USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 13
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SPACE FOR ADDITIONAL INFORMATION
RM R-302
SUFFRA
.... BOSTON (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
1499
32
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Jacqueline M StPierre
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maideu name.)
76 Bellevieu Ave
St.
Winthrop
Mass
(a) Residence. No.
(Usual place of abode)
Length of stay : in hospital or institution.
(Before death)
(Specify whether)
...
years
months 2
day 8.
in this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE|
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divoroed 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 Years. Months 2
Days
If less than 1 day Hours. .Minutes
Usual
9 Ocoupatlon :
-
industry 10 or Business :
11 Social Security No ...
12 BIRTHPLACE (City)
(State or country)
Winthrop ...... ass.
13 NAME OF
FATHER
Elphie J StPierre
14 BIRTHPLACE OF
Brockton Mass.
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Florence Donahue
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston Mass.
17
informant.
(Address)
Father
Relation, if any
A TRUE COPY.
ATTEST;
(Registrar of city or town where death-occurred) Feb . 15/46
.19
22 NAME OF
FUNERAL DIRECTOR
J F O'Maley
ADDRESS
Winthrop Mass.
Received and filed. MAR 1 1 1946 19
(Registrar of City or Town where deceased resided)
50m- (b) -6-44-14607
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-302 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
(City or Town) Children's Hospt
S
St.
(if U. S.
War Veteran,
specify WAR)
Feb. 13/46
(Dsy)
(Year)
19
& HEREBY CERTIFY,
Feb.
11
...
19.4.6.
to
That i attended deceased from
Feb 13
19
46
I last saw h ... @r ....... alive on.
Feb/13/46
19 ..
death is said to
have occurred on the date stated above, at
6:20AM
.m.
Duration
immedlate oause of death
Meningitis myelomyocele
Due to
Congenital anomaly
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of.
should be
charged sta- tistically.
What test confirmed diagnosis?
20 Was disease or injury in any way related to oooupatlon of deceased ?.
if so, speolfy
F Leonard
(Signed)
(Address)
300 Longwood Ave
Date
2-13
19
Mass
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
pCemetery
eb. 15/46
Winthrop Cem-Winthrop
(City or Town)
DATE OF BURIAL
19
Underline the cause to which death
Of autopsy
PARENTS
No.
DATE FILED
18 DATE OF
DEATH
(Month)
(If nonresident, give city or town and State)
2-301 A
Suffolk
(County)
Winthrop
(City or Town)
31 Belcher 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.
33
Registered No.
(If death occurred in a hospital or institution,
{ give its NAME instead of street and numher)
2 FULL NAME
Hannah A. Dunn Doherty
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenca. No.
31 ... Belcher ... St.
St.
(If nonresident, give elty or town and State)
Length of stay: In incoltal or Institution
( Before death)
years
months
days.
In this community 30
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
Georgbe Donerty
ite in full )
( Husband's name In full)
6 Age of husband or wife if allve years
7 IF STILLBORN, enter that fact here.
8
AGE
83 Years
Months
Days
Minutes
Usual
9 Ocoupation :
Housewife
Industry
10 or Business :
Own Home
11 Social Security No.
Boston
12 BIRTHPLACE (City)
(State or country)
Massachusetts
13 NAME OF
FATHER
Walter Dunn
14 BIRTHPLACE OF
FATHER (Clty)
Halifax
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Jane Flynn
16 BIRTHPLACE OF
MOTHER (City)
Dublin
(State or country)
Ireland
17 Katherine Brennan
Informent ( Address}
Batteridny 28 Thornton St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE the burial or transit permit was Issued : William D. Childress
(Signature of Agent of Board of Health or other)
Cegine Feb 15/46
(OmcialDesignation) ( Date of Trqueof Permit)
18 DATE OF
DEATH
tel.
14
1946 ...
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
26.6
1946
21.14
to
,
That i attended deceased from
19
46
I last sawhen allve on
2cm 1 2, 19 46 death is said to
have occurred on the date stated above, at & A
m.
Immediate cause of death.
