USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 54
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(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including 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., hicart 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 Ocoupation .- l'recise 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, however, designate the occupation by the appropriate terms, aa 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) 293 Main St No.
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.
St. { (If death occurred in a hospital or institution, ! give its NAME instead of street and number)
2 FULL NAME
Clara M. Finnegan
Farmer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT ( Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No ..
(Usual place of abode)
293 Main St. St.
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months days.
In this community+O
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED1dowed
5a If married, widowed or divorced HUSBAND of ...
(or) WIFE of
(Give maiden name Af wife in full)
James F. Farmer
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
AGE
8 70 Years Months Days
If less than 1 day
Hours
Minutes
Usual 9 Occupation:
Housewife
Industry
10 or Business:
Own Home
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country)
Sherman Sta.
Ma ine
13 NAME OF
FATHER
Cannot be learned
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Ma ine
15 MAIDEN NAME
OF MOTHER
Catherine Hayes
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Maine
17 Informant (Address)
James Farmer 293 Main St. Weet.
I HEREBY CERTIFY that a satisfactory standar certificate of death was filed wilh we BEFORE the/burial of transit permit was issued:
Health Officer kofficial Designation)
(Signature of Agent f Byard we south or other) 8/27/45
(Date of Issue of Pernu()
19 I HEREBY CERTIFY,
That I attended deceased from
mar. 2.
19 45, to Rug: 26,
19
45
I last saw her
alive on
aug 26,
, 19 >, death is said to
have occurred on the date stated above, at
7:45 P . m.
Immediate cause of death
Cerebral Hemorrhage
IMPORTANT 3 days 6 months
Due to
Hypertension,
arteriosclerosis
Due to
Chronida Degenerative astkietes
Other conditions
(Include pregnancy within 3 months of death)
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, specity
(Signed).
, M. D.
(Address) 270 Shirley St. Wielange Date Crees 27 1995
21Holy
Cross
Malden
Place of Burial, Cremation of Rompeal
DATE OF BURIAL
Ang
22 NAME OF
FUNERAL DIRECTOR
John HO males 19
ADDRESS
Winthrop
Received and Filed
19
AUG 2 0 1945
(Registrar)
100m-9-44-14955
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. PARENTS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
august
26
(Day)
(Month)
1945
(Ycar)
Duration
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
29 1945 City or Town)
( Rs'd'in, if any
(If nonresident, give city or town and State)
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 kuowledge 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 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 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, 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 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 he returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he 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 hy 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 ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall 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 hody has been 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 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 bury a human hody or the ashes 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 hoard, 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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any 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 by traumatism (including resulting septicemia), and hy 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 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 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
DEPARTMENT OF COMMERCE BUREAU OF THE CENSUS
STANDARD CERTIFICATE OF DEATH
State File No.
158
State of.)6
1. PLACE OF DEATH:
2. USUAL RESIDENCE OF DECEASED:
(a) State
mass (b) County
(b) City of town Shellac
(If outside city or town limite, write RURAL)
(If outside city of town limits, write RURAL)
(c) Name of hospital or institution :-
Huntington Center
(d) Street No.
2 Gerald
(If rural, give location)
(d) Length of stay: In hospital or institution
In this community
years, months or days)
2 du
(Specify whether
If foreign born, how long in U. S. A .?
25
years.
20. Date of death: Month
June day
year
1945
hour
minute
50 0 MM.
21, I hereby certify that I attended the deceased from
6. (a)Single, widowed, martied.
19.
to
19
4. Sex
5. Color or
race
divorced
6. (c) Age of husband or wife if
and that death occurred on the date and hour stated above.
Duration
alive years Immediate cause of death 1
7. Birth date of deceased
/ april 4 1889
(Month)
(Day)
(Year)
8. AGE:
Years 58
Months 2
Days 14
If less than one day
9/26/450
9. Birthplace
10. Usual occupation the wounded (State or foreign country)
11. Industry or business United the worker
12. Name James Cahill
Zubundan
13. Birthplace
14. Maiden name mary 0 (City, town, or count quieres state or foreign country)
Major findings: Of operations
15. Birthplace
(City, town, or county)
16. (a) Informant's own signaturenro. G. Cahill
22. If death was due to external causes, fill in the following:
(a) Accident, suicide, or homicide (specify)
(h) Date of occurrence
(c) Where did injury occur?
(City or town) (County) (Stato)
Hfd) Did injury occur in or about home, on farm, in industrial place, in public
place?
While at work? __ > (e) Means of injury (Specify type of place) Jued Ex
23. Signature trum
Address Shelton
(M. D. or other) -. Date signed 6/19/20
8-6917
U. S. GOVERNMENT PRINTING OFFICE 10-13403 SEP 26 1945
Dat per win. Cemetery
---- hr. newfoundland
Due to
Other conditions. (Include pregnancy within 3 months of death)
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
(6) Address Winthrop
June 21, 1945 (Mouth) (Day) (Year)
17. (a) Winthrop (b) Date thereof (Burial, cremation, or remove) (c) Place; burial or cremation Winthro many J. J Donoval
18. (a) Signature of funeral director ... (6) Address Shelton Ct.
19. (a) 6/20/45 (6) agatha Glynn (Dafa receiveA local registrar) (Registrar's signature)
Gang land (Site or forejen country)
Of autopsy
prowans occlusion sudden death
Due to
MOTHER FATHER
3. (b) If veteran, name war
3. (c) Social Security No.
