USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 65
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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 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 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 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
R-305 L
wirULK
(County) ) BOSTON
(City or Town)
Peter Bent Brigham Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registared No.
8316
176
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
Hugh F A Moran
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
36 Prospect Ave
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
days.
In this community
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Sept.25/46
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigatad the deeth of the person above-named and that the CAUSE AND MANNER thareof are es follows: (If an injury was involved, state_fully.) Cirrhosis of the liver alcoholism
20 Acoldent, sulolda, or homlolde (specify)
Date of ocourrenoe
19
Where did
Injury occur ?
(City or town and State)
Did Injury ooour In or about the home, on farm, In Industrial place, or In publlo place? (Specify type of place)
Manner of
Injury
Nature of
Injury
While at work?
Was there an autopsy?
NO
21 Was disease or Injury In any way related to oooupetion of deceased ?
If so, spoolfy
(Signed)
Richard Ford
M. D.
(Address)
Boston Mass
Date
9-25/46
22
Place of Burial, Cremation or Removel.
(City or Town)
Sept.27/46
DATE OF BURIAL
19
23 NAME OF
FUNERAL DIRECTOR
Richard C Kirby
ADDRESS
Boston Mass.
Sept 30/46 19
(Registrar of City or Town where deceased resided)
VI tue city or towy iu willen the deceased resided as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
25m-(d) -6-43-12056
17
Informant
(Address)
Mrs W HollandelatDadenter
A TRUE COPY? What
ATTEST :
.....
.....
(Registrar of city or town where death occurred)
DATE FILED 19
If less than 1 day
Hours.
.Minutas
Usual
9 Oocupation :
Salesman
Industry 10 or Business :
Dye stuff
11 Soolal Security No. 012-01-6790
12 BIRTHPLACE (City)
(State or country)
Bast Boston Mass,
13 NAME OF
FATHER
Hugh Moran
14 BIRTHPLACE OF
Ireland
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Margaret Connelly
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
PARENTS
AGE
8 57 .Yaars 3 Months 21 Days
5 SINGLE
(write the word)
Widowed
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of
Elizabeth L Hewitt
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Aga of husband or wife If allva
- years
7 IF STILLBORN, enter that fact hera.
(If U. S.
War Veteran,
speolfy WAR)
Winthrop Mass.
(Usual place of abode)
57
3 SEX
M
4 COLOR OR RACE[
W
No.
PLACE OF DEATH
1
Winthrop Cem-Winthrop Mass.
Reoalved and filad
OCT &
1946
301 A Suffolk
1
PLACE OF DEATH
"County) Winthink
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.
127
No. St. (If death occurred in a hospital or institution, { give its NAME instead of street and number) r
Belle Schroeder
PHYSICIAN - IMPORTANT
2 FULL NAME
( If deceased Is a married, widowed or divorced goman, give also maiden name.)
(a) Residence. No.
1497 March Share Road
St.
Reservé
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
(Specify whether )
years
months 14days.
In this community
yra.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female Muito
4 COLOR OR RACEĮ
5 SINGLE
( write the word)
MARRIED
WIOOWEO
OF arrival
Sa If married, widowed, or divorced
HUSBANO of
....
(or) WIFE of
Codaie maiden nameat site de full beder
( Hngband's name in full)
6 Age of husband or wife if alive 68 yaars
7 IF STILLBORN, enter that fact hera.
8 AGE 64 Years Months Days
If less than 1 day Hours Minutas
Usual 9 Occupation :
Industry 10 or Business :
11 Social Security No.
non
12 BIRTHPLACE (City)
( State or country)
Derange
13 NAME OF
FATHER
Fort Knox Ballon
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
not Known
17 Carl & Schroeder
Relation, if a
( Address) 1497 North Shore Road Reven
I HEREBY CERTIFY that a satisfactory standard certificate of daath was filed with me BEFORE the burkal or Danalt parmit was issued: Walter & Bakes .
....
(Signature of Agrat 6? Board of Health or other)
Health Office 9/27/46
(Official Designation) ( Date of Issue of Permet)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Septzucher
( Month)
(Day)
(Year)
19
HEREBY CERTIFY,
That !
