USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 16
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SPACE FOR ADDITIONAL INFORMATION
R-301 A
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to insert a reoltal to that effect. extracts from the laws on back of certificate. terms, so that it may of property classified. Exact statement of VecerAtion is very important. See instructions and PARENTS
100m (: ) . 1.44-13634
17 Mrs. Anna J . DunbarRelatlan, Kuny
Informant
( Address)
253 Chelsea St.
Fast Boston
I HEREBY CERTIFY that a satisfactory standard oertifloata of death was Aled with ma BEFORE the barjer ar transit permit was Issued : Www. D. Guldrezer ......
( Signature of Agent of Board of Health or other)
Marthe Officer 2/26/45
(Official Designation)
( Date of Inque of Permity
18 DATE OF
DEATH
Fel.
24- 1945
( Month)
(Day) (Year) Thet I altended deosased from
tam.
19
I lafthaw h
« ... allve on
+36.23, 1995, death Is said to
have occurred on the date stated above, at.
6 a.m.
6 Age of husband or wife if aliva
years
7 IF STILLBORN, enter that fact here.
8 AGE .75. Years Months Dayı
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Rigger
Industry
Marine
10 or Business :
11 Social Security No.
none
12 BIRTHPLACE (City)
( Siste or country)
Ireland
13 NAME OF
FATHER
Robert Young
Mejor findings:
Of operations
Date of
Of autopsy
What test confirmed dlegnosls ?
20 Was disease or jajury in any way related to oooupallon of deceased ?
(Signed)
M. D.
(Address) 305 Hamis 513 Date FaleFiks
21
Holy Cross Malden
Place of Burial, Cremation or Removal.
DATE OF BURIAL.
February
(City or Town) .. 27
19.45
22 NAME OF
FUNERAL DIRECTOR
R C Kirby
ADDRESS
Boston. >
Received and Alad
MAR 1
1945
( Registrar)
IMPORTANT 4 months
Due to
1 year
Due to
Other conditiona.
( Include pregnancy within 3 monthe of death)
IMPORTANT
Physician
Underline the cause to which death should he charged sta. tistically.
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Ann Reilly
16 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE1
white
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
widowed
5a If married, widedth gruene Mahoney
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
SOSION NOTIFIED MAR 8 1945
Suffolk (County)
Winthrop (City of Town) Winthrop Community Hospital
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.
45
.....
(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Thomas Young
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
253 Chelsea St
St.
East.
Boston 2:12.
(Usual place of abode)
.4
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
Hosp
years
-
months
7 Yours
In this community 5 yrs.
mos.
- days.
( Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
PLACE OF DEATH
No.
1
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
no -
U. S. War Veteran,
if so specify WAR).
19
I HEREBY CERTIFY,
44
Fel.24
1945
Immediate osuse of death auguina Pectoris.
Duration
If so, spaolfy.
Charles Melan
19.
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 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 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 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 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 body and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is 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 seleetmen 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 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
from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
50m.(c)-3-43-11574
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
33 Court Rd.
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.
Registrar's No. 46
§ (If death occurred in a hospital or institution,
St. [ give its NAME instead of strect and number)
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No. 33 Court Rd. St.
(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
12rs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widow
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
George O Colby
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
8
71
AGE
Years
2
Months.
21
Days
If less than I day
Hours ..
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business:
At
Home
11 Social Security No.
None
East Boston
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
George Potter
Eastport
15 MAIDEN NAME
OF MOTHER
Sarah Conry
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Maine
17 Elizabeth Colby
Daughterny
Informant
(Address)
33 Court Rd, Winthrop
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death
22 NAME OF
FUNERAL
ADDRESS
Howard Sthymotels
(Signature of Agent of Board wtHealth or other) Heath Spiel 2/28/45
7(Official Designation (Date of Issue of Permits
18 DATE OF
DEATH
Feb
25
(Month)
(Day)
1945
(Year)
19 I HEREBY CERTIFY
7
That I attended deceased from
to.
19410
Feb 25
19
45
I last saw h.
alive on
Feb 24
, 1941, death is said to
have occurred on the date stated above, at.
1000 AN.
Immediate cause of death.
Cerebral Hemorrhage
Duration
IMPORTANT
1 day
Due to.
Hypertension
5 grs.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings:
Of operations
Date of.
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased ? no
If so, specify.
Louis 7 Salerno
M. D.
(Signed) ...
(Address) 125 Pleasant St Date Fela 26 1945
21
Belleville
Newburyport
Place of Burial, Cremation or Removal.
Feb.
28
(City or Town)
145
DATE OF BURIAL
Received and filed
MAR 1
1945
19
(Registrar)
Underline the cause to which death should be charged sta- tistically.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
1
2 FULL NAME
Josie: ( Potter) Colby
(If deceased is a married, widowed or divorced woman, give also maiden name.)
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 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, Scc. 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 deccascd, 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 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 thercof 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 carly 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 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 canse 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 is made. . . . Chap. 114, Sce. 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 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, 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 .- Canse 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 .- 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 nct 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 housekceper --- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
.
RM R-302 +
1
PLACE OF DEATH
SUFFOLK
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
47
( If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
2 FULL NAME
Joseph Ralph Mann
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
(Usual place of abode)
62 Faunbar ave St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
1
months
days.
In this community 6
yrs. 6
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
18 DATE OF
DEATH
Feb 26/45
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
1/26 /45
19.
That I, attended deceased from
to ...
2/26/45
19
I last saw h ......... jmy.alive on ......
2. 26/45
death Is sald to
have occurred on the date stated above, at.
12;20p
.m.
Duration
Immediate cause of death
Pulmonary edema and congestion Tern
Due to.
Cardiac hypertrophy
yrs
Chronic glomerulonephritis
yrs
Due to.
Med Exam. declined jurisdiction
Other conditions.
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Sympa the ctomy
Date of.
2/26/45
Physician Underltne the cause to which death should be charged sta- latically.
Of autopsy aut opsy
What test confirmed diagnosis?
20 Was disease or Injury In any way related to oooupatlon of deceased?
If so, speolfy
no
(Signed)
W R Duden
M. D.
(Address)
Boston
20GB6/45
.19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ...... Mt ... Hope.
Boston
(Cemetery)
Mar
1/45(City or Town)
19
22 NAME OF
FUNERAL DIRECTOR
C R Bennion St
ADDRESS
Winthrop Mass ..
Reoelved and filed.
19
MAR ......
1945
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased 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-302 to the clerk
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Holden Maine
15 MAIDEN NAME
OF MOTHER
Alice Mc Donald
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
N B
17
Informant.
(Address)
Wife
(
Relation, if any
A TRUE COPY.
1
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
Mar .2.45
19
years
7 IF STILLBORN, enter that fact here.
Years 8 AG40 11 Months. 23 Days
If less than 1 day
Hours
.Minutes
Superintendent
Industry
10 or Business :
Jar.ka ....
Stevedore .... Co.
11 Social Security No ..
023-09-6470
12 BIRTHPLACE (City)
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