USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 40
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(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include unt only deaths caused directly or il- directly by traumatismn (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or clectrical agents, and deaths following abortinn, 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 DEATHI
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Uinder cause, the nature of an injury and of its ennsequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Coin- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shnt wnund of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Synenpe while under the influence of cthier administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- tancous nf the brain (hasal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death. )"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .-- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
-301 A
T
1
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No.
89 Freemont Street
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, 116
Registered No.
St. { {If death occurred in a hospital or institution, {give its NAME instead of street and number)
2 FULL NAME.
Nellie (Fitzherbert) Taylor
( If deceased Is a married, widowed or divorced
woman, give flso maiden name. )
(a) Residence. No.
89 Freemont Street
(Usual place of abode)
******
Length of stay: In hospital ne Institution
( Before death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Thomas "c" Taylor"
( Husband's name in full)
66
6 Age of husband or wife if etiva years
7 IF STILLBORN, enter that fect here.
8 AGE 7.3Years .9. Months Days
if less than 1 day
Hours
Minutos
Usual
9 Occupetion :
Housewife
Industry
10 or Business :
Own Home
Nono®
11 Social Security No.
12 BIRTHPLACE (City)
( Siate or country)
13 NAME OF
FATHER
New Brunswick
Canada
James Fitzherbert
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Fort .... Fairfield.
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Agnes Sloat
16 BIRTHPLACE OF
MOTHER (City)
Fort Fairfield
( State or country)
Maine
17 Hub ba dany
( Address}
af18 TextoEt Winthrop
I HEREBY CERTIFY that a satisfactory standard ogrtifoate of death was fled with me BEFORE the burist or transit permit was Issued :
(Signature of Agent offBoard of Health /or other)
HO
...
.... (Omtelal Designation) ( Date of Immuse of Permit)
18 DATE OF
DEATH
14
1945 (Year)
IP I HEREBY CERTIFY,
Thet i attended deceased from
194.5. to
19.
I last saw h ...
In alive ont
4 . 19 43 death is said to
have occurred on tha date stated above, at. 90 m.
Immediate, cause of death ...
IMPORTANT
Due to.
10 ups
Other conditiona
( Inelude pregnancy within 3 months of death)
Major findings : Of operations
Data of
Of autopsy
Whet test confirmed diagnosis?
IMPORTANT
Physician Underline the cause to which death should be charged stat. tistically.
20 Was disease or injury in any way related to occupation of deocesed ?
if so, spsoify
(Signed) (Address) Y Washerther M Data/ 15 1945 M. D.
21 Presque Isle.
Maine (City of Town)
Place of Burial, Cremationr Removal.
DATE OF BURIAL ..
June 19.
1945
22 NAME OF
FUNERAL DIRECTOR Award S. Olumolto
ADDRESS
Received and Alad. JUN 1 y 195 19
( Registrar) V
100m(i)-1.44-13634
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effeot.
MEDICAL CERTIFICATE OF DEATH
(šfonth)
(Day)
Female
White
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
months
days.
In this community22 yrs.
mos.
days.
years
June 15/40
Duration
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 hest of his knowledge and helief, served in the army, navy or marine corps of the United States in any war in which it has heeu 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 relicf 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 horder 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 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 cemetery to another, or from one grave or tomb 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 hody is buried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may he, & satisfactory written statement containing the facts required by law to he returned and recorded, which shall he accompanied, in case of an original interment, by 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 insufficient, a physi- cian who is a member of the hoard of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy 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 ahove 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 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 heen sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten or 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 heen 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 bodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody 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 hoard, from the clerk of the town where the hody is to be huried or the funeral is to he 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 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 hy recognized disease unrelated to any forum of injury, have died without recent medical attendance or whose phy- sician is ahsent 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 hy 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 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 im- portant, so 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 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, how- ever, 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
-301 A
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PLACE OF DEATH 1
Suffolk (County)
Winthrop
....
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.
Registared No.
§ (If death occurred in a hospital or institution, St. give its NAME instead of street and number)
2 FULL NAME
Catherine
(Millen) Gentle
(IL deceased is a
married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
89 Main Street
(Usual place of abode).
(If nonresident, give city or town and State)
Length of stay : In ansoltal nr Institution Hosp ...
(Before death)
( Specify whether)
/
years
6
months
days.
In this community 28 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEĮ
White
5 SINGLE
MARRIED
WIOOWED
or DIVORCEO
( write the word)
Widowed
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Cuthbert Gentle
( Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact hera.
8 94 8
AGE Years
Montha
22
Oays
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
At Hmoe
Industry 10 or Business :
11 Social Security No.
None
12 BIRTHPLACE (City)
( State or country)
Scotland
13 NAME OF
FATHER
John Millen
PARENTS
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Helen Pettle
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
17 Informant ( Address)
Norman Gentle 89" Main St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificata of death was filled with me BEFORE the burial or kronelt permit was larued :
( Signature & Agents Board of Health or other)-
June 15/45
....... ..... (Omeial'Designation) ( Date of Inque of Permit)
18 DATE OF
OEATH
(Month )
(Day)
1945 (Year)
19 I HEREBY CERTIFY,
That I attended daoaased from
19.
, Ło
19
I last saw h
allve on.
19
.. , death Is sald to
have occurred on the date stated above, at ...
Immedlate gause of death.
a fare , the
Infart
Due to
Due to
Other conditiona.
( Include pregnancy within 3 months of death)
Major findIngs : Of operations
Osta of.
Of autopsy
What test confirmed diagnosis?
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?
= ( Signed).
. M. D.
Data 6/15 19 ... )
21
winthrop
Winthrop
Place of Burial, Cremation or Removal. (City or Town) DATE OF BURIAL" June 16 19.45
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Unimog muco.
Received and Allad
JUN 1 9 1945
19
( Registrar)
100m(i).1-44.13634
1
(City or Town) 104 Highland Ave.
No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
MEDICAL CERTIFICATE OF DEATH
15
Duration
IMPORTANT
.......
.,
Howard Sahunolds
HO.
Bom, If any
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive 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 in 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 hetween February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican horder 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 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 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 hoard 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 heen delivered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall he 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 he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard 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 deatb 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 he obtained early enough for the purpose, tbe certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for auch removal; provided, that such hody 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 ohtained bereunder. If the death certificate contains a recital, as required
by section ten or 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 heen 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 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 his 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.
No undertaker or other person shall hury a human hody or the asbes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the hoard 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 he 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 sucb deaths only as those 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 disahled hy recognized disease unrelated to any forin of injury, have died without recent medical attendance or whose pby- sician is ahsent 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 hy 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 disahlcd 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 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 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, how- ever, 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 +
1
PLACE OF DEATH
Suffolk. (County)
.....
Winthrop.
(City or Toho Winthrop St.
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.
118
St. { (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Melissa Judith (MacWilliams) Wood.
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
270Winthrop
(Usual place of abode)
St.
( If nonresident, give elty or town and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
montha
days.
In this community55 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
{write the word)
MARRIED Married
WIDOWED
or DHARfler
Sa If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife i AMpod
(or) WIFE of
( Husband's name In full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8
AGE 8.0. Years
5.
Months 25 Days
-
If less than 1 day
Hours
Minutes
Usual
9 Ocoupetion :
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