USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 12
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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deathis of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
.
1
R-301 A
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a recital to that effect. PARENTS
100m-(g) -1-45-15510
I HEREBY CERTIFY thet . satisfactory stendard certificate of deeth was filed with me BEFORE the burial og transit permit was Issued ? William D. Childress (Signature of Agent of Board of Health or other)
Cegent Feb, 15/45
(Omcial Designation) (Date of Trque of Permit)
18 OATE OF
DEATH
13-1946
( Month)
(Dsy)
(Year)
Sa If married .
HUSBANO of
widow
FPotente Rea Cullinane
(Cive maiden name of wife in full)
(or) WIFE of
( Husband's name In full)
6 Age of husband or wife if allve 44 yrs yeers
7 IF STILLBORN, enter that fact here.
8
AGE 56
Yeers
5
Months
4.4ay,
If less than 1 dey
Hours
Minutes
Usual
9 Ocoupetion :
Engineer
Industry
10 or Business :
New England Telephone Co
11 Social Security No.
011-07-4105
12 BIRTHPLACE (City)
East ... Boston
( State or country)
Massachusetts
13 NAME OF
FATHER
Edward Cummings
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Catherine Brown
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
.
Ireland
.
17 Informent ( Address) Florence Rea Cummings tion, ifany 108 Brookfield Road Winthrop
DATE OF BURIAL.
February 16 1946
19
22 NAME OF
FUNERAL DIRECTOR
.
Richard C Kirby
ADDRESS
Boston
Received end fled
FEB 19 00
19
( Registrar)
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No. 108 Brookfield Road 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.
30
Registered No.
st & (If death occurred in a hospital or institution,
{ give its NAME instead of street and number)
2 FULL NAME
William J . Cummings
( If deceesed Is . merried, widowed or divorced women, give also meiden name.)
(a) Residenca. No.
108 Brookfield Road
Winthrop St
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution -fone
(Before death)
Jeers
months
days.
in this community
9
yrs.
mos.
deys.
(Specify whether )
PERSONAL ANO STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX male
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIOOWEO
or DIVORCED
( write the word)
married
HEREBY CERTIFY.
46
Zar. 13
,
to
19
C'est saw h wh
alive on.
Fer 13, 1945
death Is said to
have occurred on the dete stated above, at.
28.
m.
Immediate ceuse of death).
Venta Pulmones Educa
Due to
Due to
Antonio Valencia
1yr.
Other conditions.
( Include pregnancy within 8 months of death)
Mejor findings: Of operations
Date of.
Of eutopsy
What test confirmed dlegnosis?
IMPORTANT
Physician Underline the cause to which death should be charged sta. tistically:
20 Was disease or injury in any way related to oooupation of deceased ?. If so, Grov . H. Schwartz
( Signed)
(Addr
3) 19 Piumeera St EN3 Oste 2/14
M. D. 1985
21 Holy Cross Cemetery, Malden Place of Burial, Cremation or Removal.
(City or Town)
Duration IMPORTANT
1 Day
Thet 1 ettended deosased from
PHYSICIAN - IMPORTANT
(Was deceased a World 1
U. S. War Veteran,
if so specify WAR) ..
y.e.s.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican 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 body in a town, or remove therefrom a human hody which has not been 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 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 hody is buried. No such permit shall be issued until there shall have heen delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed hy it or by 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 he 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 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 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).
Medical examiners shall make examination upon the view of the dead hodies of ouly such persons as are supposed to have died by 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 hury 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 suchi board, from the clerk of the town where the body is to he huried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) 'Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and 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 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 agcd 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 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
DATE OF ENTERING MILITARY SERVICE Enlisted Reg. Army Dec. 10, 1917 at Boston
DATE OF DISCHARGE June 21.1919
RANK, RATING Sgt. in Med. Dept.
ORGANIZATION AND OUTFIT Med, Dept.
SERVICE NUMBER
636512
-301 A Suffolk
1
PLACE OF DEATH
(County) Winthrop
(City or Town)
The Umumontoralth of Massalpisetts 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. 31
S ( If death occurred in a hospital or institution, { give its NAME instead of street and nuniber)
2 FULL NAME
Richard H. Holt
( If deceased is a married, widowed or divorced woman, give also maiden name.)
160 Bellingham Ave., Revere St.
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
years
months days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX .
