USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 45
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14 BIRTHPLACE OF
PARENTS
Informant
( Address)
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
resided in another city or town et the time of death should be made forthwith and transmitted on Form R-802 to the clerk
Copies of returna of deaths recorded during the previous month which occurred in your city or town in case the deceased
(State or country)
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Single
MARRIEO
WIOOWEO
or DIVORCED
5a If married, widowed, or divorced HUSBANO of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive
years
Registered No.
(If U. S.
War Veteran,
speolfy WAR)
(a) Residence. No.
(Usual place of abode)
Winthrop . Mass
1945
M R-302
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)
HOSTON
(C'ity or Town)
Carney Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making retur).
Registered No.
5664
No. St. (If death occurred in a hospital or institution, give its NAME instead of street and number) r
Ann Geever
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
War Veteran,
speolfy WAR)
-
(a) Residence. No.
(Usual place of abode)
26 .... Sagamore .... Ave.
St.
.Winthro.p ... Mass ..
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
2
days.
In this community 30 yrs.
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
Single
5a If married, widowed, or divorced
HUSBAND of
(Cive maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
have occurred on the date stated above, at
11,50р
m.
Duration
6 Age of husband or wife if alive
years
Inimediate cause of death
Acute circulatory failure
Uremia.
dys
AGE
8 59 Years Months. Days
If less than 1 day Hours Minutes Due to
Usual
9 Oooupation :
Dome stic
Industry
10 or Business :
Home
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
Patrick Geever
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
"Ire land®
15 MAIDEN NAME
OF MOTHER
May Fleming
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informant ... . Geo. .Cusick.
Relation, if any
(Address)
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
June 27 1945
19
18 DATE OF
DEATH
June 24/45
(Month)
(Day)
( Year)
19 1 HEREBY CERTIFY,
6/23/45
19.
That I attended deceased from
to
6/24 /45
19.
1 last saw h .... er ..... allve on.
6/24 /45
19
death is sald to
dys
Due to
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed dlagnds?P .... ₦
20 Was disease or injury in any way related to oocupatlon of deceased ?.
If so, speolfy
(Signed)
L ......... Kenney.
M. D.
(Address)
Boston Mass Dato.
6/21/45 ...
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Holyhood
Brookline
(Cemetery)
(City or Town)
DATE OF BURIAL
June 27/45
19
22 NAME OF
FUNERAL DIRECTOR
JF O .Maly
ADDRESS
Winthrop
Received and filed
JUL 1 2 1945
19
(Registrar of City or Town where deceased resided)
. M-11)-11-12 10716
Date of
should be charged sta- tistically.
7 IF STILLBORN, enter that faot here.
-
レー
R-301 A
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that offeot.
100m(:).1.44-13634
I HEREBY CERTIFY that a urilafactory standard cartifonte of death was filled with pw. BEFORE tha bipal ør tragelt permit was Issued : Nu. D- Childrestx
(Sanature of Agents of Board of Health or other) Health office 7/5/40
(Oficial Dealgnation) ( Date of Inause of Permit)
18 DATE OF
DEATH
(Month)
(Day)
1945 ( Year)
3 SEX
7
4 COLOR OR RACEJ
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word) Mamed
5a If married, widowad, or divoroed HUSBAND
piden name of wife in full)
( or) ME of
6 Age of husband or wife if alive
41 years
7 IF STILLBORN, enter that fact here.
8 AGE 37 Years 8 Months 15 Days
If less than 1 day Hours Minutas
Usual
9 Occupation :
Industry
10 or Business:
home
11 Social Security No. none
12 BIRTHPLACE (City)
( Siate or country)
Ontario, Canada
13 NAME OF
FATHER
Maurice Udivin
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
15 MAIDEN NAME
OF MOTHER
Ethel (cannot be
leaned
16 BIRTHPLACE OF MOTHER (City) (State or country )
Canada
17 Fussell Wright Informant
Relation , Y Kany (Address) 95 Circuit Road Winthrop
21 Burai arall of Beachment- Everett Place of Burial, Cremation or Removal. (City,or Town) 6 OATE OF BURIAL 45. 19.
22 NAME OF
FUNERAL DIRECTOR
NyJuan
ADDRESS
151 Washington Cave, Chelse
Received and flad .19
JUL .. 6.
1945
( Registrar)
1
PLACE OF DEATH
Suffolk (County) Willthrop
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. 120
{ {If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
Edna Muriel Zright
2 FULL NAME
$ ( If deceased ig
married, widowed or divorced woman, give also maiden 95 Circuit Road
name.) cinthia St.
( If nonresident, give city or town and State)
Length of stay : In nepitat nr Institution
( Before death)
( Specify whether)
months days.
