USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 8
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(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 physiclans will certify to such deatha 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 physi- cian is absent from home when the certificate of deatlı 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 reaulting aepticemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 murbid cunditions, if any, related tu the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of uccupation 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 wliose 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 fainily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
1
Winthrop
(City or Town)
No.
3 SEX
4 COLOR OR RACE
White
Male
(or) WIFE of.
60
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
AGE
73 Y
6
Months
1.1 Days
9 Occupation :.
10 or Business :.
11 Social Security No.
None
14 BIRTHPLACE OF
FATHER (City)
15 MAIDEN NAME
OF MOTHER
PARENTS
(State or country)
Mass.
17
Margaret Root
CAUSE OF DEATH in plain 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.
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
Health Ofrecer
100m-2-'40-D-729-8
N. D .- WRITE PLAINES, WITIT ONFADING DLAGA INA-THIS IS A PERMANENT RECORD. Every item of
(State or country)
Mass.
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Marri
d
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Margaret Whitford
(Husband's name in full)
years
If less than 1 day
Hours
Minutes
Usual
Merchandize Agent
Industry
R H Stearns Co. (Retired)
12 BIRTHPLACE (City).
Westfield
(State or country)
Mass
13 NAME OF
FATHER
Watson Root
Westfield
Emily Pettis
16 BIRTHPLACE OF
MOTHER (City) ..
Montgomery
Relation, if any Wife
Informant. (Address) 20 Bartlett Parkway Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
1/27/44 ...
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19
HEREBY CERTIFY
That I attended deceased from
to
Jan & 6
19
44
I last saw hun alive on
buon 26
19 44 death is said to
have occurred on the date stated above, at ..
1000m.
Immediate cause of death ..
Duration IMPORTANT
Due to.
Due to. Other conditions Several anterio Solução (Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations.
Date of
Of autopsy
What test confirmed diagnosis ?.
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
(Address)
21.
Middle Farms
Westfield
Place of Burial, Cremation_or Removal. January
28,
(City or Town)
44
19
22 NAME OF
Howard Sphymolds
FUNERAL DIRECTOR
ADDRESS.
Winthrop mars
Received and filed
19
(Registrar)
(Official Designation) V
Suffolk (County)
20 Bartlett Parkway
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,
¿ give its NAME instead of street and number)
2 FULL NAME
Louis Solomon Root
.....
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Bartlett Parkway
St.
(If nonresident, give city or town and state)
In this community 40 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
years
months
days.
St.
(If U. S.
War Veteran,
specify WAR)
26
44
M. D.
Date ....
1/27
1944
DATE OF BURIAL
PLACE OF DEATH
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 hest 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 bury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not heen 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 cemctery to another, or from one grave or tomb other than the receiv- ing 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 heen delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required hy law to he returned and recorded. which shall he accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy 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 in- sufficient, a physician who is a member of the hoard of health, or em- ployed hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical 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 he obtained early enough for the purpose, the certificate of death inade 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 hody 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 re- moval of such hody has heen 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 furnish for registration any other necessary information which can be ohtained 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 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 hody is to he huried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the 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 disahled by recognized disease unrelated 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 by traumatism (including resulting septicemia), and hy 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 disahled 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 morhid 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 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 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, 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
FORM R-301
Shirley
(a) Residence. No.
783 Shirley
(Usual place of abode)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
years
PERSONAL AND STATISTICAL PARTICULARS
Ba If married, widowed, or divorced
HUSBAND of ...
Ella Ruhamah Park
(Give maiden name of wife In full)
(Husband's name In full)
80
AGE
80 Years 5 Months 20 Days
11 Social Security No ....
none
12 BIRTHPLACE (City).
Sautto Scituate
FATHER (City)
Scituate
16 BIRTHPLACE OF
MOTHER (City) ....
Lowell
(State or country)
Massachusetts
Relation, If any
Informant
Is Ella R. Park (0)
If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physician to insert a recital to that effect.
See instructions and extracts from the laws on back of certificate.
DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.
mation should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF
(State or country)
Massachusetts
13 NAME OF FATHER George Howard Jorrey
(State or country)
Massachusetts
18 MAIDEN NAME
OF MOTHER
Harriet Curling
(Address) 783 Shirley St, Winthrop Mare.
