USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 25
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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 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 hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly hy 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 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 heen given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation 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
RM R-302
1
LEOMINSTER
(City or Town)
No. Grant
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
LEOMINSTER
(City or town making return)
Registered No.
23
(If deatlı occurred in a hospital or institution, St. give its NAME instead of street and number)
2 FULL NAME
Charles Lincoln Young
(If deceased is a married, widowed or divorced woman, give also maiden name.)
44 Chester Ave.
St.
Winthrop,
Mass.
(Usual place of abode)
(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 65 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEO
Married
5a If married,
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 85 Years 4 Months.
16
Days
If less than 1 day .. Hours. Minutes
Usual
9 Oocupation :
Printer
Industry
Comercial
10 or Business:
11 Social Security No ..
None
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
George Young
14 BIRTHPLACE OF
FATHER (City)
Unable to obtain
(State or country)
15 MAIDEN NAME
OF MOTHER
Unable to obtain
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Unable to obtain
17 Catherine E. Young
Relation, if any
Informant ( Address) 44 Chester St Winthrop
A TRUE BODY Chart
ATTEST :
(Registrar of city or town where death occurred)
DATE FILEO April8, 19
47
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
April
7,
1947.
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY, April 7
That I attended deceased from
I last saw h.
im
alive on.
April 7
19 ... 4.7, death is said to
have occurred on the date stated above, at 11: 45 P. m.
Duration
Immediate cause of death Arteriosclerosis General
Years
Hypertension
Years
Due to.
Myocarditis Chronic
2 yrs
Cerebral Hemorrhage
3 yrs ....
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
Oate of.
Physician Underline the cause to which death should be charged sta- tistically.
No
20 Was disease or injury in any way related to oooupation of deceased?
If so, speolfy. William G .LeBrecht
(Signed)
M. D.
(Addre
Leominster, Mass.
Oato.
8/8/479
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthrop
(Cemetery )
April 11.
(City or Town) 19 47
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
Howard S. Reynolds
ADORESS
Winthrop, Mass.
Received and filed
APR 1 0 1947
19
(Registrar of City or Town where deceased resided)
X
1
PARENTS
50m (e)-1-41-4667
resided in another city or town at the time of death should be made forthwith and transmitted on Form R.302 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
PLACE OF DEATH
WORCESTER (County)
Chelsea
Of autopsy
What test confirmed diagnosis physical signs
(If U. S.
War Veteran,
specify WAR)
(a) Residenoe. No.
catHerthe E. MacNeil
(Give maiden name of wife in full)
19.
47
to. April
7
1947
1 R-301 AT+
PLACE OF DEATH
(County)
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.
74
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
1
5 SINGI.E
MARRIED
WIDOWED
or DIVORCED.
(write the word) Married
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of nife in full). Glamist Padidin
(Husband's name in full)
years
If less than 1 day
.. Years Months Days
Hours.
Minutes
Номконгре
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Bastaun Mask
13 NAME OF FATHER Porque Mansfield
14 BIRTHPLACE OF FATHER (City) (State or country) Freland
15 MAIDEN NAME OF MOTHER (Mary OBnew)
16 BIRTHPLACE OF MOTHER (City) (State or country)
17 Camera Hadden dres/ 122 Marche, Que Wantto Ja
Relation, if any)
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the hurtigt of transit normit was issued: frater A Making (Signature of Agent of Board of Health of other)
Health ( Official Designation)
Officer 2/1/4,
(Date of Issue of Primit?
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april
10
1947
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
January 2 1947,
april 10
That I attended deceased from
1947
I last saw been alive on. antul 10, 1047, death is said to have occurred on the date stated above, at 1: 20pm Duration Immediate cause of death IMPORTANT acute Coronary Themaboais
4 days.
Due to Bronchial asthma
1 year
Due to ...
Other conditions none
(Include pregnancy within 3 months of death)
Major findings :
Of operations
none
Of autopsy
none
What test confirmed diagnosis? Clinical
20 K'as disease cr Injury la any way related to occupation of deceased?
If so, specify. (Signed) Jaeof Chamo M. D. M. D (Address) 562 Sanlage To Date 4/11/457 Mianthusf. Wentity Whathrop 21
(City or Town)
17 1947 .... Place of Burial, Crearation or Removal. DATE OF BURIAL Curile lavelli DoDesevilla Son
ADDRESS 198 Mejoraet Que Wickrates
Recaivod and Slod APR 18 1947
19
(Regist:es)
100m-10-'39. No. 5427-e
1 3 SEX (or) WIFE of 8 AGE .. PARENTS CAUSE OF DEATH in plain 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. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Usual 3 Occupation:
(City or Town)
Winthrop Community Hospital St. No.
