USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 54
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or DIVORCED Married
Groverdecapire Rife in full)
(Husband's name in full)
56
years
If less than 1 day
Hours
Minutes
13 NAME OF
FATHER
George Douglas
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Prince Edward Island
15 MAIDEN NAME
OF MOTHER
Margaret Robinson
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Novia Scotia
17 InformanGrover C Buck Hb&bandny
( Address)
40 Chester Ave. Winthrop
Major findings:
Of operations
Casamaman of almond
Date of 7/30/46
Of autopsy
love
What test confirmed diagnosis?
Date 8/16 Winthrop
(Elty of Town)
47
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
1947
That I attended deceased from 8/16 47
19 47
death is said to
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 persou 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 hury or otherwise dispose of a human hody in a town, or remove therefrom a human body which has not heen huried, 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 tomh 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 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 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 heen sooner obtained herennder. 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 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 registar 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 hy 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 hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to be held, cr 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 disahled by recognized disease unrelated to any forum 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 hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation 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
R-301 A
PLACE OF DEATH
Suffolk. (County) Winthrop (City or Town) 378 Revere
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.
163
St. { (If death occurred in a hospital or institution, give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
Everett
-
(If nonresident, give city or town and State)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4
COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed or divorced
HUSBAND of ..
(or) WIFE of.
Give maiden name of wife in full)
Edward
5.
murphy
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE
Years
70
-
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
House wife
Industry
10 or Business:
At Home
11 Social Security No.
12 BIRTHPLACE (City)
Boston
(State or Country)
massachusetts.
V
13 NAME OF
FATHER
Jeremiah murphy.
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
England
PARENTS
15 MAIDEN NAME
OF MOTHER
margaret Kiley
16 BIRTHPLACE OF MOTHER (City) (State or Country)
England
Informant (Address)
Relation, if any ) 387 Revere Street- Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was/issued:
Signature of Agent on Board of Headed or Other) Creatie officer
(Official Designation)
(Date of Issue of Yernit)
8/22/47
19 I HEREBY CERTIFY, That I attended deceased from
19
, to
. 19
I Hast sawh alive on , 19 -,death is said to
have occurred on the date stated above, at 9:15 P. m.
Immediate cause of death (natural causes
Due to
Coronary Occlusion
Due to
arterioscentric neartónicas years
Other conditions
/(Include pregnancy within 3 months of death)
Hypertension
Major findings:
Of operations
none
Date of
Of autopsy
none
What test confirmed diagnosis?
Duration IMPORTANT
hours
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?
11 so, specify
s) Winthrop@band of health
, M. D.
21 Holy Cross
malden.
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
Charles
murphy
4
ADDRESS
519 Broadw
any . Everest .
Received and Filed AUG 2 5 1947
19
(Registrar)
tel conversation with undertaker See instructions and extracts from the laws on back of certificate. . If deceased was a U. S, War, Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. 8/22/07 per
1
No. .
Ryan>
2 FULL NAME
margaret
murphy,
(If deceased is a married, widowed or divorced woman, give also maiden name
(a) Residence.
No.
679 Broadway
(Usual place of abode)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
Everett notified 9/8 / 47
1
17 mrs Edna Latter (Daughter)
100m-9-44-14955
Date 22 (Ing 194 "
Place of Burial, Cremation or Removal.
August 25
(City or Town
1947
St.
18 DATE OF
DEATH
20
august
(Month)
(Day)
194%
(Ycar)
(Husband's name in full)
Regan
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 persou 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 seetion forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person 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 10 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 untii 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 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 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 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
by section teu ot chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead 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 have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to 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 physiciana 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 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 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
1 R-301 A
Suffolk
(County)
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.
164
{ {If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Male
.... Mc Geney
( If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased 2
U. S. War Veteran,
if so specify WAR)
No
(a) Residence. No.
483 Shirley St., Apt. 8.
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
Hosp.
( Before death}
( Specify whether)
yeara
months
O
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
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in rull)
6 Age of husband or wife if allva yaars
7 IF STILLBORN, entar that fact hera. Stillborn
8 AGE Years - Months Days
-
If less than 1 day
Hours
Minutos
Usual
9 Occupation :
None
Industry
10 or Business :
None
11 Social Security No. None
12 BIRTHPLACE (City)
( State or country)
winthrop, Mass.
13 NAME OF
FATHER
Edward McGeney
14 BIRTHPLACE OF
FATHER (City)
East ... Boston, Mass.
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary F. Nixon
16 BIRTHPLACE OF
MOTHEP. (Clty)
Oswego, Oregon
(State or country )
17 Informant ( Address) Edward T ...... McGeney 483 Shirley St., Winthrop
Relation, Fatherany
I HEREBY CERTIFY that a satisfactory standard cartiffoata of daath was fled/with me BEFORE the børlat or, transit permit was issued ; altre A. Baker ...........
(Signature of scent of Board of Health of other).
Health binich
8/22/44
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
August 21 1947
· ( Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
8/21
1947. to
That I attendad deosasad from
I last saw h ................ alive on.
. 19
death Is said to
hava occurred on tha date statad abova, at. m.
Immedlate cause of daath ...
IMPORTANT ..... ............
Due to
Due to
Other conditions.
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Data of
Of autopsy
What test confirmed diagnosis ?
IMPORTANT
Physician
Underline the cause tu which death should be charged s.t. tistically.
20 Was disease or injury in any way ralatad to occupation of dacaased ?
If so, spaolty ......
(Address)
(6)2713
, M. D.
1947
21 Winthrop Cemetery,
Winthrop
Place of Burial, Crematinn or Removal.
(City or Town)
DATE OF BURIAL
August 25
19.47
22 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby
ADDRESS
Boston, Massachusetts
Reoalved and Alad
AUG.
55.1.9.4.7 .. 19
( Registrar)
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that offoot. PARENTS
100m.(g)-1-45-15510
PLACE OF DEATH
1
(Official Designation)
( Date of Iaque of Permit)
( Signad )
grilogaly 8 21
19
Duration
(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 his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnisb 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 in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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