USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 34
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(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 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 hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morhid 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 hy 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
+
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop "(City or towh making return)
92
[ (If death occurred in a hospital or institution give its NAME instead of street and number)
2 FULL NAME
William Patten Gerrish
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution .
(Before death)
(spelunsing Hoffe
months
3
days.
In this community 38 years
months
days·
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH. May
15. (Day)
1948
YYear)
19 I HEREBY CERTIFY, That I attended deceased from
48
19
194 6. death is said to
830
P. M.
6 Age of husband or wife if alive years
7 IF STILLBORN. enter that fact here.
8 AGE 73 Years 8 Months
5
Days
If less than 1 day Hours . Minutes
Usual
·9 Occupation:
retired
Industry 10 or Business: stockman, Rust Craft Card Co.
11 Social Security No ...
021-09-1677
12 BIRTHPLACE (City).
(State or country)
13 NAME OF
FATHER.
William Gerrish.
14 BIRTHPLACE OF FATHER (City) (State or country)
Chelsea
Mass.
15 MAIDEN NAME
OF MOTHER
Emily Patten
16 BIRTHPLACE OF MOTHER (City) (State or country) Mass.
17 George H. Gerrish brother) Informant (Address) 1134 Franklin St. Melrose
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter At. Balears (Signature of Agent of Board of Health or other)
Health Officer
5/18/48
(Official Designation) (Date of Issue of Permit)
20 Was disease or injury in any way related to occupation of deceased? . N.D ..
If so, specify,
4
1
.
A
.M.D.
(Address) 30 Orlando ALE
Date 5-17 1948
21 Woodlawn Cemetery Place of Burial, Cremation or Removal. (City or Town) 19 .
DATE OF BURIAL
May 18,1948
22 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
174 Winthrop St Winthrop
Received and filed
MAY 20 1948
19
A TRUE COPY ATTEST:
(Registrar)
If deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
on back of certificate.
100m-(c)-3-46-18278
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED widowed
5a If married, widowed, or divorced
HUSBAND OF
Caroline Edith Walker February 7-, 1948 to May
11.
(Give maiden name of wife in full)
(or) WIFE OF
I last saw h IM alive on
May 11.
(Husband's name in full)
have occurred on the date stated above, at
Immediate cause of death
Cardiac decompensation
Due to .. Chronic Myocarditis
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy .
What test confirmed diagnosis?
Duration Important 4 mos
2 yrs
Important
Physician
Underline the cause to which death should be charged sta- tistically.
CharlestonN (Signed) Edion il, traunger
Everett
1
--
No.
Bay View Nursing Home, 41 .... Washington .... A.vsa
Registrar's Number
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, (if so specify WAR) .. NO.
(a) Residence. No.
98 Bellevue Avenue
Winthrop Community Hospital
3 months
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 required 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 fourteen, 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, specifying 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 section 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 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 health, or its agent appointed to issue such pernuits, 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 inter- ment, 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 na attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician 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 required of the attending physician. If death is caused by violence, the medical 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 deathi made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a perinit 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 I'nited 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 necessary information which can be obtained as to the cleceased, or ns to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. I ... (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 sanie; . . . - 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 common wealth 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 by the action of chemical (drugs or poisons), thermal, or clectrical 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 canse nume 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 termis, 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
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-7-46-19068
+ Suffolk (County) Winthrop 1 (City or Town) Winetrop Community Hospital No. PLACE OF DEATH
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.
93
James J. Mc Gee 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
49 Bates Aver
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution Uren.
(Before death)
(Specify whether)
years
months
days.
In this community
23 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
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
agnes m. St. John
(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.
& G
AGE
79
Years
3
Months
13
Days
If less than 1 day
. Hours
Minutes
Usual
9 Occupation:
Retired
Industry
10 or Business:
Marine Engineer
11 Social Security No.
018-120-4881
12 BIRTHPLACE (City) .
(State or Country)
St. Johns land
13 NAME OF
FATHER
Thomas Mc Gee
14 BIRTHPLACE OF
Dr. Johnis
FATHER (City)
(State or Country}
newfoundland
15 MAIDEN NAME
OF MOTHER
Sarah Gushue
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
St. Johns
meld
Dorathy ne See Relation Kw)
17
Informant
(Address'
49 Bates are Widowed
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
Walter A Balcers. (Signature of Agent of Board of Health or other)
Healthe office 5/ 17/48
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
16
(Day)
1948 (Ycar)
19
1 HEREBY CERTIFY,
That I attended deceased from
may 12
19
, to
may 16
19
1966
I last saw h alive on
wy 16, 194, death is seid to
have occurred on the date stated above. at
m.
3
1
Duration
IMPORTANT
Due to
com hema post operative
Due to
ofination
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
, M. D.
(Address)
21
Ninchop Cemetery
Place of Burial, Cremation or Removal.
Winthrop
(City or Town)
DATE OF BURIAL
may 19
19.48
22 NAME OF
Paul & Kelly
FUNERAL DIRECTOR
ADDRESS //
meridian Sr. E. Bfoton
Received and Filed MAY 1 8 1948
19
(Registrar)
A to
Immediate cause of death
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
st.
[ (If death occurred in a hospital or institution,
give its NAME instead of street and number) )
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
3
Date
~19.5.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer sball 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 helief, 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 hoth 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 hury or otherwise dispose of a human hody 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 10 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 he returned and recorded, which shall be accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard of health, or employed hy it or hy 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 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 ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such hody shall 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 hody has been sooner obtained hereunder. If the death certificate contains a recital, as required
Jy section ten or chapter torty-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 hodies 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 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 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 permits, or if there is no such hoard, from the clerk of the town where the hody is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly 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 persous not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., 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 hy 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 Chelsea 48 (County) 6/7 Winthrop (City or Towp) Withandon spela No. Dornfeld
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.
91. ....
§ (If death occurred in a hospital or institution.
St.
{ give its NAME instead of street and numher)
2 FULL NAME- Baby Girl Downmeld
( If deceased is a married, widowed or divorced woman, give also maiden name.) 186 ach
(Usual place of abode)
Length of stay: In hospital or Institution.
( Before death)
( Specify whether)
years
months
/
days.
In this community
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE
W.
5 SINGLE
( write the word)
MARRIED
WIDOWED
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