Attandad daosasad from
19
Sept 13
16
sept 26
to.1.
19
X6
I last saw h. fr alive on
Sept 26. 1976 death is said to
have occurred on the date statad abova, at.
5.40.7m.
Immediate cause of death.
Coronary throwlow
IMPORTANT
Dua to
arterio - sclerosia
6 450
9-13-46
8 years
( Include pregnancy within 8 months of death)
IMPORTANT
Physician
Underline the cause to which death should be charged st.I. tistically.
20 Was disease or injury in any way related to occupation of dacaased ? no
If so, specify.
( Signad)
Starito Musgrave
. M. 9.
(Address) 626 Beach St Sever Date 7-27 19 46
21
Central
Place of Burial, Crometion or Removal.
Sipt
OATE OF BURIAL.
29 0
1946
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
Frederick & magrath
ADDRESS
East Bald
Received and Aled
61 Z 7545
19
( Registrar)
·
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Seotion 10, requires physicians to Insert a reoltal to that offoot. PARENTS
100m-(g)-1-45-15510
Major findings :
Of operations
Data of
Of autopsy
What test confirmed diagnosis ?
Clinical funding
9 ........
.... ...
Due to ..
acute Myocardial Soul.
ONSUL
MEINTOS
0
Other conditions.
Diabetes Mellitus
Duration .
27. 1946
.........
( If nonresident, give city or town and State)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
hos
Registared Na.
Nunchuk Community Hora
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 hoth the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief 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 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 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 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, 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 by 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 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 auch 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 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 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 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 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 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 physicians 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 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 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 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 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
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
03-A
1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 59 Beal St.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
1.28.
[ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
59 Beals
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
days.
In this community 38
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
White
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDWidowed
5a If marrled, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Hanna Olson
(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
85
5
AGE
Years
Months
Days
2
If less than 1 day
Hours
Minutes
Usual
9 Ocoupatlon :
Engineer (Retired)
Industry
Stationery Engines
11 Social Security No ..
None
place?
home +,
(Specify type of place)
Manner of
Injury
noose of clothesline
Nature of
self- inflicted
Injury
While at work?
Was there an autopsy?
no
21 Was disease or injury In any way related to ocounation of deceased ?
If so, specify
(Signed).
Tichand/far5
M. D.
(Address) 25 Shattuck 54
Date.
9-291946
22
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
October 2
46
19
23 NAME OF
FUNERAL DIRECTOR.
Howard S Punolds
ADDRESS
Winthrop mais
Received and filed
GGT & 1946
19
( Registrar)
1
1
17
Edward Anderson
Informant
( Address)
54 Deals St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Walter it Makes (Signature of Agent of Board of Health or other)
10/2/46
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
September 29
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Asphyxig (hanging) ..... Suicide during fit of insanity
Suicide-
20 Accident, suicide, or homicide (specify)
Date of ooourrence ...
Probably
9-28 1946
Where did
Winthrop
Mayss
Injury oocur ?
(City or town and State)
Did injury ooour In or about home, on farm, In Industrial place, or In publlo
12 BIRTHPLACE (City)
(State or country)
Sweeden Le
13 NAME OF
FATHER
Andrew Anders on
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Sweeden
15 MAIDEN NAME
OF MOTHER
Anna Anderson
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Sweeden
Resien, if any DATE OF BURIAL
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. -
50m (g)-1-41-4667
No. Anders Emil Anderson
(a) Residenoe. No.
(Usual place of abode)
PHYSICIAN - IMPORTANT
(was deceased a
U. S. War Veteran,
If so specify WAR)
1946
10 or Business :
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospitai 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 standsrd 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 required 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 nesrly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be 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 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 buricd, 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 buricd. 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 licu 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 medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session 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 re- moval, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter 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 ageut, upon receipt of such statement and certificate, shall forthwith countersigu it and transmit it to the clerk of the town for regis- tration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its 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 per- son appointed to have the care of the cemetery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
Medical examiners shall make examination upon the view of the dead 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 shali forthwith go to the place where the body lies and take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
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