USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 6
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No undertaker or other person shall bury a human body or tbe ashes thereof which have been brought into the commonwealth until he has received 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 observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deatbs only as those of persons to whom they have given bedside care during a last ill- ness 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 un- related to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), 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 occupa- tion, 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 con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, 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 busi- ness, 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 bousework, write housework. For a person engaged in domestic service for wages, bowever, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
I R-305
No.
2 FULL NAME.
3 SEX
M
(or) WIFE of
15 MAIDEN NAME
OF MOTHER
PARENTS
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-305 to the clerk
11 Social Security No ..
of the city or town in which the deceased resided as soon as possible after the close of the month in which the death
occurred. (See Chap. 46, Sec. 12, G. L.)
4 COLOR OR RACE!
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Married
5a If marrled, widowed, or divorced HUSBAND of
Catherine G. Well
(Give maiden name of wife in full)
(Husband'e name in full)
6 Age of husband or wife If alive
7.3
years
7 IF STILLBORN, enter that faot here.
AGE.7.8. Years Months.
Days
Hours. Minutes
Usual
9 Occupation :
Retired
Industry
10 or Business :
Grocer
12 BIRTHPLACE (City)
(State or country)
"Boston, Mass"
13 NAME OF
FATHER
John MoIntyre
14 BIRTHPLACE OF
FATHER (City)
Ireland.
(State or country)
......
16 BIRTHPLACE OF
MOTHER (City)
Ireland
(State or country)
17 Informant. (Address)
Relation, if any Wifo
A TRUE COPY AMARRES
ATTEST :
(Registrar of city on town where death occurred)
DATE FILED
Jan ..... 29 , ... 1945
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan 24, 1945
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, etate fully.) Cerebral hemorrhage
Minor lageration of scalp - fall.
20 Accident, suloide, or homiolde (specify)
Date of oocurrenoe
19
Where did
Injury occur ?
(City or town and State)
Did Injury occur in or about the home, on farm, In Industrial place, or in publio piaoe ?
(Specify type of place)
Manner of
Injury
Nature of
Injury
While at work?
Was there an autopsy ?.... no
21 Was disease or Injury In any way related to occupation of deceased ?
If so, speolfy
(Signed)
T. Leary
M. D.
(Address)
Date ..
1/25/05
1
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Jan, 27 1945
19
23 NAME OF
FUNERAL DIRECTOR
J. F. O'Maloy
ADDRESS
Winthrop
Received and filed
19
1045
(Registrar of City or Town where deceased reelded)
26m (h)-1-41-4667
PLACE OF DEATH
Stidounty)
BOSTON (City or Town)
Boston City Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
770
19
(If death occurred in a hospital or inetitution,
give its NAME instead of etreet and number)
Joseph Mcintyre
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
125 Circuit Rd.
St.
Winthrop
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
days.
(If nonresident, give city or town and State)
40
In this community
yrs.
mos.
daye.
PERSONAL AND STATISTICAL PARTICULARS
St.
(if U. S.
War Veteran,
no
( specify WARS
W
If less than 1 day
1
Ann Harkins
22
Holy ... Cross.
Malden
303-A
Suller (County)
(City or Town) 20 hermand are
The Commontoealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
20
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). No
(a) Residence.
No.
20 mermaid ave Wuthresh
(Usual place of abode)
(If nonresident, give city or town and State)
months
days.
In this community 25 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4 COLOR OR RACE|
White
5 SINGLE
( write the word)
Single
MARRIED
WIDOWED
or DIVORCED
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 AGE ... 4.1 .. Years. Months .Days
if less than 1 day Hours. .Minutes
Usual
9 Occupation :
Retail .... Store .... Proprietor
Industry
10 or Business :
Retail ... Variety .... Store
11 Social Security No ...
.....
none
12 BIRTHPLACE (City)
St. John's
(State or country)
New Brunswick
13 NAME OF
FATHER
William Cohen
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Flora Wolgemuth
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Lewis ..... Cohen
Informant ( Address) 65 Hazelton St. Mattapan
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : William D. Children (Signature of Agent of Board of Health or other)
agent
1/28/45
(Official Designation) (Date of Issue of l'ermit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
7 am -
27-1945
(Year)
(Month)
(Day)
19 | HEREBY CERTIFY that I have Investigated the
death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved Rte fully.) Carbon monoxide porsenna
20 Acoident, suloide, or homiolde (specify)
Jucidal
...
Date of ooourrenoe.
Jan-27-
1945
Where did
Neitherop. 22:
Injury ooour ?
(City or town and State)
place?
abouthome
Did Injury ooour In or about home on farm, In Industrial place, or In publio
(Specify type of place) Manner of Found dead in ken gas
Injury
Nature of
filled Kitchen
Injury
While at work?
.Was there an autopsy ?.
no
21 Was disease or Injury in any way related to oooupation of deceased ? -
If so, specify
(Signed)
M. D.
(Address)
Bortin
)and-28-1945
22
Tifereth Israel of Winthrop Everett
Place of Burial, Cremation or Removal.
