Town of Winthrop : Record of Deaths 1947, Part 70

Author: Winthrop (Mass.)
Publication date: 1947
Publisher:
Number of Pages: 544


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 70


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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 hody of such a person. he shall forthwith go to the place where the body lies and take charge of the sme; . . - 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 received 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 tosuch deaths only. as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.


(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed


(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying. e.g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.


Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had 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, however, designate the occupation by the appropriate terins, 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


Fulfill


7(County) Kinchrap


(City or Town) 272 River Road No.


1


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.


209


Registered No. " (If death occurred in a hospital or institution, { give its NAME instead of street and number) SŁ.


2 FULL NAME William G. Dwyer


(If deceased Is a married, widowed or divorced, woman, give also maiden name.)


(a) Rasidence. No.


272 /Fiver Road Wincheap


(Usual place of abode)


Length of stay: In hospital or institution


( Before death)


(Specify whether)


years


months


days.


In this community


13 gra.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


male


4 COLOR OR RACE


White


5 SINGLE


( write the word).


Single


50 if marriad, widowed, or divorced HUSBAND of


(Give maiden name of wife In full)


(or) WIFE of


( Husband's name in full)


6 Age of husband or wife if aliva yaers


7 IF STILLBORN, enter that fact here.


8


AGE


42 Years


Montha


-


Days


if less than 1 dey


Hours ...


Minutas


Usual


9 Occuoellon :


Steward


industry


10 or Business:


6 lub


11 Social Security No. 022-05-8702


12 BIRTHPLACE (City)


( Sinte or country)


Bastan, Mass.


13 NAME OF


FATHER


Patrick Dwyer


14 BIRTHPLACE OF


FATHER (City)


(State or country)


.... Ireland


15 MAIDEN NAME


OF MOTHER


Ulice Donahue


16 BIRTHPLACE OF


MOTHER (City)


....


Bostan,


(State or country )


mais.


17 Are Willing Callate ( isten) ( Address)


I HEREBY CERTIFY that a satisfactory standard aorhinoate of wrath was Alles with and BEFORE the burial or trebuit permit was Issued!


are of Aspot on Board of Health or other)


(Official Designation) ( Date of Inque of Perunit) 10/28/ 47


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Detaber


26


1947


( Month)


(Day)


(Year)


19 | HEREBY CERTIFY,


Ect.25


1947.


to


Oct . 26.


That I attended deosasad from


19


47


I last saw him allva on.


Oct - 26, 1947 death Is said to


have occurred on the deto stated abova,


3:50 $


.m.


Immadlato cause of death


anche cordero dicotatia


IMPORTANT .......... 20 mars


Due to


0


cir


Due to


Other conditiona.


( Include pregnancy within 3 months of death)


Major findIngs :


Of operations


Data of


Of autopsy


What test confirmed diagnosis?


IMPORTANT


Physician


Underline the cause to which death should be charged sta- tistically.


20 Was diseasa or injury in any way ralated to oooupallon of dacaesad ? No


if so, spoolfy ...


. M. D.


(Signad)


(Address) 200 Work, and Data Get 27 1947


21


Ouivan Treneren


Place of Burial, Cremation of Removal. (City or Town) DATE OF BURIAL Vetaher 29, 19:47


22 NAME OF


Fairly Brac.


FUNERAL DIRECTOR


ADDRESS


Mintkrapf Maxe.


Health officer


Received and Aled


OCT 291947


19


( Reglatrar)


100m. (g)-1-45-25510


. If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, requires physlolans to insert a recital to that effect. PARENTS


1


PLACE OF DEATH


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR) 20


(If nonresident, give clty or town and State)


MARRIED


WIDOWED


or DIVORCED


Duration


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 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 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, 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 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 ovcr. 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)


275 Main Street


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 ita Agent. 210


Registered No. S (If death occurred in a hospital or institution. St. ( give its NAME instead of street and number)


2 FULL NAME


Carrie Estelle (Somerby) Duston


( If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Rasidence. No.


275 Main Street


(Usual place of abode)


St.


( If nonresident, give city or town and State)


Length of stay: In Anspital or Institution


( Before death)


(Specify whether)


yeara


months


days.


In this community


59 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


5 SINGLE


( write the word)


18 DATE DF


DEATH


October


27


1947


Female


4 COLOR OR RACE


White


MARRIED


WIDOWED


or DIVORCEDWidow


5a If married, widowed, or divoroed HUSBAND of


(or) WIFE of


CharlesF


( Husband's name in full)


6 Age of husband or wife if alive years


7 IF STILLBORN, enter that fact hera.


8


AGE87


Yeers


10


Monthe


1


Days


Minutas


Usual


9 Dcoupetion :


House wife


Industry


At ..... Home


10 or Business :


11 Social Security No ..


None


Ellisworth


12 BIRTHPLACE (City)


( State or country)


Maine


13 NAME DF


FATHER


Augustus # Somerby


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Unable to obtain


15 MAIDEN NAME


DF MOTHER


Frances E Murch


16 BIRTHPLACE DF


MOTHER (City)


( State or country)


Unable to obtain


17 Harry Duston


Born, If any


Informant


( Address )


275 Main St. Winthrop


I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE the urlgl ør trangit parmit was Issued : Water A. Kapell


(Signature of Agent of Board of (Health or other) Health Ofice


10/29 /47


( Date of Inque of Permit)


MEDICAL CERTIFICATE OF DEATH


( Month)


(Day)


(Year)


19 | HEREBY CERTIFY.


That I attendad deceased from


19


to


19


I last saw h ........... .. ailve on


, 19


. death Is said to


hava occurred on tha data statad abova,


10:45 A.


n.


Duration


Immediata oause of death Uremia


2 wks


Dua to


· Chronic Mephritis


year


Due to


Other conditiona.


( Include pregnancy within 3 months of death)


Major findings:


Df oparations


Data of


Df autopsy


What test confirmed diagnosis ?


clinical


IMPORTANT


Physician Underline the cause to which death should be charged v .. Istically


20 Was disease or injury in any way related to occupation of deceased ? no


If so, spaoify.


arthur@Maria


( Signad)


(Address) Winthrop Board of Herdown/Oct. 27947


Winthrop


21


Winthrop


l'iace of Burial, Cremation or Removal.


DATE DF BURIAL


Oct.


29


(City or Town)


1947


22 NAME DF


FUNERAL DIRECTOR


ADDRESS


Recaived and flad


OCT31 1947


19


( Registrar)


100m.(g)-1-45.15510


If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to Insert a reoltal to that effeot. extracts from the laws on back of certificate. serra, w faar ir may be property classified. Exact statement of UeberAtion is very important. See instructions and PARENTS


1


PLACE OF DEATH


No.


COmetal Designation)


-


If less than 1 day


Hours


IMPORTANT


M. D.


PHYSICIAN - IMPORTANT


( Was deceased a


U. S. War Veteran,


if so specify WAR)


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 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 forth with 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 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 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 forin of injury, have died without recent medical attendance or whose phy- sician is ahsent 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 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.




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