USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 56
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Other conditions. (Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations.
Of autopsy
What test confirmed diagnosis ?.
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 ...........
an carlem
M. D.
(Signed)
(Address) 186 /rencelan 87 CB Date 8-11-
21
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL.
1941
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed AUG 13 1948
19
(Registrar)
MARRIED
WIDOWED
or DIVORCED Angle
100m-2-'40-D-729-a
I HEREBY CERTIFY that a satisfactory standard certificate of death way filed with me BEFORE the burial oy transit permit was issued : Walter A Lakering. (Signature of Agent of Board of Health or other) Health Mler 8/11/18
(Official Designation) (Date of Issue of Permit)
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business:
+
1 No. Whenthe Comm (a) Residence. No. 101 Banks (Usual place of abode) Length of stay: In hospital or institution Naap. (Specify whether) years 8 hrs PERSONAL AND STATISTICAL PARTICULARS 3 SEX 4 COLOR OR RACE 5 SINGLE (write the word) 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. ... years 7 IF STILLBORN, enter that fact here. If less than 1 day Usual 9 Occupation : Il Social Security No. 12 BIRTHPLACE (City) (State or country) 13 NAME OF HER Arananda Grasso 14 BIRTHPLACE OF FATHER (City) (State or country) adescar. 15 MAIDEN NAME OF MOTHER PARENTS 16 BIRTHPLACE OF MOTHER (City) .. Boston (State or country) 17 Relation, if any Informant ... (Address) CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION 8 · AGE Years Months. Days .Hours 2.5.Minutes is very important. See instructions and extracts from the laws on back of certificate.
St.
(If U. S.
War Veteran,
specify WAR).
months
days.
Date of.
Durction IMPORTANT
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 helief tlie 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 hy 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 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 no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiv- ing 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 hody is huried. No such perniit shall be issued until there shall have been delivered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required hy 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 lieu thereof a certificate as hereinafter provided. If there is no atteuding 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 hoard of health, or em- ployed by it or by 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 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 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 re- moval of such hody has heen sooner obtained 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 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 deceased, or as to the manner or cause of the deatb, which the clerk or registrar may require .- Chop. 114, Sec. 45, G. L., (Tercentenary Edition).
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 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 Heaith 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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahiy due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 important, 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 hy the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who lad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
RM R-302
1
Boston
(City or Town)
No.
Magnolia Rest Home
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
Boston
(City or town making return)
Registered No.
70599
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Julia A Mahaney
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
24 Edgehill Road
St.
Winthrop
Mass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution ...
(Before death)
(Specify whether)
....
years
months
4
In this community
yrs.
mos
4
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE|
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If marrisd, widowed, or divorosd
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Timothy ... Mahaney.
(Husband's name in full)
years
7 IF STILLBORN, snter that faot hsre.
8
AGE 80
Years.
...... Months
23
.. Days
If less than 1 day
Hours ..
......
.. Minutes
Usual
9 Ocoupation :
At ... Home
Industry 10 or Business :
11 Soolai Security No ....
None
12 BIRTHPLACE (City)
(State or country)
South Vedham Mass.
13 NAME OF
FATHER
Michael Tobin
14 BIRTHPLACE OF
Ireland
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Lee.
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informant (Address)
Mary GarnerRelation 'Niede.)
A TRUE COPY.
Warming
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED August 16 19 18
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
August6 , 19
48 to
That I attended deogasod from
August 199
218
I last saw h ....... er ... alive on.
August 6, 19
40 death Is said to
havs ooourred on the date stated above, at
8:112
m.
Duration
Immediate oause of death.
Hypostatic pneumonia
8-6-48
to
Due to.
8-10-4 8
Due to.
Other conditions ..
Cardio vascular dis.
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
should be
charged sta-
tistically.
What tsst confirmed diagnosis?
Ces of breathing
20 Was dissase or injury in any way relatsd to oooupation of dsopassd?
If so, spsolfy.
I Gittleman
(Signsd)
(Address)
Boston Mass
Date.
8-12, 48.
21 PLACE OF BURIAL, St Mary's Cem-Canton Mass.
CREMATION OR REMOVAL
(Cemetery)
August 13/48City or Town)
19
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
J S Waterman & Sons
Boston Mass.
Rsosivsd and filed AUG-2-3-1948 19
(Registrar of City or Town where deceased resided)
50m-(b)-6-44-14607
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
ar
PLACE OF DEATH
Suffolk (County)
CERTIFICATE OF DEATH 46 Magnolia St St.
(If U. S.
War Veteran,
speolfy WAR)
August 10/48
6 Age of husband or wifs if alive
PARENTS
Of autopsy
Physician Underline the cause to
which death
.......
A R-301 A
PLACE OF DEATH
Suffolk /XCounty)
Wruttrop
(City or Town)
No ...... Winthrop com.
Harital
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.
160
2 FULL NAME
annie Maria Laphana
(If deceased is a married, widowed or divorced woman, give also maiden name.)
47 Washington Une Suur
(a) Residence. No ..
(Usual place of abode)
......