(City or Town)
23 NAME OF
FUNERAL DIRECTOR.
151 Washington Live. Chelsea
ADDRESS
Received and filed
18: 3 3 1015
19
(Registrar)
extracts from the laws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a recital to that effect
50m (g)-1-41-4667
1
PLACE OF DEATH
1
No. Helen
2 FULL NAME.
Cohen
(If deceased is a married, widowed or divorced woman, gite also maiden name.)
Length of stay : in hospital or institution.
NO
(Before death)
(Specify whether)
years
(Give maiden name of wife in full)
7
BAtistHey
DATE OF BURIAL
January .... 28th,
19 45
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physlolan 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 deatlı, stating to the hest of his knowledge and helief the nanie of the deceased, his supposed age, the disease of which he died, defined as required 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 precerling section or hy section forty-five of chapter one hundred and four- teen, sliall, 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 tlie 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 ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety-cight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person sliall bury or otherwise dispose of a human body in a town, or remove thercfrom a human body which has not been buried, until he has received a permit from the board of health, or its agent sppainted 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 exliume a human body and remove it from a town, from one cemetery to another, or from one grave or tonih other than the receiving tomb 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 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 hy 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 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 medical examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to an- other within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as ahove provided and in the pos- session 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 re- moval, unless a permit in the usual form for the removal of such body has been sooner ohtained hereunder. If the death certificate contains a recital, as required hy 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 it> agent, upon receipt of such statement and certificate, shall forthwith countersign in and transmit it to the clerk of the town for regis- tration. The person to whom the perinit is so given and the physician cer- tifying the cause of death slrall 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 re- quire .- 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 ageut appointed to issue such permit», 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 he held, or from a per- son appointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion ).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy violeuce. 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.
. . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may he, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the hest of his knowledge and helief.
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 persous 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 uurelated to any form of injury, have died without recent medical attendance or whose physi- cian 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 in- directly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following shortion, 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and ( 2) under manner, the mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation hy suspension, suicidal." "Syncope while under the influence of ether 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 heen due to disease, specify: (1) Under cause its known or presumahle nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the hrain (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
01 A
1
PLACE OF DEATH
Suffolk (County)
BOSTON NOTIFIED
3753 1 2 1945
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.
21
A { (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Roberta Goveia
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
233 Saratoga St. Fast Boston St.
.East .... Boston.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or institution .Hospital - years .
(Before death)
(Specify whether)
months 14 days.
In this community __ yrs.
mos. 14 days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
female
white
4 COLOR OR RACEJ
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
single
Sa 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 Yeers
Months 14 Days
if less than 1 day Hours Minutes
Usual
9 Occupation :
at home
Industry
10 or Business :
none
11 Social Security No.
none
12 BIRTHPLACE (City)
(Siate or country)
Mass
Winthrop
13 NAME OF
FATHER
Augustino Goveia
14 BIRTHPLACE OF
Lowell
FATHER (City)
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Sarah Petralia
16 BIRTHPLACE OF
MOTHER (City)
East Boston
( State or country) Mass.
17
informent ( Address )
Augustino ... Goveia 233 Saratoga St. P. Bosto
I HEREBY CERTIFY that a satisfactory standard certificata of death was filled with me BEFORE the burial or transit/permit was issued : "m. D. Chil dressx.
( Signature of Agent of Board of Health of other)
Health (Official Designation) ( Date of Issue of Permit)
1/30/45
18 DATE OF
DEATH
Jan.
27/
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
Thet I attended deceased from
Jan 13
1945.
Ło
Jam 27
1945
Vlast saw h &M alive on fem
2/7, 19.45, death is said to
have oocurred on the date stated above, at. 2:40 P .m.
Duration
Immediate couse of death Prematurity
Due to
Due to
Other conditions
( Include pregnancy within 3 months of death)
IMPORTANT
Mejor findings:
Df operations
Date of
Of eutopsy.
What test confirmed diagnosis?
20 Was disease or injury in eny way related to oooupation of deceased ?
If so, spaoify
( Signed )
ar caplan
(Address) / 86/ Mieten t& CBm Date 1-29 1940
. M. D.
Place of Burial, Cremation or Removal.
(City or Town )
DATE OF BURIAL January 31,1945
19
22 NAME DF
FUNERAL DIRECTOR
R.C. Kirby
ADDRESS
Boston
19
( Registrar)
Ru B. y Health
100m(1).1.44.13634
If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physicians to insert a reoltal to that offoot. PARENTS
-
Winthrop (City or Town)\ No.
Winthrop Community Hospital
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
no
1945
IMPORTANT
....
Physician Undertine the cause to which death should be charged sta- tistically.
Received and Alad
martin
21
Relation, 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 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 samne 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, sball, 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 bundred 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 110 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 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 wbo 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 sorty-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 aud 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).
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