I HEREBY CERTIFY that a satisfactory etandard certificate of death was, filed with me BEFORE the burial or transit permit was issued:
(Signature of Ageft of Board of Health or other)
Health Mucle
1/29/4%
"(Officlal Designatlon) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
1 an
27
1944
(Month)
(Day)
(Year)
I HEREBY CERTIFY,
That I attended deceased from
January
10, 1939
to Jamary 27 1944
w him alive on
January 261944, death is said to
have occurred on the date stated above, at.
5:30 A:
Immediate cause of death ...
Cerebral Hemorrhage
Due to.
arteriosclerosis
Due to
Senility
Other conditions.
none
(Include pregnancy within 3 months of death)
Major findings:
Of operations
nowe
Date of.
Of autopsy
none
clinical x
What test confirmed diagnosis ?.
laboratory
20 Was disease or injury in any way related ta occupation of deceased ?. no
If so, specify
(Signed) Jacob
aleranno M.D.
M. D.
(Added ) 562 Hurley St Date 1/27/144
I Forest Hills Kutluop. negen maso
Place of- Bariat, Cremation or Romeral.
(City or Town)
31
DATE OF BURIAL January
19 44
22 NAME OF
FUNERAL DIRECTOR
Ernest H. Spanell
ADDRESS
Nouvelle Massachusetts
Received and filed 19
8
A TRUE COPY ATTEST:
(Registrar)
MARGIN RESERVED FOR BINDING
1 No. 783 3 SEX 4 COLOR OR RACE white Male (or) WIFE of e Age of husband or wife if alive .. 7 IF STILLBORN. enter that fact here. 8 9 Occupation : Industry 10 or Business: 14 BIRTHPLACE OF PARENTS N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of infor- Usual none 100m(h)-1-41-4695
Suffolk (County) PLACE OF DEATH ...... Winthrop (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
19
Howard Cushing Jorrey
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St
months
days.
(If nonresident, give city or town and State) In this community 3.5 yrs. mos. days.
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Manud
If less than 1 day Hours .Minutes
years
Duration Important I mo
5 years 2 ....
3 years
Important
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
....... .
Registered No. [ (If death occurred in a hospital or Institution, St. [give its NAME instead of street and number) PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran? If eo, (specify 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 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 belief the name of the deceased, his supposed age, the disease of which he died. defined as required by section one, where same was contracted, the duration of his last Illness, when last seen alive by the physiclan 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 fourteen, 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, specifying 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 pro- vision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this section and of sections forty-five, fortv-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 nineteen hundred and seventeen .- General Laws, Chep. 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 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 tomb other than the receiv- ing 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 hody is buried. No such permit shall be 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, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. if there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by It or hy the selectmen for the purpose, shail upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. if such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot he 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 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 re- moval of such body has heen sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-
wix, 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 stateinent 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 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, 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 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 hody is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or hurlal 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 thoss 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 by recognized disease unrelated 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 septicemia), and by 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 occupation, the sudden deaths of persons not disahied 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 important, 80 that the relative healthfulness of various pursuits can he 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, 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
Suffolk (County)
The Commontoralth of Massarinisetts 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. 20
Registered No. 1 or Institution
(Was deocased a U. S. War Veteran, if so specify WAR)
no.
(a) Residence. No.
(Usual plece of abode)
Hospital
years
months
-days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male White
4 COLOR OR RACEJ
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
Single
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
( Husband's name In full)
6 Age of husband or wife if elive
years
IF STILLBORN. enter that fact here.
8 AGE Years - Months Days
than 1 day Hours Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( State of country )
Winthrop
Mars.
13 NAME OF
FATHER
Josephe W. Barry
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Roxbury
(State or country)
mass. 0
15 MAIDEN NAME
OF MOTHER
Mary L. Smitherman
Winthrop
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
wass.
17 Informant (Address) /12) Locust Stil whin.
Father
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the butra or transit permit was Issued : mos. Childress
(Shenature of Agent of Board of Heakh or other)
Le altre officer 1/3/144
(Offclal Designation) / ( Date of Issue of Permit)
18 DATE OF
DEATH
Jan
30 2€
( šfonth )
(Day)
(Year)
19 J HEREBY CERTIFY.
g 29
.
That I attended deosased from
19.
44
to
030
19/2
I last saw h .............. allve on
19
death Is sald to
have occurred on the date stated above, at
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