USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 62
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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 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 dicd; 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 aforcsaid 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, 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 by the selectmen for the purpose, shall upon application make the certificate rc- 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 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 body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the ueceased 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 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 elerk 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 is 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 lics 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 ohservance 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 pliy- 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 ahortion, hut 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 heen 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 domestie 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
R-301 A
1
Winthrop
(City or Town)
No. Winthrop Community Hospital
The Commontoralth 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
Registered No. § ( If death occurred in a hospital or institution, St. { give Its NAME Instead of street aud number)
2 FULL NAME
Anne Kiley
( If deceased is a married, widowed or divorced woman, give alao maiden name.)
(a) Residence. No.
30 Beal St. . Winthrop
St.
(if nonresident, give city or town and State)
Length of stay: in hospital or Institution
Hospital - years
months
₴ days.
In this community
yrs.
mos.
1 days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
4 COLOR OR RACE|
white
5 SINGLE
( write the word)
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 aliva
years
IF STILLBORN. enter that fact here.
8 AGE Years
Months
1
Days
if less than 1 day
Hours.
.. Minutes
Usual
9 Occupation :
None
Industry
10 or Business :
None
11 Social Security No.
None
Winthrop
'2 BIRTHPLACE (City)
( Siate or country)
Mass.
13 NAME OF
FATHER
Joseph P. Kiley
14 BIRTHPLACE OF
FATHER (City)
Charlestown
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Anna M. Hamilton
16 BIRTHPLACE OF
MOTHER (City)
Dorchester Boston
(State or country)
Mass.
17 Anna M Kiley
Relation, If any mother
Informant
( Address)
30 Beal St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial, or transit permit was Issued : Vm. D. Childress x
(Signature of Agent of Board of Health or other) Health Mice 9/25/14
.... (official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
Sixt
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Sept 22, 1944
to.
Sent 23
19.
I last saw h ......... ... aliva on
Sent 23, 19 YY, de
have occurred on the date stated above, at
12:50Pm
.m.
Duration
Immadiate .oause of death.
IMPORTANT
Dua to
Dua to
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations
Date of
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 ralated to oooupation of daoeased ?.
If so, specify ..................
(Signad),
....... , M. D.
(Address) Zu saucereally ust Bata.
21
Holy Cross, Malden
(City or Town)
l'iace of Burial, Cremation or Removal.
DATE OF BURIAL
September 25 1944.
19
22 NAME OF
FUNERAL DIRECTOR
Richard C. Barbara
ADDRESS
Boston
Raoeivad and flad.
SET 25 1344
19
( Registrar)
100M-£ - 2-42-8855
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
PLACE OF DEATH
Suffolk (County)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so speolfy WAR).
NO
(Usual place of abode)
(Before desth)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
23,1944
That I attanded deosased from
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physicien or registered hospital medical officer sball forthwith, after the death of a person whotn he has attended during his last illuema, at the request of an undertaker or other antburized person or of any member of the family of the deceased, furnisb 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. deflued as re- quired by section Que. where same was contracteel. the duration of his last illness, when last seen alive by the physician or officer aud the date of bia death ... Cen. Laws, Chiap. 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 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 immediate cause of death as nearly as he can state the saine. For neglect to comply with any pruvision of this section, auch physician or officer shall forfeit ten dollars. For the purposes of thia sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deeincd to have taken place hetween February fourteenth, eigliteen hundred and ninety eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred aud sixtcen and nineteen hundred and seventeen. G. L. Chiap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman 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 ita agent appointed to issue such permita, 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 froin a town, from one cemetery to another, or from oue 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 aball have been delivered to sucb board, agent or clerk, as the case may be, & satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original internient, by a satisfactory certificate of the attending physician, if any, aa required by law, o1 in lieu thereof a certificate aa hereinafter provided. If there is no attending physician, or if, for sufficient reasons, hia certificate cannot be obtained early enough for the purpose, or is insufficient, a pbysl- 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 ia caused by violence. the medl- cal examiner chall make such certificate. If such a permit for the removal of a human body. not previously interred, froin one town to another within the counnouwealth cannot be obtained early enough for the purpose, tbe 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 body has been sooner obtained hereunder. If the death certificate containa 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 hren engaged. such recital shall appear upon the permit. 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 muy uther uece+ sary information which can be obtained as to the deceased, ur as to the manner of cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, C. L., ( Tercentenary Edition).
