 21 days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Imale White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
Congeta Capodilupo
(or) WIFE of
( Husband's name in full)
6 Age of husband or wifeAf alive 78 yrs years
7 IF STILLBORN, enter that fact Here.
8 AGE58 Years Months 23 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation(
Machinist
Industry
10 or Business :
Jathe Hand
Ll Social Security No. 021-10-2528
12 BIRTHPLACE (City)
(State or country)
East Breton
.....
Muss
13 NAME OF
FATHER
John Simpson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Mass
15 MAIDEN NAME
OF MOTHER
Annie Farkin
Portland.
17 Mrs toward faite
Informant (Addres) 3056da Kommt Bald
I HEREBY CERTIFY that a satisfactory stanitena filed with me BEFORE the burial or transit permit was issued: Www. D. Childress (Signature of Agent of Board of Health, or other)
Health Aplica 8/30/49
( Official Designation) (Date of Issue of Pernnt)
18 DATE OF
DEATH
Ceq.
28.1944
(Month )
(Day)
(Year)
COLHERES
44
Laura 28
CERTIFY,
19.
to.
19
....
I last saft hu
alive on
aug 28
19 44
death Is said to
have occurred on the date stated above, at
6 A.
m.
Immediate cause of death.
Ceuta Pulmonar Edema
Due to
Charrier Myocarditis
Due to
Chique Uplimites
Other conditions.
Colar Precionia
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?
Underitne the cause to which death should be charged na- tisticallf. tto
20 Was disease oginjury in any way related to occupation of deceased ?
if so, specify.
Alorss. A. Schwartz
(Signed).
(Address)
19 Brucela SVE13
Date 6/29
Place of Burial, Cremation or Remgyal.
21
8/30/44
(City or Town)
DATE OF BURIA
Woodlawn Everett
1944
22 NAME OF
Frank E. Grown
FUNERAL DIRECTOR ..
ADDRESS
East Bouton
Received and filed
AUG 3 0 1944
.19
(Registrar)
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 reoltal to that effeot. PARENTS
100m (d)-1-41-4667
Duration
IMPORTANT
........
10 Days
IMPORTANT
Physician
M. D.
16 BIRTHPLACE OF
MOTHER (City)
( State or country)
Maine
Relation, if any
Sister
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St. East Boston
(If nonresident, give city or town and State)
That I attended deceased
from
(Give maiden name of wife in full)
MEDICAL CERTIFICATE OF DEATH
PLACE OF DEATH
East Boston
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physiolan or registered hospital medloal 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 atandard 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 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 offleer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or 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 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, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexl- can border service of nineteen hundred and sixteeu 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, fromn the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectinen 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 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 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 physiclan certifying the cause of death shall thereafter furulsh 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).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such 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 ia made. .. . Chap. 114. Sec. 46, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have 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 auch 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 discase unrelated to any form of injury, have died without recent medical attendance or whose physi- 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 by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deathis 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 discase, 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 .- l'recise statement of occupation is very im- portant, so that the relative healthifulness of various pursuits can be kuown. 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 desth, report the usual occupation prior to illucss. 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, 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 R-301
Suffolk 47
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No .. 08
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
BRENTON FENWICK BEST
(If deceased is a married, widowed or divorced woman, give also maiden name.) 10 Locust Skwithroa
(write the word)
istvanced
Sa If married, widowed, or hovedre In. Locke
6 Age of husband or wife if alive.
years
If less than 1 day
Hours
Minutes
11 Social Security No .. ...... Annão County
12 BIRTHPLACE (City)
(State or country)
norta sester
(State or country)
houd textil
15 MAIDEN NAME
OF MOTHER
Boabella (unknown)
16 BIRTHPLACE OF
MOTHER (City)
Tengo!
in County
(State or country)
nova Sentir
(Address)
10 Focust VS. Stutters
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www.D. Childrens.
(Signature of Agent of Board of Health or other) health officer 8/30/44
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
29
(Month)
(Day)
(Year)
19 DHEREBY CERTIFY . That I attended deceased from
Caux 18
19 44, to
aug. 29
1944
I last saw b ........ alive on.
amy 29
........ , 19 .. 5.2., death is said
to have occurred on the date stated above, at. 9.25Am.
5da
Duration
Immediate cause of death
Branche porcumaria Teramano
.........
Due to
Due to
Corona
2 Ko+
Other conditions Semelet (Include pregnancy within 3 months of death)
Major findings :
Of operations
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