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
(Specify whether)
years
months
3
days.
In this community
mos.
days
37 yrs.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
white
5 SINGLE
(write the word)
windows
5a If married, widowed, or divorced HUSBAND of.
(or) WIFE of
(Give maiden name of wife in full)
Jolm 7, Paskam
(Husband's name in full)
6 Age of husband or wife if alive .years
7 IF STILLBORN, enter that fact here.
8
80
Years
6
Months ..
24
Days
If less than 1 day Hours Minutes
9 Occupation :
none
10 or Business:
at Home
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
new Bedford
13 NAME OF
FATHER
Otis T. Sherman
14 BIRTHPLACE OF
FATHER (City)
ArchesTu
(State or country)
mano
15 MAIDEN NAME
OF MOTHER
maria Galley
16 BIRTHPLACE OF
MOTHER (City).
New Bedford
(State or country)
mayo
17 Otis E Fagham ( som)
(Address)
47 Work and Wandlung
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Matter At. Makers (Signature of Agent of Board of Health or other)
Health Officer 8/12/48
(Official Designation) // (Date of Issue of Permit)
18 DATE OF Rug 12 1248
DEATH.
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY.
That I attended deceased from
aug 10
19 ... to.
Chungast (2, 19 45
I last saw h Or alive on Quigent 12, 194d, death is said to have occurred on the date stated above, at ........ 2 ..... 3.65 ... . m Duration Immediate cause of death ..... Cerchal Hemontage
IMPORTANT 7 days
Due to. artenschermo
Other conditions Uneenia (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 ?. Co
If so, specify ... (Signed Jacob & Chiamo M. M. D.
(Address) 5 62 Cercley
Date /12/19
2: 50 Dant Local ways. wear
Place of Buffar, Cremation or Removal
DATE OF BURIAL ..
august 15
19458
22 NAME OF
VE. Ti Wilson
1908
FUNERAL DIRECTOR
ADDRESS
New Bedford Mano
Received and filed
AUTO : 3 1948
19
(Registrar)
1 AGE Usual PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry
100m-2-'40-D-729-a
Relation, if any
Informant.
Major findings:
Of operations
none
Of autopsy none
Date of
What test confirmed diagnosis? Clima
MEDICAL CERTIFICATE OF DEATH
MARRIED
WIDOWED
or DIVORCED
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR). Mass.
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, definded 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.
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 perinits, 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 receiv- ing 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 in- sufficient, a physician who is a member of the board of health, or em- ployed 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 chtained 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 re- moval 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 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. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he lias 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 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 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 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 mcans the discase, 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 important, 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 terms, as housekeeper-private family, cook-hotel, etc. For a person who had 110 occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301
1
PLACE OF DEATH
Sufolk
(County)
Winthrop
(City or Town)
No.
117 Highland Ave
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
161
Registrar's No.
S (If death occurred in a hospital or institution,
{ give its NAME instead of street and number)
St.
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEMarried
5a If married, widowed, or divorced
HUSBAND of
Dr. Patrick napr. of Mccarthy
(or) WIFE of
(Husband's name in full)
74
" Age of husband or wife if alive. years
7 IF STILLBORN, enter that fact here.
8
73
AG
Years.
Months.
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business:
Own Home
11 Social Security No.
Lowell
12 BIRTHPLACE (City)
(State or country)
Mass
13 NAME OF
FATHER
John
6. Fryer
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Bridget Hogan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant Dr. Patrick H. McCareMion, if any
(Address)
117 Highland Ave
L HEREBY CERTIFY that a satisfactory standard certificate of death
was filed with me BEFORE the burial or transit permit was issued :
Walter Grabar
(Signature of Agent of Board of Health or other) aug 15-48
(Official Designatlon)
(Date of Issne of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
august
13
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY
That I attended deceased from
January 2, 1948 to
to.
Ящий 13
1948
I last saw h
08
august 13, 1948, de
ath is said to
have occurred on the date stated above, at 450 P. M.
Immediate cause of death
Duration
IMPORTANT
Thour
Coronary Thrombosis
Due to.
Fiulminating
Due to. Julinegativo
Other conditions
Cerebral Humorlage
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Home
Janny 2-1948
Date of
Of autopsy. What test confirmed diagnosis?
-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.
Patich H. MC Party.
(Signed)
(Addre
315 Harvard Cambial Date 0/13
M. D. 19 48
woodlawn
Everett
Place of Burial, Cremation or Removal.
DATE OF BURIAL_
(City or Towa)
Aug. 161948
19
22 NAME OF
FUNERAL DIRECTOR
John F. O Males
ADDRESS
Winthrop
Received and filed. AUG 25 1948 19
A TRUE COPY ATTIST:
(Registrar)
from the laws 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. (1) - 1-45-15510
1
7 FULL NAME
May
Bell Fryer Mccarthy
(If deceased is a married, widowed or divorced woman, give also maiden name.)
117
Highland Ave
St.
years
months
days.
(If nonresident, give city or town and State)
In this communie
yra.
mos.
days.
1948
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall fortbwith, after the death of a person whom be 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 helief 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.
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