3.(0) FULL NAME michael 7. Cahillv
MEDICAL CERTIFICATION
18
V
that I last saw h
alive on
19
6. (b) Name of husband or Wife Lignes mi
(If not in hospital orinstitution, write street number or location)
(c) City or town
Minthroz
Registrar's No.
(a) County
Fairfield
RM R-301
PLACE OF DEATH
(County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No. 159 ...
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Re·
NEW JERSEY DEPARTMENT OF HEALTH-BUREAU OF VITAL STATISTICS
Registrar's No.
County _... Vonmouth
FORMER OR USUAL RESIDENCE
Stata Mass.
County
Suffolk
Fort Monmouth
City or Borough ___ Winthrop
(If cotalde aity or borough Thaits, Mme tovaskip)
or institution
Street No ...
1/3 Pleasant Street
(If rural give leontina)
Length of Stay
In this Community. yTE .....
mos.
days
_hrs. | foreign country? Ho
_country
Kindly Type or Print
FULL NAME
EDWARD AUGUSTUS COATES
(Surname last, first name bere)
MEDICAL CERTIFICATION
IF VETERAN. NAME WAR
NO ..
SEX
COLOR OR RACE
Male
White
Single, Married, Widowed or Divorced (write the word) Widowed
Age, If Ifving
(Give full melden sama) (or) WIFE OF
EMITA Frances Jones
DATE
BIRTH DATE OF DECEASED (Month, day and year)
Dec 5, 1853
AGE
Years
Months
Days
91
7
24
If Less Than One Day
Min.
BIRTHPLACE (City or town) (State or country)
Vermont
USUAL OCCUPATION ..
Industry or business
Other conditions ... (Include pregnancy within 3 meuthe of death)
PETLICIAN
NAME Edward M. Coates
-
Major Andlare:
Of operations
the tren to
CONT. CAUSE
Vermont
MAIDEN NAME Cynthia Foster
BIRTHPLACE (City or town) ... (Site or country)
Vermont
If death were due to external causes, All in the following: Accident, suicide, or homicide (spectty).
Date of occurrence.
Where did Injury ocourt ...
(Cky ar town) (County)
af deceased?
M. D.
.Dato.
19
(City or Town)
19
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
(Official Designation)
(Date of Issue of Permit)
DRIL OL BORTAL
22 NAME OF
FUNERAL DIRECTOR ADDRESS
Received and filed
SEP 26 1945
19
A TRUE COPY ATTEST: (Registrar)
city or town and State)
yrs.
mos. days.
F DEATH
Day) (Year)
That I attended deceased from 19
19 death is said to
m.
Duration Important
29.45
that I last aw Hm allve on ...
29 July
death occurred on the date stated above, at .... 9:00 P. m.
Immediate cause of death ... Arteriosclerosis generalized
Due to .....
Due to ....
Important
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
18 MAIDE OF MO
PLACE OF ACCIDENT
(A&trem)
Fort Monmouth, NJ.
PLACE OF BURIAL Cremation or Removal ..
Cambridge, Mass.
DATE 71 July. 125 Cambrid e Cemetery
FUNERAL John , Flock
While at work !. lang of, Injury
Signature. O. W. HAFFAR, Capt, M.C. MD
Regioml Hospital,Ft Monmouth,ly
Address
Level Regitrer.
DATE OF DEATH 29 July
13 45
I HEREBY CERTIFY, That I attended the deceased from 29 July
19 ___ to.
Hrs.
Windsor
CAUSA
Retired
12 BIRTHPLA (State or co
97
MOTHER FATHER
BIRTHPLACE (City or town). (Sente or country)
should be
Of autopsy-
Did Injury occur in or about bome, on farms, in Industrial place, to publie place ?....
(Specify type of plass)
DIRECTOR (Adin2417 BrengAssy Long French : N. J
RECEIVED 31 July 1.45
(Was deceased a U. S. War Veteran? Ii so, (specify WAR)
DO NOT WRITE IN SPACES BELOW
PLACE OF DEATH
Township Oceanport
City or Borough, Nams of Hospital
(If not in hospital or institution write street nomber or location)
PLACE
480
Ba If married HUSBAND of
SOCIAL SECURITY
RESIDENCE
If married, widowed or dwerved HUSBAND OF
Citizen of If to, name
No.
1 Length of stay PE 3 SEX (or) WIFE of. 6 Age of husk 7 IF STILLB 8 AGE ... Y Usual 9 Oocupatio Industry 10 or Busines 11 Social Sec 13 NAME FATHE 14 BIRTH FATHE 16 BIRTH PARENTS MOTH (State o 17 Informant ... (Address) If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physician to insert a recital to that effect. mation should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. 100™(h)-1-41-4695 N. B .- WRITE PLAINLY, WITH ONFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of infor- (State o
INFORMANT
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwitb, after the death of a person whom he has attended during his last Iliness, 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 tbe name of the deceased, his supposed age, the disease of which be died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by tbe 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 fourteen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any pro- vision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this section and of sections forty-five, 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 shali, 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 nineteen hundred and seventeen .- General Laws, CLAS AR 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 huried, 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 receiv- ing 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 ls in- sufficient, a physician who is a member of the board of health, or em- ployed hy it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human 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 he returned to the town from which it was removed within thirty-slx hours after such removal, unless a permit in the usual form for the re- moval of such body has heen sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-
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 tbe physician certifyIng the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chop. 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 dled 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.
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