USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 6
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FATHER (City)
(State or country)
mass
15 MAIDEN NAME
OF MOTHER
Eileen Bradley
16 BIRTHPLACE OF
MOTHER (City)
( State or country)
East Boston
mass
Joseph F. Fielding Father Japrinceton ff
I HEREBY CERTIFY that a satisfactory standard certificata of death was Aled with me BEFORE the buristor transit permit wes issued : Walter A- aktig
( Signature of Agent of Board of Health or other)
Theatthe office 1/20 147 ......
(Omcial Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
la
Laura
( Month)
18.1947
( Day )
( Year)
19 HEREBY CERTIFI,
Lac/10, 1947. 5
Y jast saw h ......... . alive on.
death is said to
have occurred on the date stated above, at
1132A
m.
Duration
Immediate couse of death) ..
Steel lora.
IMPORTANT
Due to
Inychroblestras
Due to
Other conditions
RH negativ Hoor
( Include pregnancy within/8 months of death)
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed dlegnosis?
IMPORTANT Physician
Underline the cause to which derth should be charged vt .. trstically.
20 Was disease or injury in any way related to oooupation of deceased ?
if so, spocity.
Jungs. H . Schwartz
( Signed)
. M. D.
(Address) 19 Priceline 56 ESZ Data 1/19
21
Italy Cross
Piace of Burial, Cremation or Removal.
DATE OF BURIAL.
Malden
Jan 20 1947
22 NAME OF
FUNERAL DIRECTOR
Charles H. Treanor
ADDRESS
Each Boston
19
Received and Alad
IAN 231947
( Registrar)
100m-(g)-1-45-15510
1 Usual 9 Occupation : PARENTS 17 Informant ( Address ) If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physioians to Insert a recital to that effect. 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 should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain N. B .- . WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every Item of information Industry 10 or Business :
PLACE OF DEATH
(County) Winthrop (Gity, or TownLA Winthrop Community Hospital
No. Baby Girl Fielding
( If deceased is/a married. widowed or divorced woman, give/ miso maiden name.)
50 Princeton ft
St.
(If nonresident, give city or town and State)
MEDICAL CERTIFICATE OF DEATH
x3
to.
19
East Boston
2 FULL NAME
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 helief 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.
No undertaker or other person shall bury 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 hoard, 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 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 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 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 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 by 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 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 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
RM R-301 A
Suffolk (County)
1 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. 19
§ (If death occurred in a hospital or institution, { St. 1 give its NAME instead of street and number) }
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. 69 Fremont St (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
7 days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4
COLOR OR RACE
White
5 SINGLE (write. the word)
MARRIED
Single
WIDOWED
or DIVORCED
5a If married, widowed or divorced HUSBAND of .
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
AGE
Years
Months
Days
15 legs
ess than 1 day 5 Minutes
12 BIRTHPLACE (City)
Tinthrop
(State or Country) Massachusetts
13 NAME OF
FATHER
Thomas Fraher
FATHER (City)
Roxbury
(State or Country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Alice F. Sears
16 BIRTHPLACE OF MOTHER (City) (State or Country)
Boston
Massachusetts
17 Thomas Fraher
( Rathery )
Informant (Address) 69 Fremont St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with pure BEFORE the burial or transit permit was issued:
Walter A. Gallery (Signature of Ageht of Board of Health or other)
(Official Designation) (Date of Issuy of Perunit) 1/20/47
19 I HEREBY CERTIFY.
Jan 18
, 19
47.0
to
That I attended deceased from
Jun 19
, 19
47
I last saw h ~~ ~ alive on Jan//K. 194 death is said to
have occurred on the date stated above. at
7 9; m.
Duration
Immediate cause of death
atalectasis of Jumps
Due to
Prematurity
tung
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Date of
Of autopsy
none
What test confirmed diagnosis? Clinical affinances
20 Was disease or injury in any way related to occupation of deceased? La
If so, specify
John
1. Williams
(Signed)
M. D.
(Address)
429 Beaconft.
Date Sam 1.9. 1947
Winthrop
21
Winthrop
Place of Burial, Cremation or Removal.
January
27.
To Town)
DATE OF
CURIAL
John F. Omaley
47
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop Massachusetts
Received and Filed JAN 23 1947
19
(Registrar)
IMPORTANT 240 240
Due to
IMPORTANT
Physician Underline the cause to which death should be charged sta-
3 SEX te. (or) WIFE of 8 1 Usual 9 Occupation: Industry 10 or Business: 11 Social Security No. PARENTS If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. 100m-9-44-14955 N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD. Every item of 14 BIRTHPLACE OF
1 PLACE OF DEATH
Registered No.
2 FULL NAME
Female ....
Fraher
(If deceased is a married, widowed or divorced woman, give also maiden name.)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH Jan 19 (Day) ( Month)
1947 (Ycar)
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 other 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 perinit 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 such removal; provided, that such body 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
Dy section ten or chapter forty-six, tual 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 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 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 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 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 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
Z
1
RM R-301 A
PLACE OF DEATH
(County)
@City or Town)
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. 20
St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number) }
PHYSICIAN - IMPORTANT (Was deceased a 3 & a, War Veteran. if so specify WAR)
"(If nonresident, give city or town and State)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
2 SEX Percule
4
COLOR OR RACE
5 SINGLE (write the word).
MARRIED
WIDOWED
or DIVORCED
Jungle
5a It married, widowed or divorced HUSBAND of ..
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
8
AGE
Years
Months
Days
If less than 1 day
.. Hours
Minutes
11 Social Security No ..
12 BIRTHPLACE (City)
(State or Country)
13 NAME OF
FATHER
14 BIRTHPLACE OF FATHER (City) (State or Country)
Cash Boston
15 MAIDEN NAME OF MOTHER
Сверка Жипрви
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
1/1.4672.
Relation if any )
100m-9-44-14955
I HEREBYCERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter &Baker (Signature of Agemuf ti Ilealth or other)
4.0. Jan. 24, 1947 (Date of Issue of Permit)
(Official Designation)
20 Was disease or injury in any way related to occupation ot deceased? no
If so, specity ..
(Signed)
Mercie marco
7
, M. D.
Date 1 194.7
Place of Burial, Cremation or Removal. DATE OF BURIAL
(City or Town) 19
22 NAME OF FUNERAL DIRECTOR
ADDRESS
Received and Filed JAN 29 1947
19
(Registrar)
47
Stillborn
20
. 19 4%, death is said to
6.05 P
have occurred on the date stated above, at
m.
years Immediate cause ot death Aeath in Utero - Premature
Separation 1 Placenta
Due to Cinencephalin
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy
June.
Duration IMPORTANT 2 mars 6 hits
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
What test confirmed diagnosis?
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Lamay
20
1947
(Ycar)
(Month)
(Day)
19 I HEREBY CERTIFY, That I attended deceased from Jan 20 . 19
47.10
. un 20.
19
I tast sow h
-elwe on
(a) Residence. No.
(Usual place of abode)
340 Buvodrive
St.
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months_
days.
1
No. Menitush Com. Thank Bati
2 FULL NAME
(If deceased is a marned, widowed or divorced woman, give also maiden name.)
(or) WIFE of Usual 9 Occupation: PARENTS 17 Informant (Address· If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF Industry 10 or Business:
21
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer sball forthwitb, 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 hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
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