No undertaker or other person shall bury a hunian 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 ur its agent appminted to issue such permita, 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 fruin a person appointed to have the care of the cemetery or burial ground in which the interment is made ... . Chap. 114. Sec. 46. C. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died hy violence. If e medical examiner has notice that there is within lils county the hody 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, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calls for the observance of the following rulea of practice :
(1) Attending physicians will certify. to such deatha only aa those of persona to whom they have given bedside care during a last illuess from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deathe only aa those of persons who, thuugh disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbyel- cian ia ahsent from home when the certificate of death ie needed.
(8) Medloal Examiners will Investigate end certify to all deaths sup- posably due to Injury. These include not only desths coused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deathe following abortion, but also deaths from disease resulting from Injury or Infootion related to occupation, the sudden deaths of persona 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 causea death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principai 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 ia very im- portant, so that the relative healthfulnesa of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the discase causing death, 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 buine. For a woman whose only occupatiou was that of honie buusework. write bouxework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, as housekeeper-private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A
1
PLACE OF DEATH Suffolk
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 183
County Winthrop (City or Towny Registered No. Winthrop Community Hospital. § (If death occurred in a hospital or institution, St. ( give its NAME instead of street and numher)
2 FULL NAME ...
( if deceased is a married, widowed or divorced woman, give also maiden name. )
66 Wyman
(a) Residence. No.
(Usual place of abode)
star.
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months days.
In this community _
yrs.
mon.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
Single
5a 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 fact here. Stillbom
8 AGE
-
Years
Months Days
If less than 1 day - Hours Minutes
Usual
9 Ocoupation :
Industry
10 or Business :
11 Social Security No.
winthrop
12 BIRTHPLACE (City)
( State or country)
wass.
13 NAME OF
FATHER
John P. Karkein
14 BIRTHPLACE OF
FATHER (City)
East Boston
(State or country)
mass.
15 MAIDEN NAME
OF MOTHER
Helen O'Holleran
16 BIRTHPLACE OF
Cambridge.
MOTHER (City)
(State or country)
wcass. 0
17 John P Larkin Relations, if any
Informant ( Address) 66 wyman ST.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the barist or transit permit was Issued:
{Signature of Agent of.Board of Health or other) Le altre Officer 9/25/44
(Official Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
(Month)
(Day)
1444 ( Year )
19 | HEREBY CERTIFY,
19.
That I attended deceased from
19
I last saw h ..
alive on
, 19
..... , death is said to
have occurred on the date stated above, at
9:09 a.
m.
Immediate oause of death
still for
IMPORTANT
.........
Due to bilabial defila
Due to
Other conditions.
( Include pregnancy within 8 months of death)
IMPORTANT
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
If so, specify.
(Signed)
(Address )
21
Nous Gross Walden
Place of BurialCremation or Remoral.
(City of Town)
DATE OF BORIAL ..
September
25
1944
22 NAME OF
FUNERAL DIRECTOR
John G. Kelly
ADDRESS
11 meridian ST., S. 13.
Received and fled
SEP 2.51944
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
No. Tuale)
Larkin
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
Roslindale
1
Boston Mass.
(If nonresident/give city or town and State)
MEDICAL CERTIFICATE OF DEATH
23
5
Duration
Physician Underline the cause to which death should be charged sta- tistically.
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, he 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 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 hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomh 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 huried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, 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 he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed hy it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human hody, 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 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 body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, tuat 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 furnish for registration any other neces- sary information which can he 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 hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within bis county the hody of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; .. .- General Laws, Chap. 38, Sec. 6.
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