USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 87
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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 perinit 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 deccascd, 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 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).
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 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), therinal, 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
-301 A
1
PLACE OF DEATH
Suffolk (County)
winthrop (City or Town)
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 261₺/
Registered No.
{ {If death occurred in a hospital or institution,
{ give its NAME instead of street and number)
2 FULL NAME
Ethel Florence Pitts (bonin)
( If deceased la a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN . IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify W'AR)
(a) Residence. No.
25 Woodside Ave.
(Usual place of abode)
( If nonresident, give elty or town and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
months
days.
In this community / O yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4 COLOR OR RACE
white
5 SINGLE
( write the word)
MARRIED
WIDOWEO
or DIVORCEO
married
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
John" mapquest wife in full)
( Husband's name In full)
6 Age of husband or wife if alive years
75
7 IF STILLBORN, enter that fact here.
8
AGE
Yeora
Months
Days
If less than 1 day
Hours
Minutes
Usual - 9 Occupation :
Industry
10 or Business :
At nome
11 Social Security No.
None
12 BIRTHPLACE ( City)
( State or country)
Nova Scotia
13 NAME OF
FATHER
Thomas bonin
14 BIRTHPLACE OF
FATHER (City)
Nova Scotia
(State or country)
15 MAIDEN NAME
OF MOTHER
isabella hichards
16 BIRTHPLACE OF
MOTHER (City)
Nova Scotia
( State or country )
17 John H rittgs
Husband
Informant
( Address)
25 woodside ave With
I HEREBY CERTIFY that a satisfactory standard certificate of deeth was filed with me BEFORE/the burhat or.transit, permit was Issued :
(Signature of Agent. of. Board of Health ar other)
Health /(Official Designation)
( Date of Imque of Permity 40
MEDICAL CERTIFICATE OF DEATH
1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deosamed from
April 15, 1939
DECEMber 29.
19 44
....
I last saw h Er
allve on.
December 27. 19 44, death is said to
have occurred on the date stated above, at
7.30 A.m.
Immediate cause of death. Widespread metastatic Carcinoma IMPORTANT
to all banEs- origin un-
Que to
determined.
Due to
Arterios cleanitic Heart
disease
Other conditions
HOME
( Include pregnancy within 3 months of death)
Mejor findinga:
Of operetions
none
Date of
Of eutopsy
none
What test confirmed diagnosis ? X-rays Clinical + Lab Charged .
20 Was disease or injury in any way related to ocoupallon of deceased ?
If so, specify,
(Signed) Maurice Traunstein prthem D.
( Address)
562 cholas St. Date Decembero 29,199
21
inthro
cemetery winthrop
Place of Burial, Cremation or Removal.
DATE OF BURIAL.
Jan . 2, 1945
19
22 NAME OF
FUNERAL DIRECTOR
Kirby pros. @ nirby
ADORESS
210 winthrop at. w.
Received and flied 19
( Registrar)
6 months
2 months
....... IMPORTANT
Physician
Underline the cause 10 which dearh should be
extracts from the laws on back of cerriricare. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physiolans to Insert a recital to that effect. PARENTS
100m(i).1.44-13634
-
No. 25WoodsideAve.
St.
St.
18 DATE OF
DEATH
DecEncher
29
Duration
Housewife
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 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 he, 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 or chapier forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter 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
RM R-302
Suffolk
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Chelsea
262
(City or town making return)
661
Registered No.
(If death occurred in a hospital or institution, St.
give its NAME instead of street and number)
Emil J.Schmitz
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St.
(a) Residenoe. No.
(Usual place of abode)
hospital
7
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
M
4 COLOR OR RACE|
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, &rlavoroJane Lynch
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's pome in full)
6 Age of husband or wife if alive years
7 IF STILLBORN. enter that fact here.
8
68
5
4
If less than 1 day Hours Minutes
Drop man
Usual
9 Occupation :
Industry
Railroad
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Now York
Emil
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
Germany
(State or country)
Elizabeth Springer
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
Germany
(State
newvital Records
Relation, if any
17 Informant. (Address)
(
A TRUE COPY.
Joseph G. Tyrell
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
12/1/44
19
18 DATE OF
Doc. 1, 1944
DEATH
(Month)
(Day)
(Year)
19
INGARERY CERTIFY,
19
to ..
Dec. 1
44
19 death Is said to
have occurred on the date stated above, at
10:25
Duration
Immediate cause of death Uremia
Pneumonia
Due to.
Cerebralvascular accident
1 ro.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of
Underline the cause to which death should be charged sta- tistically.
What test confirmed diagnosis ?
clinical
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify
(Signed)
A .. Roubley.
M. D.
(Address)
Soldiers ....... Homo. Date.12.1 ... 19
.44
21 "PLACE.OnSURDOD Com . Winthrop, wass .
CREMATION OR REMOVAL ..
(Cemed . 4, 1944(City or Town)
DATE OF BURIAL
19
John F. Offaley
22 NAME OF
FUNERAL DIREYORAtlantic St.winthrop
ADDRESS
Received and filed
19
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred In your city or town in case the deceased
1
PLACE OF DEATH
(County) Chelsea
'SIdfors' Home Hospital No.
years
months
days.