Consulta IMPORTANT
Due to
Lutero palermo
Due to
Other conditions
( Include pregnancy within 8 months of death)
IMPORTANT
Mejor 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)
(Address) 4 Wastingman Date 2-14-1941
is) }
21
Holy cross
Malden, Mass
DATE OF BURIAL
February
16
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Ithe F. Ounaley
Received and fled
FEB 20 045
( Registrar)
100m. (g) - 1-45-15510
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 reoltal to that effeot. PARENTS
PLACE OF DEATH
-
1
No.
(Specify whether)
.........
(Usual place of abode)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
MEDICAL CERTIFICATE OF DEATH
Duration
Physician Underline the cause to which death should be charged sta- tistically.
Place of Burial, Cremation or Removal.
(City or Town)
46
.....
19
19
If less than 1 dey
Hours
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, wben 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 bave 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 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 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 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 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, 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 witbin 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, 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 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.
No undertaker or other person sball bury a human body or the asbes thereof which have been brought into the commonwealth until he bas 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 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 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., 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 healtbfulness 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-301 A
Suffol'
(County)
Wint no.
(City or Town) Je T'enksbury street 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.
34.
Ragistered No. { (If death occurred in a hospital or institution, give its NAME instead of street and numher) St.
PHYSICIAN - IMPORTANT
2 FULL NAME
katherine M. banahy
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
33 Tewksbury street
St.
(If nonresident, give clty or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years "
months -
daya. " -
In this community
1 yra. 6
mos.
day
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACEI
white
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Single
5a if married, widowed, or divorced HUSBAND of
(Give malden name of wife In full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive
yaars
7 IF STILLBORN, enter that fact here.
77 Years
-- Months ..... Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
at .... home
11 Social Security No. . one
12 BIRTHPLACE (City)
Jowe
(Siate or country)
la. g
13 NAME OF
FATHER
John J. Danahy
14 BIRTHPLACE OF
FATHER (Clty)
-reland
(State or country)
15 MAIDEN NAME
OF MOTHER
LarT Gorman
16 BIRTHPLACE OF
MOTHER (City)
.......
Ireland
(State or country)
17 iss Anna Danahy
Relatlon, If any
Informant ( Address) Do ekspur St.
S.L.2.1
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with to BEFORE the burial or transit permit was Issued? William D. Childress
(Signature of Agent of Board of Health or other)
agent Feb 15/46
..... (Omichs) Deignation) ( Date of froue of/ Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
OEATH
February
15
(Day)
( Month)
(Year)
19 | HEREBY CERTIFY,
January 29
19.
That I attended deosased from
46. 10.
February 15, 19 46
I last saw h ...... > ... allve on. February 14, 1946 death is said to have occurred on the date stated above, at 6:20 Am. Duration Immediata cause of daath
IMPORTANT
24 hours X ....
Due to
Arteriosclerosis and
Hypertension
Due to
Other conditions
Chronic hypertrophiceiti
( Include pregnancy within 3 months of deathy
5 years. IMPORTANT
Major findings:
Of operations
none
Date of
Physician Underline the cause to which death should he
What test confirmed diagnosis? Clinical + Laboral nured il. TRicaly
20 Was disease or injury in any way related to oooupation of deceased ?..... L.0.
If so, spaolfy
M. D.
(Signed) Maurice Traunstein
(Address) 562 Chiley St.
40 02 Feb15, 1946
21
Few Valvary
Place of Burial, Cremation or Removal.
DATE OF BURIAL
- februar --
13
(City or Town)
,46
19
22 NAME OF
J. A. Mahoney& Some
FUNERAL DIRECTOR:
ADDRE
644 Dialing Cheet Pax mars
Recalved and Aled. 833 12 1945
19
( Registrar)
100m-(g)-1-45-15510
1 3 SEX female 8 AGE If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS aztracts from the laws on back of certificate. ···· ·· ·· · property cissi. se o UPATION is very Important instructions and Industry 10 or Business :
PLACE OF DEATH
(Usual place of abode)
(Was deceased a
U. S. War Veteran,
if so specify WAR).
1946
Cerebral Hemorrhage
Retired
Of autopsy
nous
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 persou 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 hy 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 iu 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 hetwecn 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 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 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 tomh 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, 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 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 hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot 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 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 heen sooner obtained hereunder. If the death certificate contains a recital, as required
by section ieu of chapter ioriy-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 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 body of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall hury a human hody or the 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 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 hy 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, hut 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., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every person aged 10 years or over. If the occupation had 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 by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
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