USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 76
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Woodbury Kenerson
14 BIRTHPLACE OF
FATHER (Clty)
Unable ..... to ..... obtain
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Penny
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Unable to obtain
17
Mary I Either Daughter" any
Informent
( Address)
25 Faun Bar Ave, Winthrop
I HEREBY CERTIFY that a satisfactory standard oartifloata of daath was Med with me BEFORE the burist' or transit parmit, was Istved : Traiter 7
(Signature of Agent of Board nt Health or other)
11/18/47
( Date of Inque of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
November
16
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
april
Thet 1 attended deceased ,from
19
to.
46
november 16
19
17
I last saw h.
en
allve on
november 16. 1947
death Is said to
have occurred on tha date stated above, at
5 55 A
.m.
Duration
Immedlate ceuse of death Cardine decompensation
Due to
arterio salerotic hart
disease
Due to
Other conditions.
suite debility
( Include pregnancy within 3 months of death)
IMPORTANT
Physician Underline the cause to which death should be charged st .. tistically
20 Was disease or injury in any way related to oogupation of deceased ?
If so, spaolfy ..
Paul Material
( Signed)
. M. D.
(Address) 238 Shore Drive Withit Li
Data
11/17
19/7
21 Oak Grove
Medford
l'lace of Burial, Cremation or Removal.
(City
Nov
47
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR.
Lunchup
ADDRESS
....
Received and flad
NOV 1 - 1947
.... 19
( Registrar)
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 offoot. PARENTS
1
No.
St.
Mildred Ann (Kenerson) Hatfield
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
1947
IMPORTANT
2 months years
Major findings :
Of operetions
Date of
Of eutopsy
What test confirmed diagnosis?
Clinical
6
(Omcial Designation)
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 hest 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 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 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 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 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 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 hody 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 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-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
1
PLACE OF DEATH
SUFFOLK (County)
12/8/47
The Commontoralth 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.
232
death occurred ir a hospital "{ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
MARY
THERESA
MCGRAIL
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or Institution.
(Before death)
HOSPITAL
(Specify whether)
years
months
2 HRS 25 Ml this community
yrs.
mos.
'days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
White
4 COLOR OR RACE|
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
Sa If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Ilushand's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN. enter that fact here.
g
47
Years
Months
Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
School .... Teacher
Industry
City Of Revere
10 or Business :
11 Social Security No ..
None
12 BIRTHPLACE (City)
NO. Andover
(State or country)
Mass
13 NAME OF
FATHER
Peter Mc Grail
14 BIRTHPLACE OF
FATHER (City)
Unknown
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Bridget Connolly
16 BIRTHPLACE OF
Unknown
MOTHER (City)
(State or country)
Ireland
17 Thomas Mc Grail
Relation, if any
( Address)
Informant. ... 84 Freasant St To . Andover
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was Issued :
(Signature of Agent of Board of Health-or other)
Health Check 11/19/47
(Official Designationy (Date of Issue of A'ermit)
18 DATE OF
DEATH
NOVEMBER
18, 1947
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
november18 1947
to.
november 18
1947
I last saw her alive on
nor.
18, 1947, death is sald to
have occurred on the date stated above, at.
5.25 Pm.
Immediate cause of death.
SUB ARACHNOID HEMORRHAGE
IMPORTANT 3 HRS.
Due to
Generation arteriosclerosis?
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Major findIngs : Of operations
Of autopsy
What test confirmed diagnosis ?
Lumbar puncture
charged sta- tically.
20 Was disease or injury in any way related to espupation of deceased ?. If so, specify
M. D.
('Signed)
620 Beachst Date 11-28-1947
(Address)
Nwen No. Andover
zifoly sepulchre
l'lace of Burial, Creniation or Removal.
NOV.
194 (City or Town)
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
John Breen
ADDRESS
373 Oak ST LAWRENCE TASS
Received and filed
NOV 19 1941
19
( Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS
100m (d)-1-41-4667
WINTHROP (City or Town) WINTHROP No.
62 CENTRAL
AVE.,
St.
REVERE
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(If nonresident, give city or town and State)
COMMUNITY HOSPITABLE
Registered No.
