Town of Winthrop : Record of Deaths 1948, Part 37

Author: Winthrop (Mass.)
Publication date: 1948
Publisher:
Number of Pages: 524


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 37


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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 certifylng 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 bis 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 buman body or the ashes thereof which have been brought into the commonwealth until be 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 sucb 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 pby- sician is absent from home wben 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 boine. For a woman whose only occupation was that of bome 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) Canthos (City of Town) 34 Willow Out No.


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


Registered No.


99


{ (If death occurred in a hospital or institution, give its NAME instead of street and numher)


Jathina B( Show) Stacy


( If deceased isce married, widowed or divorced woman, give also maiden, name.) Gast Barringlos N. A. St.


(a) Residence. No.


(Usual place of abode)


Length of stay: In hospital or Institution


( Before death )


(Specify whether)


years months days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACEJ Female White


MARRIED


WIDOWED


Or DIVORCED Rance


5a If married, widowed, or divorced HUSBAND of


Fameol Story


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name In rull)


75


years


7 IF STILLBORN, enter that fact here.


8 AGE 68 Years 3 Months 7 Days


if less than 1 day


Hours.


Minutes


Usual 9 Occupation ;


Industry


10 or Business :


11 Social Security No. inne


Dition


12 BIRTHPLACE (City)


(State or country)


nowyMR.


13 NAME OF


FATHER


Inshia Shaw


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Uniflex obtain


15 MAIDEN NAME


OF MOTHER


Cmifine Stark


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Unable to OFlaws


17 Comlyn Ingenson


Relation, if


Informant ..


(Address) 34 Wayswave Weather


I HEREBY CERTIFY that a satisfactory standard certificate of death was MI BEFORE the burial pr transit germit was Issued : Natter A Mall of


(BIguature 9 Agent of Board of Health or other)


Thealth Office 5/22/48


(Omcial Designation) (Date of Issue of Permit)


18 DATE OF may


22


1948


(Day)


(Year)


19 I HEREBY CERTIFY.


That I attended deosased from


may12


€8


May 22


19:48


19.


I last saw heraliva on


may 20, 1998, death Is said to


have occurred on the date stated above, at 8. 15 Pm.


Immediata causa of death


Carciscona


of servis


Due to


Due to


Other conditions


( Include pregnancy within 3 months of death)


Major findings:


Of operations


Data of


Of autopsy


What test confirmed diagnosis?


Physician Underline the cause to which death should be charged st .. tistically.


20 Was disease or injury in any way related to occupation of deceased ?


If so, specify.


(Si


Grapple Gregorio


. M. D.


(Address) 336 Summer SB Date 5/32 1948


Treintanet.


Sheentand N.H.


Place of Burial, Cremation or Removal.


(City or Town)


DATE OF BURIAL


Muy 2.3


1948


22 NAME OF


4. Verne Wordt


FUNERAL DIRECTOR.


ADDRESS orlémouth 1.1.


Received and fied JUN 1 1948


.....


19


( Registrar)


100m. (g)-1-45-15510


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 recital to that effect. PARENTS


2 FULL NAME


n. N. 6/7/48


.St.


(Was deceased a U. S. War Veteran, if so specify WAR)


( If nonresident, give city or town and State)


MEDICAL CERTIFICATE OF DEATH


Duration 2 gr


6 Age of husband or wife if alive


5 SINGLE


( write the word)


DEATH


(storth)


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 hy 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 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 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 he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required


by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can 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 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, 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 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


t


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 town making return)


· Registrar's Number


100


S (If death occurred in a hospital or institution ¿ give its NAME instead of street and number)


PHYSICIAN-IMPORTANT NO. (Was deceased a U. S. War Veteran, (if so specify WAR)


2 FULL NAME


John Prince Cushman


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


(a) Residence. No.


73 Otis Street


(Usual place of abode)


St


(If nonresident, give city or town and State)


Length of stay: In hospital or institution hospital


(Before death)


(Specify whether)


years


months


5


days.


In this community


25 years


months


days'


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


male


-


white


5 SINGLE (write the word)


MARRIED


WIDOWED


or DIVORCEDmarried


5a If married, widowed, or divorceHelen Estey


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 72


years


7 IF STILLBORN, enter that fact here.


8 AGE 72 Years 6 Months 27 .Days


If less than 1 day


.Hours .


Minutes


Usual


·9 Occupation:


Builder and Ship joiner


Industry 10 or Business: Frank Cushman & Son


11 Social Security No. .


none


12 BIRTHPLACE (City)


(State or country)


East Boston Mass


13 NAME OF


FATHER


Frank Cushman


14 BIRTHPLACE OF FATHER (City) (State or country)


East Boston Mass.


15 MAIDEN NAME


OF MOTHER


Carrie Prince


16 BIRTHPLACE OF MOTHER (City). Boston (State or country) Mass.


17 Mrs. J. P. Cushman Relationof any 21 Mount Auburn' Cambridge, Mass. Place of Burial, Cremation or Removal. (City or Town)


Informant (Address) 73 Otis St. Winthrop Mass.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit Permit ofas issued:


Waller


(Signature of Agent of Pose of Health or other)


H.O.


3/29/48


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


(Months


May 27 (Day)


1948


19 I HEREBY CERTIFY, That I attended deceased from


October 24-, 1944, to May 27-


., 1


4


I last saw h. I.l.t ....


alive on


May 27-


19.t .... , death is said to


have occurred on the date stated above, at


8 32


M.


Immediate cause of death


Cerebral Hemorrhage


Duration Important 5 day


Due to ArTerio Sclerosis


Due to


Other conditions


(Include pregnancy within 3 months of death)


Cardiac


DE Compensation


Major findings: Of operations.


Date of


Of autopsy


What test confirmed diagnosis?


20 Was disease or injury in any way related to occupation of deceased? ...........


If so, specify


(Signed)


M.D. (Address) 200 Washington Any Date 5.29 - 1945


DATE OF BURIAL


June 1,1948


19


22 NAME OF


FUNERAL DIRECTOR


alfred B. March


ADDRESS


174 Winthrop St. Winthrop ...


Received and filed JUN 3 . 1948


19 -.


(Registrar)


A TRUE COPY ATTEST:


1Eur


Important


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


on back of certificate.


If deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to insert a recital to that effect. PARENTS


100m-(c)-3-46-18278


1


No ..


Winthrop Community Hospital


St.


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 I'nited 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 sanie. 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 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 tomh 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 no 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 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 I'nited States in any war in which it has been engaged, such recital shall appear upon the perinit. 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 perinit is sofgiven and the physician certifying the cause of death shall thereafter furnish for registration any other necessary 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. ... , (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 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 supposahly dne 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.




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