USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 65
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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 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. cte. As principal cause name the discose causing death. As related causes, rame carlier morbid conditions, if any, related toj the principal cause and any important complication of the principal cause.
Statement of Occupation. - Frecise statemert of cccupation is very; im- portant, so that the relative 1. - Ichfulness 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 discase causing death, report the ushi occupation prior to illness. If the deceased had retired from business, report the usual occupation prier to retirement. Children not gainfully employed may be returned as st 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, coox-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
M R-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. See instructions and extracts from the laws on back cf certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.
t
Suffolk
(County) Winthrop (City or Town) ,70 Waldemar Ave
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 AGE Registered No.
........... St. [ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME.Mary .......... Fulham ..... Flynn
(If deceased is a married, widowed or divorced woman, give also maiden name. )
(WasdPHYSICIAN . IMPORTANT
U. S. War Veteran,
if so specify WAR)
70 Waldemar Ave
St.
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
days.
(If nonresident, give city or town and State)
In this community 21
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
100M-10-47-22153
I HEREBY CERTIFY that a satisfactory standard certificate of death
was fiied with me BEFORE the burial er transit permit was issued :
Walter &Baker
(Signature of Atint of Board of Health or other)
HO (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
September
4
(Month)
(Day ) )
1948
(Year)
September 1947,
I HEREBY CERTIFY,
That I attended deceased from
to.
September, 1948
I last saw her alive on
august 28, 1948, death is said to
have occurred on the date stated aboge, at
5:30 Am.
Immediate cause of death.
Probable coronary occlusion minutes
Due to ...
Arterio-sclerotic heart disease year
Je to Generalized arterio -
Other conditions .....
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
clinical
IMPORiFANT Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased? Mo
If so, spe
Arthur @ Murray
.M. D. (Address) Winthrop Mass Date 4 de 67 1948
21.
Holy
Cross
Malden
Place of Burial, Cremation of Removal,
DATE OF BURIAL.
onown)
22 NAME OF
FUNERAL DIRECTOR ...
ADDRESS
2.19. 1 Sept Im HO mater Winthrop
Received and Filed.
SEP 7
1948
19
(Registrar)
1
No
(a) Residence. No ...
(Usual place of abode)
3 SEX
4 COLOR OR RACE
-
Female
White
5a If married, widowed or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
171111am J
Flynn
(Husband's name in full)
7 IF STILLBORN, enter that fact here.
8
AGE
82
Months
Days
Usual
9 Occupation:
Housewife
11 Social Security No ...
12 BIRTHPLACE (City)
Boston
(State or Country)
Mass
13 NAME OF
FATHER
John N. Fulham
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Ireland
15 MAIDEN NAME
OF MOTHER
Ellen Leonard
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or Country)
Ireland
17
Informant
John
Flynn
(Address)
70
Waldemar Ave
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF
Industry
10 or Business:
Own Home
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCEDWidowed
6 Age of husband or wife if alive. years
If less than 1 day
.Hours
Minutes
Duration
·IMPORTANT
sclerosis
years
(Relation, if any)
Sept/48
PLACE OF DEATH
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 dearn of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert 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 samme. 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 shail, 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 froin 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 sconer obtained hereunder, If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army. navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health. or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .. .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths orly 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 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 cause name the discase 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
RM R-302
2 FULL NAME
3 SEX
M
(or) WIFE of
8
AGE
76
Industry
10 or Business :
11 Soolal Security No ...
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF
15 MAIDEN NAME
OF MOTHER
PARENTS
(State or country)
17
Informant.
(Address)
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
(State or country)
4 COLOR OR RACE
W
5 SINGLE
(write the word)
Married
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorcedouisa Fallen
HUSBAND of
(Give maiden name of wife in full)
(Husband'e name in full)
6 Age of husband or wife if alive 72
years
7 IF STILLBORN, enter that fact here.
Years
6
Months
1
.Days
If less than 1 day Hours Minutes
Usual
9 Ocoupation :
Retired
Steel Worker
None
England
13 NAME OF
FATHER
George Cartwright
FATHER (City)
England
16 BIRTHPLACE OF
MOTHER (City)
England
Wife
(
Relation, if any
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred) 19 Sept. 9
MEDICAL CERTIFICATE OF DEATH
Sept. 5/48
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
June ... 29 .....
19
18
That I attended deceased from
to
Sept. 5. 19 48
[ last saw h ......... ] malive on
Sept. 5, 19 40 death Is said to
have occurred on the date stated above, at
8 AM
m.
Duration
Immediate oause of death ... Undetermined
Mins.
Heart Failure
Due
Hypertensive Arterio Scierotic Heart Disease
Due to.
Other conditions.