In this community
2 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
19 I HEREBY CERTIFY,
That I attended deosased from
19 ...
I last saw h. alive on 19 daath Is said to
have occurred on the date stated
above, at 11.30P m.
Duration
Immediate causa of death
Oua to
jisduction
Due to
Other conditiona.
( Include pregnancy within 8 montba of death)
Major AndIngs: Of operations
Oata 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 ralatad to occupation of deceased ? If, so, speoity.
( Signad) ...
( Address
Bon fitimesto te 7-5 1945
....... M. D.
No.
(City or Town) 95 Circuit Road
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, Lo if so specify WAR)
(a) Rasidenca. No.
(Usual place of abode)
200
....
years
Hamilton
Ło
IMPORTANT
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 hy the preceding section or by 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 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 bury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not heen huried, until he has received a permit from the hoard 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 hody is huried. No such permit shall he issued until there shall have been 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, hy a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard of health, or employed hy 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 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 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 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 hody has heen 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 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 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 hody lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human hody or the ashes thereof which have heen hrought 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 hoard, from the clerk of the town where the hody is to he 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 form 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 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 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 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 Town) No.
49 Hermon 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.
130
St. § (If death occurred in a hospital or institution, give its NAME instead of street and number)
PHYSICIAN - IMPORTANT ( Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No.
(Usual place of abode)
49 Hermon St St.
Length of stay: In hospital or institution
-
(Before death)
(Specify whether)
years
months
days.
In this community yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4
COLOR OR RACE
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Single
Male White
5a If married, widowed or divorced HUSBAND of ...
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 AGE 75 Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Shipper
Industry 10 or Business:
Candy
031 -- 09 -- 9346
11 Social Security No.
12 BIRTHPLACE (City)
(State of Country)
South Boston
Mass
13 NAME OF
FATHER
Joseph E. Wilson
14 BIRTHPLACE OF
FATHER (City)
.(State or Country)
Finland
15 MAIDEN NAME
OF MOTHER
Margaret Mckeon
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Mass
17 Eileen Informant (Address) 49
Wilson Hermon St ( ReMieće )
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Nu. D-Childress & (Sign dure of Agent of Board of Health Another) .
Health (Official Designation)
officer 7/6/45
(Date of Issue of/Permit,
18 DATE OF DEATH July (Month
5 (Day)
1945 (Ycar)
19 I HEREBY CERTIFY,
. 19
, to ,
That I attended deceased from July , 19
45
Just saw halive on
S
19 Sdeath is said to
have occurred on the date stated above, at
3.30 m.
Duration
Immediate cause of death
Due to arteno Saleina
Due to
Other conditions (Include pregnancy within 3 months of death)
MPORTANT
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? If so, specify
M. D.
(Signed) Imlangton en date ofTo 1945 (Address)
21 Winthrop Winthrop
Place of Burial, Cremation or Removal
(fity of Town)
DATE OF BURIAL July 11 1845 2- 6-19 45
22 NAME OF
FUNERAL DIRECTOR
John F. O malley Winthrop,
ADDRESS
Received and Filed JUL 1 0 1945
19
(Registrar)
100m-9-44-14955
See instructions and extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
2 FULL NAME Joseph H. Wilson (If deceased is a married, widowed or divorced woman, give also maiden name.)
(If nonresident, give city or town, and State)
40
MEDICAL CERTIFICATE OF DEATH
Physician Underline the cause to which death should be charged sta- tistically.
Boston
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital medical officer shall forthwith, after the death of a person whom be has attended during his last illness, at the request of an undertaker or other authorized person or of any member of tbe 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, bis 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, Cbap. 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 fourtb, nineteen hundred and two, and the Mexican border service of nineteen bundred and sixteen and nine- teen bundred and seventeen. G. L. Cbap. 46, Sec. 10.
No undertaker or otber person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body wbich 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 tbe 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 sball 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, bis 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 tbe attending physician. If death is caused by violence, tbe 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 tbe 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 sucb removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after sucb removal, unless a permit in the usual form for the removal of such body has been sooner obtained bereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, tuat the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of bealtb, 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 furnisb for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the deatb, 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 bave died by violence. If a medical examiner has notice that there is witbin his county the body of such a person, be sball fortbwith 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 sball bury a buman body or the asbes thereof which bave 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 beld, or from a person appointed to bave the care of the cemetery or burial ground in which the interment is made. . .. Cbap. 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 deatbs 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 wbo, though disabled by recognized disease unrelated to any forin of injury, bave died witbout recent medical attendance or whose pby- sician is absent from home wben 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 tbe 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 wbich causes death, not the mode of dying, e. g., heart failure, aspbyxia, asthenia, etc. As principal cause name the disease causing deatb. 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 deatb, 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 bad no occupation whatever write none.
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