USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 47
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ID
Other conditions.
( Include pregnancy within 8 months of death)
IMPORTANT
Physician
Major findings: Of operations
Underline Data of the cause to which death should be charged sta. What test confirmed diagnosty?
Of autopsy
Clinical condição
gistically.
20 Was disease or injury in any way falatad to boeupation of dacaased 4 ......
If so, spaoify
('Signad)
M. D.
(Address) 25 Beacon fly
19144
21
, Cremation or Removal. 7(City or Town )
DATE OF BURIAL ...
1946
22 NAME OF
FUNERAL DIRECTOR Jouby Bras
ADDRESS
Received and fled 1111 16 1946 19.
map. 7/23/46 per If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, requires phyelolans to Insert a recital to that effeot. PARENTS
100m-(g)-1-45-15510
2 FULL NAME
No. Body Boy Alivey
( If deceased is a married widowed or divorced woman, give also maiden name.) 12 Real MY
St.
(If nonresident, give city or town and State)
In this community
yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
years
months
days.
Due to
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital medical officer shall fortbwitb, 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 helief 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 bis 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 tbe preceding section or hy section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the hest of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in wbicb it has been engaged, insert in the certificate a recital to that effect, speci- fying the 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 bundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen bundred and sixteen and nine- teen bundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not heen buried, until he bas received a permit from the hoard of health, or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the 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 tomh 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 buried. No such permit sball he issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of bealth, 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 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 he returned to the town from which it was removed within thirty-six hours after sucb removal, unless a permit in the usual form for the removal of such body bas been sooner obtained bereunder. 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, 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 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, be shall fortbwith 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 buman 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 huried 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 sucb 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 sucb 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 pby- 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 hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disahlcd 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, lastbenia, 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 bad 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-botel, 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
-301 A
1
PLACE OF DEATH
Suffolk (County) Winthrop. (City or Town)
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.
128
No. Winthrop Community Hospital
(If death occurred in a hospital or institution, St. { give its NAME instead of street and number) }
2 FULL NAME
Arthur C. Cotter
(If deceased is a married. widowed or divorced woman, give also maiden name.)
(a) Residence. No. 40 Madison Ave., (Usual place of abode)
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 RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Single
5a 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 Years
Months 7 Days
If Jes than 1 day
. Hours
Minutes
16 hrs 35 min
Usual
9 Occupation:
Industry 10 or Business:
11 Social Security No.
Tinthrop
12 BIRTHPLACE (City).
(State or Country)
Massachusetts
13 NAME OF
FATHER
Arthur C. Cotter
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Gladys M. Egan
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Chelsea
Massachusetts
17 Arthur C. Cotter
Informant
(Address?
40 Madison Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or tumsit permit was issued: Water & Saker (Signature of Agent of Board of Health other)
Realita Officer 7/12/46
(Official Designation) (Date of Issue of Permit)
19 HEREBY CERTIFY, July1 0 , 19
I last saw h
malive on
have occurred on the date stated above, at m.
Duration
Immediate cause of death
himal
IMPORTANT
17/08/6.
Due to
Umirkcal
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury In any way related to occupation of deceased? If so, specify
(Signed)
, M. D. 7/11 19 46
(Address)
21
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
14.6
22 NAME OF
FUNERAL DIRECTOR
John H Ci maley
DATE OF BURIAL
ADDRESS
Winthrop Massachusetts
Received and Filed JUL 161946
19
(Registrar)
AS to
Tik lomy death is said to
, 19
9:30
10
(Day)
1476 (Ycar)
(Month)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
St.
(If nonresident, give city or town and State)
(Specify whether)
16 10
35 min
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR) .
See instructions and extracts from the laws on back of certificate. If deceased was e U. S. Wer Veteren, G. L. Chep. 46, Section 10, requires physicians to insert e recitel to that effect. PARENTS map. 1/23/46
)0m-9-44-14955
Amherst
( "fathery )
Physician Underline the cause to which death should be charged sta- tistically.
Due to
live's a intenten.
That I attended deceased from
(Give maiden name of wife in full)
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 bas 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 hest of his knowledge and belief the name of the deceassd, 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 othcer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required hy 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 hody in a town, or remove therefrom a human body which has not been buried, 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 uo undertaker or other person shall exhume a human hody 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 huried. No such permit shall be issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot 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 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 above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall he returned to the town from which it was removed within thirty-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 teu vi chapier ivity-six, tuat the urceased 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 he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died 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 hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the hody is to he 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 ohservance 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal canse.
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 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
01 A Y
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) .... Winthrop Community Hospital
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 Agente 220
Registared No.
{ {If death occurred in a hospital or institution,
SŁ.
give its NAME instead of street and number)
2 FULL NAME
Baby Boy Bowley
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
17 Center St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
( Specify whether )
years
10 min.
months
days.
In this community
yrs.
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED-
Sa If married, widowed, or divorced
HUSBAND of
(Cive maiden 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.
8 AGE Years Montha Days
If less than 1 day
Hours 0 Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
win hrop
12 BIRTHPLACE (City)
(Sinte or country)
Masg
13 NAME OF
FATHER
Alfred J Bowley
PARENTS
14 BIRTHPLACE OF
Hinchester
FATHER (Clty)
Unable to obtain
(State or country)
mass.
15 MAIDEN NAME
OF MOTHER
Mildred Alden
16 BIRTHPLACE OF
MOTHER (City)
Milton
(State or country)
Mass.
17 Hospital Records
Relation, if any
Informant
( Address)
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE the burial pr tranalt permit wey Issued :
Walter
&Baker
HOT
....
(Official Designation) ( Date of Toque of Permit)
18 DATE OF
DEATH
July on
(bay)
1946
(Year)
19 I HEREBY CERTIFY,
That I attended deosased from
July 11
1946.
20 July 11
1946
hast och him allve on .
July H1 5-45. 1946.
have occurred on the date stated above, at to Je
m.
death is sald to
Immediate cause of death
cerebral hemorrhage.
Duration
IMPORTANT .....
...
93/02/2.9
Other conditions
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy ....
July11 -1946
What test
Confirmed' diagnosis?
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 ?. If so, spacify
( Signed)
Jennie & Rotman
M. D.
(Address) 47 Washington On Date 7-1111946
21 Winthrop Winthrop Winthrop
(City or Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL ..
July ..... 12
19.
46
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and fled
JUL1-6-1946
19
( Registrar) Y
If decaased was a U. S. War Veteran, G. L. Chap. 46. Seotion 10, requires physicians to insert a recital to that offoot. par hosp 7/2.3/46 per harp. 7/23/46
Due to
delivery
Due to.
100m(i).1-44-13634
7/12/46
No.
PHYSICIAN - IMPORTANT
gwas deceased a
U. S. War Veteran,
if so specify WAR)
St.
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 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, 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 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 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 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
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