USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 15
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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 body or the ashes thereof which have been hrought 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 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 hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 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 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
138
RM R-302
Suffolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
1637
43
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Walter Lehr
(If deceased is a married, widowed or divorced woman, give also maiden name.)
25 Buckthorne Terrace
(a) Residence. No.
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution.
(Before death)
(Specify whether)
years
months 2
day s.
In this community 17 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
M
4 COLOR OR RACE|
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divoroed
Agnes Joyce
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve
49
years
7 IF STILLBORN, enter that faot here.
8 AGE ... 53 ..... Years Months. Dayı
If less than 1 day .. Hours .Minutes
Usual
9 Ocoupatlon :
Merchant
Industry 10 or Business :
Neckwear
11 Social Security No.
025-09-1626
12 BIRTHPLACE (City)
(State or country)
New .... York ... New .... York.
13 NAME OF FATHER William Lehr
14 BIRTHPLACE OF
FATHER (City)
(State or country)
New York N.Y.
15 MAIDEN NAME
OF MOTHER
Anna Sell
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
New York New York
17 Informant (Address)
Wife
Relation, if any
A TRUE COPY
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
Feb/21/47
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Feb. 17/47
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
F.e.b ....... 15 ..
19 .... 4.7 ... , to
That I attended degeased from
Feb/17/479
I last saw h ...... i.m .... allve on ....... F.e.b ....
1.7 /47 , 19
death Is sald to
have ooourred on the date stated above, at.
4 AM
.m.
Duration
Immediate oause of death.
Coronary arterio sclerosis
...
3 Yrs
Plus
** xwithmyocardialinfarction
Due to ....
Other conditions.
Myesthenia gravis
(Include pregnancy within 3 months of death)
Physician Underline the cause to
Major findings :
Of operations.
None
Date of.
should be
Of autopsy
What test confirmed diagnosis?
Autopsy.
20 Was disease or Injury In any way related to oooupation of deceased ?.
If so, spoolfy.
(Signed)
J .... S .... I.Achty
M. D.
(Address)
Mass .. Gen .Hospt
Date.
2-179
47
21 PLACE OF BURIAL,
CREMATION OR REMOVALWoodlawn NewYork
(Cemetery )
(City or Town)
DATE OF BURIAL
Feb.20/47
19
22 NAME OF
FUNERAL DIRECTOR
J F O'Maloy
ADDRESS
Winthrop .. Mass ..
Reoelved and filled. MAR 10 1347
19
(Registrar of City or Town where deceased reslded)
THIS IS A PERMANENT RECORD
WRITE PLAINGT, ITETIT ONRAVINTO DEREN IHN resided in another city or town at the time of death should be made forthwith and transmitted on Form R.802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
PARENTS
50m. (b)-6.44-14607
PLACE OF DEATH
(County)
1
Boston
Registered No.
(City or Town)
No.
Mass.General Hospital
St.
(If U. S.
War Veteran,
spoolfy WAR)
Winthrop Mass.
W
P
4
which death
charged sta- tistically.
A R-301 A
PLACE OF DEATH
Suffolk 14 (County) Motifud €/47
1 Winthrop (City or Town) Winthrop Community Hospital 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.
Registered No.
{ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
st
( If nonresident, give city or town and State)
In this community33
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
( Month)
1
1947
(Day)
(Year)
19 | HEREBY CERTIFY.
1
19 40
That I attended deceased from
7
1947
1 last saw h.
.allva on
19 ....... , death Is said to
have occurred on tha date stated above, at.
m.
Immediate cause of death
Duration 17 %
IMPORTANT
Conce Ellareandit's
19-1
Due to
Due to
Other conditions
( Include pregnancy within 8 months of death)
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
Underline the cause to which death should be charged sta. tistically.
20 Was disease or injury in any way relatad to occupation of deceased? If so, spaoify
('Signed)
1
Z
M. D.
(Address)
Date.
19 .-.
21Puritan .... Lawn .... Mem ....... Park ......... ea.b.o.dy. Place of Burial. Cremation or Removal. (City or Town)
DATE OF BURIAL .... Feb.24
1949
22 NAME OF
FUNERAL DIRECTOR Michael Sticella
ADDRESS 10 No. Bennett St., Boston
really
(Omelal Deaignation)
( Date of Traue 8) Peromit)/
100m. (g)-1-45-15510
2 FULL NAME
Frank E. Anderson
(a) Residenca. No.
9 Gladstone
(Usual place of abode)
V
Length of stay : In hospital or Institution
( Before death)
3 SEX
Male
4 COLOR OR RACE
White
Sa If married, widowed, og divoroed-
HUSBAND of
Lillian J. Witham
(or) WIFE of
( Husband's name in full)
74
7 IF STILLBORN, enter that fact here.
8
AGE 7.5
Years
Months
Days
Usual
9 Occupetion :
Tailor
Industry
10 or Business :
11 Social Security No.
None
12 BIRTHPLACE (City)
Gloucester
13 NAME OF
FATHER Andrew Anderson
15 MAIDEN NAME
OF MOTHER Delia Sullivan
PARENTS
If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, raquires physicians to insert a recital to that affect.
