USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 66
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by section ten or 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 and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can he 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 hody lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived 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 hody is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given 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, 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 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
-301 A
Suffolk .....
13/ 444g
Winthrop (City or Town) 106 Bellevue Ave.
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.
200
Registared No. (If death occurred in a hospital or institution. St ( give its NAME instead of street and number)
2 FULL NAME
Nellie Elizabeth (Knowlton) Drew
( If deceased is a married, widowed or divorced woman, give also maiden name.)
106 Bellevue Ave .
(a) Residenca. No.
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months
days.
in this community 50 yrs.
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
White
MARRIED
WIDOWED
or DIVORCEO Widow
50 If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Fred W Drew
f wite in full )
( Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 81
AGE
Years
O
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Ocouoetlon :
Housewife
Industry
Own Home
11 Social Security No.
None
12 BIRTHPLACE (City)
Rockland
( Siate or country)
Maine
13 NAME OF
FATHER
Charles Knowlton
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Unable To Obtain
16 BIRTHPLACE OF
MOTHER (City)
(State or country)Unable To Obtain
17 Frederick Drew
Informant ..
S delstion, if any
( Address) 106 Bellevue Ave, Winthrop
I HEREBY CERTIFY that a satisfactory standard oartifiosta of death was fied with me BEFORE the burlai or/transit parmit waa, lerued : Walter & MaleriD.
(Signature of Agent of Board of Health nr other)
Healtre price 10/14/4,
( Official Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
October
10
( Month)
(Day)
1947 (Year)
19 | HEREBY CERTIFY,
Thet I attended deosased from
December, 1946, to
October
1947
I last saw her alive on
October 10, 1947.
have occurred on the date stated above, at 12:30 P
.m.
Immedlete oause of death
Cerebral Hemorrhage
Que to
Hypertension
Due to
Other conditions.
Hypertensive Heart Disease 10 years
( Include pregnancy within 3 months of death)
IMPORTANT
Mejor findings :
Of operations
none
Oate of
Of autopsy
none
What test confirmed diagnosis ?
Clinical
20 Was disease or injury in any way related to ogupation of deceased } (220 If so, spaoify ........
( Signedy/ C
(Address) Winthrop Areas
Winthrop
M. D.
Date /1 9 1947
21
Winthrop
l'Isce of Burial, Cremation or Removal.
(City gr Town)
OATE OF BURIAL
October 14
47
19
22 NAME OF
FUNERAL DIRECTOR
Howard SU Inolets
ADORESS
....
Reosived and flad
OCT 1 / 1047
19
( Registrar)
Duration
IMPORTANT .... 4 weeks
Means
Physician Underline the cause to which death should be charged sta. tistically
100m. (g)-1-45-15510
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, requires physicians to insert a recital to that effect. PARENTS
1
PLACE OF DEATH
( County)
No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE| 5 SINGLE
( write the word)
11
10 or Business :
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 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 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 body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for 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 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 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 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 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
R-301 A
Suffolk,
(County)
Winthrop
(City or Town)
No. LO Lowell Road.
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.
Registared No.
201
{ (If death occurred in a hospital or institution. St. [ give its NAME. instead of street and number)
2 FULL NAME.
MURIEL SPENCER UNDERHILL,
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residenca. No.
49 Lowell Road,
( Usual place of abode)
St.
(If nonresident, give elty or town and State)
Length of stay: In Ansoltal or Institution
( Before death)
( Specify whether)
months
days.
In this community
2 yrs. C
mos.
0
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
Claufire meiden game
ame tnice! !!!
( Husband's name In full)
6 Age of husband or wife if eliva years
7 IF STILLBORN, enter that fact here.
8 AGE 05 Years 10 Months 11 Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
None ..
Industry
10 or Business :
11 Social Security No.
Mone .....
12 BIRTHPLACE (City)
( Siste or country)
13 NAME OF
FATHER
Courtney Spencer Foster,
14 BIRTHPLACE OF
FATHER (City)
ENGLAND ...
(State or country)
15 MAIDEN NAME
OF MOTHER
Sara Farmer,
16 BIRTHPLACE OF
MOTHER (City)
( State or country )
ENGLAND,
17 Informant (Address) 49 Love IT ROAD
"is: Barbara Underhill(
Hrlation, K ALY
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled, with me BEFORE the burial, or transit permit was Issued : Walter i Haklar
(Signature of Agent of Board of Health or other)
1 fixer 10/15
7(Omelal Designation)
1 ( Date of Issue of Permit)
18 DATE OF
DEATH
October 13, 1947
( 3fonth )
( Day)
(Year)
19 | HEREBY CERTIFY,
Thet I attended deceased from
1917.
to
October 13, 1947
I last saw h .......... .. allve on
October 13. 1947 death Is said to
have occurred on tha date stated above,
at
845 p
m.
Immediate oouse of death.
Carcinomaloses
Due to Carcinoma o vagina
: 1 year
Other conditiona
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Biopsy of vaginal well:
prof. Wereword pad / Data of
3/11/47
Of eutopsy
V
What test confirmed diagnosis?
abora
IMPORTANT
Physician Underline the cause to which death should be charged st .. tistically.
20 Was disease or injury th ony way related to oooupallon, of deceesed ?
If so, spaolfy
( Signed )
M. D.
(Address )
238, Swore Blue Wyw Hn Data
12/19 1947
21 .i.t. AHoura Creator
Place of Burial, Crematinn or Removal.
DATE OF BURIAL
October 16,
(City or Town)
47
19
22 NAME OF
FUNERAL DIRECTOR
..
ADDRESS
....
Raoalvad and Alad. OCT 16 1947
19
( Registrar)
100m (X) 1 45 19510
1
PLACE OF DEATH
PHYSICIAN - IMPORTANT
( Was deceased a U. S. War Veteran, if so specify WAR) ..
None,
...
years
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 reoltal to that effeot. PARENTS
Duration
IMPORTANT 3-4 anos
Due 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 hest 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 inarine 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 hetwecn 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 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 he 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 or 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 aud 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 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.
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