USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 25
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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 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 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 hody 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 physicfans 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 physfcfans will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to any forum 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 hy 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 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
1301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
125 Cliff Ave.
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. 66.
{ (If death occurred in a hospital or institution, St { give its NAME instead of street and number)
2 FULL NAME
Hannah Louise Anderson
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
235 Court Road
St.
(Usuxi plece of abode)
Nursing Home
14
( If nonresident, give sity or town and State)
Length of stay : In hnepltel nr Institution
(Before death)
(Specify whether)
years
months
days.
in this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
White
4 COLOR OR RACE|
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 fuli)
6 Age of husband or wife if alive
ysars
7 IF STILLBORN, enter that fact here.
ÅGE 80 Yeers 11 Months 8 Days
if less then 1 dey
Hours
Minutes
Usual
9 Occupetion:
Dress Maker (Retired)
Industry 10 or Business :
11 Social Security No.
None
12 BIRTHPLACE (City)
( Siste or country)
Maine
13 NAME OF
FATHER
Edwin Anderson
14 BIRTHPLACE OF
FATHER (City)
Boothbay
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Vesta Weeber
16 BIRTHPLACE OF
MOTHER (City)
Boothbay
(State or country)
Maine
17 Viola o'Brien
Niete ion, if any
Informent ( Address) 235 Court Rd. Winthrop
¡ HEREBY CERTIFY that a satisfactory standard certificate of deeth wes filed with me BEFORE the burial or transit permit was issued:
{Signature of Agent of Boardy of Health or other) april 5/46
(Official Designation) (Date of Imque of Permit)
18 DATE OF
DEATH
Qpray
4,
1946
(Year)
(Month)>
(Day)
19 | HEREBY CERTIFY,
Thet 1 ettended deosased from
Jan 10,
1946
.
to
Gammal 4
1946
I last saw h.C.f ...... alive on
April 3. 1946, death Is said to
have occurred on the date stated above, at /0 9 m.
Duration
Immediate pouse of death.
Cerebral demuchas
Due to
Carranca hypertenin
Due to
Other conditions
( Include pregnancy within 3 months of death)
Mejor findings:
Of operations
-Date of
Of eutopsy
What test confirmed diagno
Clinical Signs
IMPORTANT 48 hours .... 0 years
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceesed ? if so, spsoify
( Signed)
(Address)
, M. D.
De Gea / 4 1946
21
Winthrop
winthrop
Piace of Burial, Cremation or Removal.
DATE OF BURIAL ......
April
6
(City or Town)
46
19.
22 NAME OF
FUNERAL DIRECTOR award S Quimales
ADDRESS,
Winthrop mais.
19
Received and Alled. APR 8 1946
( Registrar)
100m(i)-1.44.13634
If deceased waa-a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
-----
110
Boothbay
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
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 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, 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 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 hody 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 he accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot 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 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 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 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 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 body 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 board 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 he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. .. . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given 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 forin of injury, have died without recent medical attendance or whose phy- sician is absent from home wben the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by 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 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
MM R-302
Middlesex
(County)
Cambridge (City or Town) Holy Ghost Hospital No.
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Cambridge
(City or town making return)
§ ( If death occurred in a hospital or institution, St. give its NAME instead of etreet and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
187 Court Road
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
W
(Month)
(Day)
( Year)
19 | HEREBY CERTIFY,
Feb .
6
That I attended deceased from
I last saw h.1m
alive on
Apr.
3
19 46
death is said to
have occurred on the date stated above, at. 12.45 A. m.
Duration
Inimediato cause of death. Arterio sclerotic & hypertensive heart disease
10 yrs
8 AGE 79 Years - Months. .Days
If less than 1 day
Hours.
Minutes Due to.
Usuai
9 Oooupation :
Shoe Worker
Industry
10 or Business :
Retired
11 Social Security No ...
None
12 BIRTHPLACE (City)
(State or country)
Hudson
New York
13 NAME OF
FATHER
Alden Jones
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Hudson
New York
15 MAIDEN NAME
OF MOTHER
Susan Senter
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Litchfield
N. H.
17 Miss Dorothy Jones
Dalatin tery
Informant
( Addrese)
187 Court Road,
Winthrop
A TRUE COPY.