Physician Underline the cause to which death should be
Date of
Duration
AGE
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 atteraled during his last illness. at the request of an malertaker or other authorized person or of aux metuher of the family of the deceased, furnish for registration a stamulard certificate of death, stating to the best of his knowledge and behet the Dance of the drerased. his supposed age, the disease of which he ched, 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 hy 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 helief, served in the army, navy or marine corps of the I'nited 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 condy with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tien 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 ex- peilition and the Philippine insurrection, which shall, for said purposes. he deemed to have taken place between February fourteenth. cighteen hundred alul ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen 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 liralth, 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 exhnme a human hody and remove it fromin a town, froin 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 he returned and recorded, which shall be accompanied. in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law. or in licu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed hy 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 forin 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 fårty-six, that the deceased served in the army, navy or marine corps of the United States in any way in which it has been engageil. Such recital shall appear upon the permit. The board nf health, or its agent. wjam receipt of such statement atul 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 canse of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased. or as to the manuer or cause of the denth, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such primits, or if there is un 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 persou 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).
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 liea and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
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 deatha 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 physiclans 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 physi- cian 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 in- directly by traumatism ( including resulting septicenila), and by the action of chemical ( drugs or poisons), thermal, nr electrical agents, and deaths following abortion, but also deaths fromn 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 discase cansing 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 ou 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 terms, as housekeeper-private family. cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-301 A
PLACE OF DEATH
County)
12/8/47
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.
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME.
(If deceased is » married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
15 transfert
St ........
(If nonresident, give city or town and state)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
(write the word) Single or DIVORCED
5a If married, 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 alive.
7 IF STILLBORN, enter that fact here Hellioni
8
AGE Years Months Days
If less than 1 day Hours Minutes
Usual 9 Occupation: Industry 10 or Business:
11 Social Security No ...
12 BIRTHPLACE (City): Privatharof mass (State or country)
13 NAME OF
FATHER
Youth Costa
14 BIRTHPLACE OF FATHER (City) .. (State or country)
Boston
15 MAIDEN NAME
OF MO
Mina Cardinale
16 BIRTHPLACE OF MOTHER (City) ... (State or country)
maso
217 Jorge Costa, fatih)
Informent ... (Address) 15 frankot 2%.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
(Signature of Agents of Board of Health or other) Machte CRecer 11/19/47 / (omclal Designation) (Date of Issue of Purmit)
18 DATE OF DEATH. noi 19,
(Month)
(Day)
(Year)
19 ROMERE
CERTIF 19/7, to
That I attended deceased from
1947
I last saw h ............ alive on. 19 death is said to
have occurred on the date stated above, at Immediate cause of death.
m.
Duration IMPORTANT
Due to
Due to.
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations.
Date of
Of autopsy.
What test confirmed diagnosis ?.
20 Was disesse or injury in any way related to occupation of deceased ?.
If so, specify E) LEatenza (Signed) 238 Maverick Bach Date /1/19
M.D.
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
100 20
19,966 ..
22 NAME OF
FUNERAL DIRECTOR Lance Di tecto
ADDRESSTOXMLauchace.fr
Received and filed. 19
NOV 10 194kč
(Registrar)
100m-2-40-D-729-A
CAUSE OF DEATH in plain terms, so that it may be properly classined. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
1
(City or Towny
nthrob (Immunity Hosp
... St.
(If U. S. War Veteran, specify WAR)
no
i've also maiden name.) @
-
MEDICAL CERTIFICATE OF DEATH
1947
PARENTS
Underline the cause to which death should be charged sta- tistically.
21 ..
Relation, if any
Costa
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 whoin he has attended during his last illness, at tlie 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, definded as required 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.
No undertaker or other person shall bury or otherwise dispose of a human hody in a town. or remove therefrom a human body which hag not heen huried, until he has received a permit from the hoard of health, or its agent appointed to issue such perinits, 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 tomb other than the receiv- ing tomh to another in the same cemetery, until he lias received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the hody is huried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required hy law to he returned and recorded, which shall he 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 he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot he obtained early enough for the purpose. the certificate of death made as above provided and in the possession of the undertaker desiring to inake such removal shall constitute a permit for such removal; provided, that such hody 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 re- moval of such body has been sooner ohtained hereunder. If the death certificate contains a recital, as required hy 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 hoard 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 necessary information which can he ohtained 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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