In this community
yTs.
mos.
days.
(If U. S. War Veteran,
Spanish
Winthro't specify WAR)
Ttet! attended deceased from 19
I last saw h
live on
5days ...
AGE
Years
Months.
Days
PARENTS
Of autopsy
M R-302
1
....
mas Dannero State Hospital, Hathouses! No.
h occu in a hospit
give its NAME instead of street and number)
madeleine Claire Shaw
(If U. S.
War Veteran,
speolfy WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 161 Quincy ave. Winthrop mass
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution ..
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female White
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that faot here.
AGE
70 Years.
Months
.. Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
Unable to unk
Industry 10 or Business :
11 Social Security No .....
none
12 BIRTHPLACE (City
(State or country}
Springfuld Mars.
13 NAME OF
FATHER
Charles Shaw
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Palmer mass.
15 MAIDEN NAME
OF MOTHER
abigail Holt
16 BIRTHPLACE OF
MOTHER (City)
albiniston, Com.
(State or country)
17 mary K. m. Phille Relation, if any Informant (Address) Hallarge mart
A TRUE COPY.
ATTEST :
(Registrar of city "or town where death occurred)
DATE FILED
January 2
19 425
18 DATE OF
DEATH
December 23, 1944
(Month)
(Day)
(Year)
19 }HEREBY CERTIFY, Lec. 15
That I attended deceased from
I last saw h
Malive on
Dec. 23, 19 44 death is said to
have occurred on the date stated above, at
4.40 0.
.. m.
Immediate cause of death arterio aclerotic heart
disease
Due to ..
Broncho pneumonia
6 days.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
should be charged sta- tistically.
Of autopsy
Clinical
What test confirmed diagnosis ?
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify.
Les Maleti
......
, M. D.
(Signed)
(Addres
3) Hathorne Man Date 142944
21 PLACE OF BURIAL,
CREMATION OR REMOVAL Lassen Grove Ware
(Cemetery ),
(City or Townia
DATE OF BURIAL
December 27
1944
22 NAME OF
FUNERAL DIRECTOR
2. Richard (Walked)
ADDRESS
Ware, ma
Received and filed
JAN 19 0015
.19
(Registrar of City or Town where deceased resided)
25M-(f)-11-42 10746
of the city or town in which the deceased resided. (See Chap. 16, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk Copies of returne of deaths recorded during the previous month which occurred in your city or town in case the deceased
PLACE OF DEATH
(County) Danvers
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No. 263
2 FULL NAME
(Give maiden name of wife in full)
to 2
Dec. 23
Duration
Physician Underline the cause to which death
PARENTS
RM R-305 1
2 FULL NAME
(a) Residenoe. No.
(Usual place of abode)
3 SEX
4 COLOR OR RACE
l'ale
White
(or) WIFE of
(Husband's name in full)
5.3
7 IF STILLBORN, enter that fact here.
8
AGE
Years
53
Months
Days
Usual
9 Occupation :
Supervisor
10 or Business :
11 Social Security No.
011-07-5504.
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Wife ..
.....
of the city or town in which the deceased resided as soon as possible after the close of the month in which the death
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-305 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
Industry
N E Tel and Tel
occurred. (See Chap. 46, Sec. 12, G. L.)
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced
HUSBAND of
Mary E Harrigan
(Give maiden name of wife in full)
6 Age of husband or wife If allve years
If less than 1 day
Hours.
Minutes
12 BIRTHPLACE (City)
(State or country)
Brookline Vass.
William J Wood
15 MAIDEN NAME
OF MOTHER
Margaret Hurley
17
Informant.
(Address)
Relation, if any
A TRUE COPY. Chramais
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
Nov 16/44
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Nov 13/44
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Acute circulatory failure Chronic cardiac disease with auricular fibrillation
20 Acoldent, sulolde, or homlolde (specify)
Date of occurrence.
19
Where did
Injury occur ?
(City or town and State)
Did Injury occur in or about the home, on farm, In Industrial place, or In
publlo place?
(Specify type of place)
Manner of Injury
Nature of Injury
While at work?
Was there an autopsy?
21 Was disease or Injury In any way related to occupation of deceased ?
If so, specify
(Signed)
W H Watters
M. D.
(Address)
Date ..
11/131924
22
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Nov 16/44
19
23 NAME OF
FUNERAL DIRECTOR
J ..... F ..... O .! Maley
ADDRESS
Winthrop
Received and filed.
OCT 5 1945
19
(Registrar of City or Town where deceased resided)
25m (h)-1-41-4667
PLACE OF DEATH ,
1
(City or Town)
No. 818 Harrison Ave.
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
HONTOR
(City or town making return)
₹ 64
9834
Registered No. (If death occurred in a hospital or Institution, give its NAME instead of street and number)
William J Wood
(If deceased is a married, widowed or divorced woman, give also maiden name.)
49 .... Lewis ... Ave
..........
St.
-inthro.p ... Mass.
(If nonresident, give city or town and State)
Length of stay : In hospital or Institutlon
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
SUFFOLK (CountBOSTON"
St.
war Veteran.
speolfy WAR)
١
السعدي
1
-
1
-
١٠
-
-
1
-
-
.
.
I
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