USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 55
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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 tbe clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
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 aud 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 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 bave 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 deatbs 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- posally 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
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.
Registered No.
165
give its NAME instead of street and numher)
2 FULL NAME
Mary
F
McGeney
(Nixon )
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Realdenco.
No.
483 Shirley St. , Apt. 8
St.
(Usual place of abode)
Length of stay: In anapital or institution 4 hrs. 20 mins.
( Before death)
( Specify whether)
months days.
In this community
1 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
August
21.
1947
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
That I attended deceased from
19.
.....
to
8 .... 21
19.47.
I last saw hdny
..... alive on.
1947
desth is sald to
have occurred on the date stated above, at 47. 30 17
m.
Immediate oause of death
Clare. Currier
IMPORTANT ... 1947
Due to.
Sabor (Juana-)
Due to
Other conditions
(Include pregnancy within 3 months 'of death)
IMPORTANT
Physician
Underline the cause to which death should be charged 4 ... tistically.
20 Was disease or injury in ony wey related to occupation of deceased ? If so, spoolfy.
( Signed)
(Address)
11 betof-21
M. D. 19 4/7
2winthrop Cemetery,"Winthrop
Place of Burial, Cremstion or Removal
(City or Town)
DATE OF BURIAL
August 25
19
47
22 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby
ADDRESS
Boston, Massachusetts
Received and fled AUG 25-49-47 19
( Registrar)
100m. (g)- 1-45.15310
1
3 SEX
Industry
10 or Business :
12 BIRTHPLACE (City)
( Siste or country)
14 BIRTHPLACE OF
PARENTS
16 BIRTHPLACE OF
MOTHEP. (City)
( State or country)
If deceased was a U. S. War Veteran, G. L. Chap. 45, Section 10, requires physiolans to insert a recital to that effeot.
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
(State or country)
4 COLOR OR RACEI
5 SINGLE
( write the word)
Married
MARRIED
WIDOWEO
or DIVORCEO
Farmers
white
5a If married, widowed, or divoroed
HUSBANO of
(Cire maiden name of wife in full)
(or) WIFE of
Edward ... McGeney
( Husband's name in rull)
6 Age of husband or wife if alive 36
years
7 IF STILLBORN, enter that fact here.
8
AGE 31
Years
1 Months 21 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
At home
11 Social Security No. Unknown
Oswege.
Oregon
13 NAME OF
FATHER
Francis Herbert Nixon
FATHER (Clty)
.Grene1 ................... Lowa
15 MAIDEN NAME
OF MOTHER
Della Harbin
Dallas
Oregon
17 Edward T. McGeney
Hastahoy
Informant ( Address) 483 Shirley St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was Aled with me BEFORE the burial or Vaneit permit was Issued: 8. Ihaveer
(Signature of Agrat of Board of Heilth & other) .......
( Date of freue of Perpift) 8/22/17
(Official Designation)
Major findings:
Of operations
Oata of
Of autopsy
What test confirmed diagnosis ?
Duration
st.
§ (If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
W.W.2
(If nonresident, give city or town and State)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall fortbwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired 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. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or hy 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, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican horder service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody 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 110 undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving 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, 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 wbo 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 he 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 such removal; provided, that such hody shall he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section teu 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 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 hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within bis 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 hury a human hody or the asbes 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 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 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., beart 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 by the appropriate terms, as housekeeper- private family, cook-botel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE Dec. 31 1942
DATE OF DISCHARGE Cura. 28 1943
RANK, RATING PHC.C
ORGANIZATION AND OUTFIT WAC Detachment 1106 th service ani tu
SERVICE NUMBER
A- 906 275
-301 A
PLACE OF DEATH
Folk (County)
dommernel Notified
147
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Hospital
To be filed for burial permit with Board of Health or its Agent.
Registered No.
166
1
2 FULL NAME Bartholomeus Staller
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
36 hanson Quenue
St.
(If nonresident, give elty or town and Stete)
Length of stay : in hospital or Institution
( Before death)
( Specify/ whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
august.
23.1947
(Month)
(Day)
(Year)
HEREBY CERTIFY,
aug. 1.
1947
to .
Thet I attended deosased from
I last south um
.... alive on
Que A3, 19 47 death Is said to
heve occurred on tha date stated above, at ...
V
4 'UP.
6 Age of husbend or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 AGE 9 Years Months ... Days
If less than 1 dey Hours Minutes
Usual
9 Occupetion :
Retired
Industry
10 or Business :
Compositor
11 Social Security No. 0010-03-7243
12 BIRTHPLACE (City)
( State or country)
Boston mars.
13 NAME OF
FATHER
Bartholomew Halley
14 BIRTHPLACE DF
FATHER (Clty)
(State or country)
Sseland
15 MAIDEN NAME
OF MOTHER
Callorines Maria
16 BIRTHPLACE DF
MDTHEP. (City)
( State or country)
Ireland
( Sister
Relation, it any
17 Mão. alice Smith ."
informent
( Address)
36 40
I HEREBY CERTIFY that a satisfactory standard certificate of data Mlad with me BEFORE Heburial transif permit was issued:
ADDRESS
22 NAME DF
FUNERAL DIRECTOR
760 har ST.
Windloster
(Signature of Agent of Board nf [heWith of other) Health Officer 8/23/47
(Dmtcial Dealgnation) (Date of Issue of Permit)
( Registrar)
6 hrad ......
2 De
Other conditions
( Include pregnancy within 3 months of death)
Mejor findings :
Of operetions
Date of
Df eutopsy
What test confirmed diagnosis?
IMPORTANT
Physician Underline the cause to which death should be charged,st .. tisticalls
20 Was diseese or injury in ony way raiated to oocupalion of deceesed ? If so, spaolfy,
...
/8/23
M. D. 1947
( Signed ) 19 Primeros 24 24th Clubun Com. Comprade Place of Durial, Cremation or Removal. (City or YoBydas, 1947
RATE OF BURIAL.
agy 27-
100m-(g)-1-45.15510
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46. Seotion 10, requires physicians to Insert a recital to that effeot. PARENTS
1
Winthrop -
(City or Town) Winthrop Comm
No.
St.
{ (If death occurred in a hospital or institution, "} give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased 2
U. S. War Veteran,
if so specify WAR)
What I
( Usual place of abode)
yeers
months_ / days.
In this community
yrs.
mos.
days.
3 SEX
Znale
4 CDLOR OR RACE
-
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
Dias og Horan Har
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name In rull)
Duration
Immediate ocuse of death ..
Heute Pulmonar Educa
Due to
Saucer of Stomail.
Due to
Intertuil obstruction
.......
21
·
Received and fiad
AUG 2 5 1947
august 23
1947
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 in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican 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 110 undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, tuat 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 aud 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).
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