ATTEST : Frederick (Regist
April ofity of tory where death occurred)
19
Received and filed 1.5.2 1946
(Registrar of City or Town where deceased resided)
19
DATE FILED
21 "PLACE OF BURIAL,
Mit. Hope Cem. Boston
CREMATION OR REMOVAL
Apr formgery )1 94 6
19
(City or Town)
DATE OF BURIAL
22 NAME OF
James F. Hickey
FUNERAL DIRECTOR
ADDRESS
403
Main St ........ rockton.
M. D.
(Address)
Pneumonia
5 dys
Other conditions
(Include pregnancy within 3 monthe of death)
Physician Underline the cause to which death
Major findings :
Of operations
None
Date of
should be
Of autopsy
None
charged sta- tistically.
What test confirmed diagnosis?
None
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify.
Joseph L. Tan sey
(Signed)
Boston, Mass .
Date
4/4/ 19
46
25M-(1)-11-12 10716
lesieu in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
1
PLACE OF DEATH
Harry C. Jones
(If U. S.
War Veteran,
speolfy WAR)
No
Winthrop
(Usual place of abode)
Hospital 1
1
monthe
,29
days.
years
In this community 15
yre.
mos.
days.
Sa If married, widowed, er divorced A. Gilgan
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband'e name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that faot here.
18 DATE OF April 4, 1946
DEATH
Registered No.
553
67
to
Apr. 4
19 ... 46
Due to
R-301 A 1
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 10 Harbor View Ave.
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.
68 ....
{ (If death occurred in a hospital or institution, St { give its NAME instead of street and number)
2 FULL NAME
Florence Helen Royle
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
10 Harbor View Ave.
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
years
months
days.
In this community
34tra.
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEJ
White
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)
18 DATE OF
DEATH
april
4
1946
(Year)
( )fonth)
(Day)
19
Jan 15
HEREBY CERTIFY,
That I attended deosased from
1946.
to
april 4
1946
I last saw her alive on
april 4, 1946 death is said to
have occurred on the date stated above, at
1.00 F
m.
Immediate oeuse of death
Chronic Muscular Atrophy
IMPORTANT
18mos
Due to
Due to
Other conditions
( include pregnancy within 3 months of death)
Major findings:
Of operations
Of autopsy.
What test confirmed diegnosis ?
Clinical Signs
IMPORTANT
Physician Underline the cause to which death should be charged sta . tistically.
20 Was disease or injury in any way related to occupation of deceased? NO If so, specify
( Signed)
Manuel HOSrien
. M. D.
(Address) Winthrop mass Date April 4 1946
winthrop
21
winthrop
Plece of Burial, Cremation or Removal.
DATE OF BURIAL
April
(City or Town ) 46
22 NAME OF
de Howard S Junolas
ADDRESS
Winthing marks
Received and filed APR 8 1946
( Rerletrar)
7/8-NL
19
140
(Signature of Agent of Boardhof Health or other) april 5/46
(Official Designation) (Date of Irque of Permit)
Mdªtitelrany
Informant
( Address) 10 Harbor View Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or trangt permit, was Issued :
From-(x).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 recital to that effect. PARENTS
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE
43 Years
4
Months
2
. Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Office Work
Industry
Shipping Co.
10 or Business :
11 Social Security No.
11) 010-09-4838
Somerville
12 BIRTHPLACE (City)
( Siate or country)
Mass.
13 NAME OF
FATHER
Matthias Royle
14 BIRTHPLACE OF
FATHER (City)
( State or country)
New Jersey
15 MAIDEN NAME
OF MOTHER
Edith Brinsley
16 BIRTHPLACE OF
MOTHER (City)
( State or country)
England
17 Edith M Royle
Com schildren
a
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
St
( If nonresident, give city or town and State)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
Duration
Date of
Registared No.
No.
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 be has attended during bis 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, bis supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, wben last seen alive by the physician or officer and the date of his death ... Gen. Laws, Cbap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf 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 hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person sball 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 sball exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there sball have been delivered to sucb board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, bis certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner sball 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 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 bealth, 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 furnisb for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
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