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
extracts from the laws on back of certificate.
should be carefully supplied. But should be stated LANGIST. MUSICIANS movie state CAUSE Of DEATH In plain
( State or country)
Mass
5 SINGLE
( write the word)
MARRIED
WIDOWED
Or DIVORCECarried
(Give maiden name of wife In full)
6 Age of husband or wife if allva years
If less than 1 day
Hours
Minutas
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Sweedun
16 BIRTHPLACE OF
MOTHER (City)
( State of country)
Ireland
17 Informant Lillian J. Anderson( quior, If any (Address) 9 Gladatenest. E. Boston
I HEREBY CERTIFY that a satisfactory standard certificata of death was filled with an BEFORE the Durishor transit parmit was Issued ? Katies
(Signature of Agent of Board of Health or other) afacer 2/24/47
Received and Aled. HAR 1 1947
19
( Registrar)
( If deceased ie a married. widowed or divorced woman, give also maiden name.)
years
months
2 days.
( Specify
Whether )
Boston
IMPORTANT Physician
...
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital 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 tbe family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where saine 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 tbe 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 tbis 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 Cbina 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 fourtb, nineteen hundred and two, and tbe 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 auch 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
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 countersigu 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 sball 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 shall bury a human body or the ashes thereof which bave 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 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 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, 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
M R-303-A
1
PLACE OF DEATH
Sullalk (County) Bostur (City or Town) en route to mars. Sen. No.
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH Hospital St. ¿ (If death occurred in a hospital or institution, . give its NAME instead of street and number)
To be filed for burial permit with Board of Health or its Agent.
Registered No.
15
2 FULL NAME
John Jseth Bell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence!
No.
33 Perkein St. Written
St.
(Usual place of abode)
Length of stay: In hospital or Institution.
(Before death)
( Specify whether)
years
months
days.
(If nonresident, give city or town and State)
In this community 41 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACEJ
Trite
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEBingle
58 If married, widowed, or dlvoroed
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that fact here.
8
AGE
41 Years
Months
Days
If less than 1 day
Hours .......
.Minutes
Usual
9 Occupation :
Fireman
Industry
BAR.R.
10 or Business :
11 Social Security No ....
012 -- 18 -- 6080
12 BIRTHPLACE (City)
(State or country)
Masg
13 NAME OF
FATHER
Martin Bell
14 BIRTHPLACE OF
FATHER (City)
Bangor
(State or country)
Me.
15 MAIDEN NAME
OF MOTHER
Ruth Smith
16 BIRTHPLACE OF
MDTHER (City)
Quincy
(State or country)
Mass
17 Martin Bell
( Address)
2 Orchard St Beachmont
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the budal or Transit permit was issued :
(Signature of Agent of Board of Health or other)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
February 21 -1947
(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 followsa (If, an injury was involved, state fully.)
Duodenal ulcer.
Clara Interstitial replicates
20 Accident, sułolde, or homlolde (specify)
Date of ogourrenoe
19
Where did
Injury goour ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publlo
place ?
(Specify type of place)
Manner of
Oud que chly en route to
Injury
Nature of
hospital
Injury
While at work ?
.Was there an autopsy?
21 Was disease or Injury in any way related to oooupation of deceased?
If so, spoolfy.
art .....
M. D.
(Signed)
Boston
Jul -21- 1947
(Address)
22
Winthrop
linthron
Place of Burial, Cremation or Removal.
(City or Town)
23 NAME OF
FUNERAL DIRECTOR
FormHOmaley
Vinthrop
ADDRESS
Received and filed. MAR 1 1947
........ 19
(Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect
extracts from the laws relative to the return of certificates of death.
should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF DEATH in plain terms,
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for
50m-(f).6-43-12056
.
(Official Designation)
Relationsif any
DATE OF BURIAL.
Feb. 24
7947
197
Informant
Winthrop
PARENTS
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
r
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 su umlertaker or other authorized person or of any member of the family of the deceased, furnish for registration a stamlard certificate of death, stating to the best of his knowledge sud belief the naine of the deceased, his supposed age, the disease of which he died, defined as required hy 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. 16, 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, wud 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 purposea 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 l'hilippine insurrection, which shall, for said purposes, be deenteil 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 aud 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 huried, until he has received a perinit froin the board of health, or ita agent appointed to Issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to snotlier, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from tlie board of health or its agent aforesald or front the clerk of the town where the body is buried. No such permit shall be issued until there ahall have been delivered to such board, agent or clerk, as the case may he, 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 meinher 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 provideil and in the pos- aession 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 haa heen sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which
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