Gasiphine V (added) (Monfils)
2 FULL NAME
(a) Residence. No. (Usual place of abode)
Alcapitalei
years
Length of stay: In hospital or institution A/G. (Specify/whether)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 122 Washington Live.
St.
(If nonresident, give city or town and state)
months
days.
4
In this community
yrs.
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
22 NAME OF FUNERAL DIRECTOR
.Date of
.. ,
6 Age of husband er wife if alive. 7 IF STILLBORN, enter that fact here.
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 regis- tration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, bis 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 bis death . .. Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove thercfrom a human hody which bas 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 hoard, 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 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 hoard of health or its agent aforesaid or from the clerk of the town where the hody is huricd. No such permit shall be issued until there shall have been de- livered to such hoard, agent or clerk, as the case may he, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall he 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 physician who is a member. of the board of health, or employed hy" it or by- the selectmen for the pur- pose, shall upon application make the certificate required of the at -. tending physician. If.death is caused by violence, the medical exam- iner 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 he obtained early enough for the purposes the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal sball constitute a permit for such removal : provided, that such body shall he returned to the town from which it was removed witbin 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 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, 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 fur- nish for registration any other necessary information which can be ohtained 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.)
SPACE FOR ADDITIONAL INFORMATION
No undertaker or other person shall bury a human body or the ashes thereof which have heen brought into the commonwealth until he has received 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 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, Scc. 46, G. L., (Tercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice:
(1) Attending physicians will certify to such deatbs only as those of persons to whom they have given hedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deatbs only as those of persons who, though disabled hy recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is absent from bome when the certificate of death Is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), 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 occupa- tion, tbe 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 con -- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, 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 deatb, report the usual oceupation prior to illness. If the deceased had retired from husi- ness, report tbe 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 bousework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
1 R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No 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 Agent.
25
...
§ (If death occurred in a hospital or institution, St. {give its NAME instead of street and number)
2 FULL NAME.
Katherine F. Abbott
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ....
562 Shirley St.
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
(Specify whether)
years
months
8 days.
In this community 35
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a If married, widowed, or divorced
HUSBAND of ....
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
.years
7 IF STILLBORN. enter that fact here.
AGE
73 Years
Months. Days
If less than 1 day Hours ..... Minutes
9 Occupation:
Housekeeper
Industry
10 or Business :.
Amp Hoine
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Vermont
13 NAME OF
FATHER
George Abbott
14 BIRTHPLACE OF
FATHER (City) .....
(State or country)
Vermont
15 MAIDEN NAME
OF MOTHER
net mnom
16 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
Vermont
InformantMrs. Jeanne Carty
Relation, if any Fosterchild ...........
(Address) 70 Sumitt Ave., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Trater A. Khalexix.
(Signature of Agent of Board of Health/or other)
4/14/44
(Official Designationy (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april
11
1947
(Month)
(Day)
(Year)
19) I HEREBY CERTIFY,
January 6
, 1947, to Ciprix 11
... ,
That I attended deceased from
1947 I last saw her alive on aprile /1, 1947, death is said to have occurred on the date stated above, at 6:30 p: m. Duration IMPORTANT 8 days
Immediate cause of death Spolus
Cerebral
Due to.
artenorderstic heart
disease
Due to.
Urania
Other conditions more
(Include pregnancy within 3 months of death)
Major findings:
Of operations.
none
Date of.
Of autopsy
What test confirmed diagnosis ?.. clinical
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
(Signed) Starob Chamo, hits.
... M. D.
(Address) 562 Hurley St, Wehate /11/987
21 ... Woodlawn Everett quand
Place of Burial. Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
April 14,
1947
19
22 NAME OF
Richard H, White
FUNERAL DIRECTOR
ADDRESS
147 Winthrop St., Winthrop
Received and filed
APR 18 947
19
(Registrar)
-
5 years ... 3 dbago
IMPORTANT PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
100m-2-'40-D-729-a
1 8 DOMPARENTS is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Usual
Registered No.
(If U. S.
War Veteran,
specify WAR)
(Usual place of abode)
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 liis 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 discase 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.
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 receiv- Ing 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 cierk, 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 herelnafter provided. If there Is no attending physician, or if, for sufficlent reasons, his certificate cannot be obtained early enough for the purpose, or ls In- sufficient, a physician who Is a member of the board of health, or em- ployed by lt or by the selectmen for the purpose, shall upon application make the certificate required 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 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 re- moval of such body has been sooner obtained hereunder. If the death certificate contalns a recltal, as required by sectlon ten of chapter forty- slx, 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 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 require .- 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 received a permit so to do from the board of health or its agent appointed to issue such permite, 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 physician is absent from home when the certificate of death Is needed.
(3) Medical Examiners will Investigate and certify to all deaths supposably 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, asthenla, 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 important, so that the relative healthfulness of various pursults 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 galnfully 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, however, 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.
M R-301 A
Suffolk (County)
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
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