(Include pregnancy within 3 monthe of death)
Physician
Major findings :
Of operations
Benign prostatic
8-19-48
hypertrophy
Date of
Of autopsy.
Myocardial fibrosis
What test confirmed diagnosie ?.
biopsy.
20 Was disease or injury in any way related to oooupation of deceased?
If so, speolfy.
D. B Stearns
(Address)
Winthrop Cem-Winthrop Mass.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
(Cemetery)
DATE OF BURIAL
Sept ..... 8/18
19
22 NAME OF
FUNERAL DIRECTOR
F E Brown
ADDRESS
SEP 20 1948
19
Received and filed
(Regietrar of City or Town where deceased resided)
50m-(b) -6-44-14607
1
Boston
(City or Town)
No.
Mass. Memorial Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
78943
1
(If death occurred in a hospital or institution,
St.
give ite NAME instead of street and number)
John W Cartwright
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
71 Waldemar Ave.
(a) Residenoo. No.
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay : in hospital or Institution ..
(Before death)
(Specify whether)
years
2
months
7
day 8.
In this community
yre. 2 mos.
7 days.
PERSONAL AND STATISTICAL PARTICULARS
DATE FILED
Underline the cauee to which death should be charged sta- tistically. No
(Signed)
Boston Mass
Date 9-5
(City or Town)
East Boston Mass:
Winthrop Mass.
(If U. S.
War Veteran,
spoolfy WAR)
PLACE OF DEATH
Suffolk (County)
Annie Skidmore
-301 A
from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, raquires physicians to insert a recital to that effect. PARENTS
PLACE OF DEATH
Suffolk
(County)
Winthrop
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be dled for burial permit with Board of Health or its Agent.
184
S (If death occurred in a hospital or institution,
'{give its NAME instead of street and number)
(Was deceased a
U. S. War Veteran,
if so specify WAR).
PHYSICIAN-IMPORTANT
{
2 FULL NAME.
Helen Lyons
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
(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
days.
In this community Zo yrs.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widow
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Martin Lyons
(Husband's name in full)
6 Age of husband or wife if alive.
ycars
7 IF STILLBORN, enter that fact here.
8
AGELO G
Years.
Months.
Days
If less than 1 day
Hours ..
.Minutes
Usual
9 Occupation :
At home
Industry
10 or Business:
Household
11 Social Security No.
12 BIRTHPLACE (City)
Manchester
(State or country)
NH
13 NAME OF
FATHER
Andrew Smith
14 BIRTHPLACE OF
FATHER (City)
Patterson
(State or country)
N.J.
15 MAIDEN NAME
OF MOTHER
Sarah Tierny
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informantteorge J.Smith
Relation, if any (brother ... )
(Ad 174 Laurel St Manchester N. H.
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death Walter . Marie
(Signature of Agent of Board of Health or other Health Visuele. 9/14/48 ?(Official Designation)
(Date of Issue of Permis)
18 DATE OF
DEATH
Sept
11
1948
(Year)
(Month)
(Day)
19 I HEREBY CERTIFY, That I attended deccascd from
19
Jan
1
to
48
Co Sehit 11.
19 ..
48
I last saw her alive on.
Seht 11 , 1948, death is said to
have occurred on the date stated above, at f 45 p.M.
Immediate cause of death
Carcinoma 1 Boul
Duration IMPORTANT 1947
1948
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Major findings:
Of operations.
Canas y Bowel+ lucy
Date of april 1948
Of autopsy.
220
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased ? 10 If so, specify ac Benjamin M. D.
(Signed)
(Address)
Chelsea
Date 9/13 1948
21
Place of Burial, Cremation ff Removal. (City or Town)
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR.
ADDRESS
1
R.J. De Heilo
Received and filed SEP-4-6-1948 19
(Registrar)
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
I
50m-(e)-3-43-11574
1
No.
Revere 10/8/48
(City or Town) 43 Markington Line
St.
Registrar's No.
78 Shawmut St Revere
St.
/7
Due
Metastases to Liver
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 eertify 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 bundred 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 heen huried, until he has received a permit from the hoard 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 tomh to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the hody is buried. No such permit shall he issued until there shall have heen delivered to such board, agent or clerk, as the case inay 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, hy a satisfactory certificate of the attending physician, if any, as required hy 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 cnough for the purpose, or is insufficient, a physi- cian who is a member of the hoard of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence, the inedi- 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 reinoval, 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 perinit. 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).
No undertaker or other person shall bury a human body or the ashes thereof which have heen brought into the commonwealth until he has re- ceived a permit so to do from the board of bealth 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 he buried or the funcral 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).
Medical examiners shall make examination upon the view of the dead hodies 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.
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