Male
4 COLOR OR RACEĮ
Wbite
5 SINGLE
( write the word)
MARRIED
WIDOWED
Or DIVORCEDWidowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Emma B. Buckley
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive
years
IF STILLBORN. enter that fact here.
8 AGE
83 Years
-
Months
- Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
Retired Boat Livery
Industry
10 or Business :
Self
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or conutry)
West Alexandria
13 NAME OF
FATHER
Rufus Holt
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ohio
15 MAIDEN NAME
OF MOTHER
Katherine Kelley
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ohio
17 Mr. Richard Holt RcBon if any
Informant ( Address)
178 Bellingham Ave Revere, Ma
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 of other)
Health Check 2/15/46
(Official Designation) (Date of Issue of Pergfit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
February 18,
1946
(Month )
(Day)
(Year)
19 I HEREBY CERT FY,
That i attended deosased from
Nov15
1946.
.
I last saw h / im alive on
700 12, 19/6 death Is said to
have occurred on the date stated above, at.
3.30 7.m.
Immediate cause of death
Carcinoma O/ Colon
IMPORTANT
Est 1 year
Due to
Due to
Other conditions
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Physician L'uderline the cause to which death should be
charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deoeased ?. 200
If so, specify
(Signed)
Jamal L. (O Brien
M. D.
(Address)
Winthrop
Date tab 14/ 1946
21 Glenwood Cemetery, EverettMass Place of Burial, Cremation or Removal (City or Town)
DATE OF BURIAL
February 15,1946
19
22 NAME OF
FUNERAL DIRECTOR
Edith M. Merwin
ADDRESS
305 Beach St. , Revere, Mass
Received and Aled 19
FEB 1 0 1945 (Registrar)
.
100M-F -2-42-8855
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to insert a recital to that effect. PARENTS
No.
48 Washington Ave
......
St.
Registered No.
PHYSICIAN - IMPORTANT
(Was deocased
U. S. War Veteran,
if so specify WAR)
(Specify whether)
to ...
Feb. 13
1946
Duration
Of autopsy
What test confirmed diagnosis? Clinical Signs
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 whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of ans meniber 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, 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 fitness, when last seen alive by the physician or officer and the date of his death ... Cen. 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 bundred 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 I'nited States in aus 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 saine. 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 bunilred 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 between February fourteenth. eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen bundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman 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 ita 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 otber person shall exhume a buman body and remove it from a town, from one cemetery to another, or from oue grave or tomb other than the receiving tonib to another In the same cemetery, until he has received a permit from the board of health or ita agent aforexaid or from the clerk of the town where the body is buried. No sucb permit shall be issued until there shall bave been delivered to sucb board, agent or clerk, as the case may be, a satisfactory written statement containing the facta required by law to be returned aud 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. oi in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasous, his certificate caunot be obtained early enough for the purpose, or is insufficient, a pbysi- cian who is a member of the board of health. or employed by It or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. if death is caused by violence. 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 the commonwealth cannot be obtained early enough for the purpose, tbe certificate of desth made as above provided and in the possession ot tbe undertaker desiring to make such removal shall constitute a permit for such removai; 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 recitai, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States lo any war in which It has been engaged. sucb 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 nece+ 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 way require .- Cbap. 114. Sec. 45. G. L., (Tercentenary Edition).
No undertaker or other person shall bury a hunian body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if There is no such board, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which ibe interment is made. ... Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medicai examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within hls county the body of such a person, he shali forthwith go to the place where the body lies aud take charge of the same; ... - General Laws, Cbap. 38, Scc. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to sucb deatbs only as those of persons to whom they have given bedside care during a last liluess from disease unrelated to any form of Injury.
(2) Board of Health physlolans will certify to such deaths only as those of persons who, though disabled by recogulzed disease unrelated to any form of injury. have died without recent medical attendance or whose pbyat- cian is absent from home when the certificate of death is needed.
(3) Medloal 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 septleemla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseass resulting from injury or infeotlon related to occupation, the sudden deaths of persons not disabisd by recognized disease, and those of persons found desd.
Statement of Cause of Death. Cause of death means the disease, or complication which causes death. not the moile of dying, e. g., heart fallure, asphyxia, asthenla, 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 compilestion 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 ou account of the disease causing death, report the usual occupation prior to Iliness. If the deceased bad retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at hvine. For a woman wbose only occupatiou was that of bome bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as bousekeeper-private family, cook-hotei, etc. For a person who bad no occupation whatever write none.
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