USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 20
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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 registra- tion. 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 of 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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons 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 huried 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 follow- ing 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 deathsonly 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work dore during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
L
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
Registered No.
50
No. Winthrop Convelescent Home
J(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME David J. Dwyer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 83 Central Avenue
se Chelsea,
Kass.
(If nonresident, give city or town and State)
Length of stay: In place of death
.years
months.
3
days. In place of residence.
1.0 vea
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
(Month)
(Day)
(Year)
8 SEX
Iale
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDried
4 I HEREBY CERTIFY.
That I attended deceased from
Feb. 27
1951, to March 1
51
I last saw him alive on.
March 1
19.5. ( .. , death is said to
have occurred on the date stated above, at
5.18 p
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE 71
Years
Months
Days
If under 24 hours
Hours .... . Minutes"
13 Usual
Occupation:
Pressman
(Kind of work done during most of working life)
14 Industry
or Business:
Rubber Lill
15 Social Security No.
None
16 BIRTHPLACE (City).
(State or country)
Ireland
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
none
Date of operation
.Was autopsy performed?
200
What test confirmed diagnosis?
Clinical
5 Was disease or injury in any way related to occupation of deceased?
200
If so, spe
(Signed)
city Indie w. Dickinson
M ._ D. (Address) Winthrop Mand
Date March 2 1951
Holy Cross Cemetery alden, lass. Place of Burial or Cremation (City or Town)
DATE OF BURIAL
March 5,
1,51
7 NAME OF
FUNERAL DIRECTOR
William F. Welsh
ADDRES
721 Broadway Chelser, Lass.
Received and filed 19
MAR ... 7. 1951
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Bridget licGuire
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21 Informant argaret Dwyer (Address) 85 Central Ave, Chelsea
(wife)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter f. Baleer f- KSignature of Agent of Board of Health or other)
Health
affiche
3/2/5/
(Official Designation)
(Date of Issue of Permit)
UCTIONS FOR CERTIFICATE
giving OF DEATH
t enter than one for each b) and (c)
does not mean f dying, such lure. asthenia, ns the disease, ations which h.
d conditions, ng rise to the e (a) stating lying cause
ions contrib- death but not he disease or ausing death.
100M-(D)-10-48-24658
ANTE
CEDENT (b)
CAUSES
and chronic myocarditis.
generalized arteriosclerosis
Due To (c)
10a If married, widowed, or divorced
HUSBAND off argaret IcCarthy
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Iscompensating theart
about 7 days.
10 years 2 years
.......
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR)
no
(Usual place of abode)
3 DATE OF
DEATH
march
1
1951
To be filed for burial permit with Board of Health or its Agent.
R-301A 1
17 NAME OF
FATHER
Cornelius Dwyer
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 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 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 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 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 registra- tion. 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).
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 persons 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 follow- ing 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 deathsonly 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-303-A
1
PLACE OF DEATH
Sullink ( County) Winthrop Registered No. (City or Town) 22 Washing Ton are No. St. § ( If death occurred in a hospital or institution, ৳ give its NAME instead of street and number)
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or Its Agent.
51
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
(a) Residenoo. No.
(Usual place of abode)
Length of stay: In hospital or Institution.
(Before death)
( Specify whether )
years
months
days.
In this community 10 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE|
Female
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED idoweA
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Georgedire muldername 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.
8
67
AGE
Years
7
Months
Days
16
if less than 1 day
Hours
........... Minutes
Usual
School teacher retired
Industry
Public school
11 Soolal Security No ...
12 BIRTHPLACE (City)
Best Chester
(State or country)
Pennsylvania
13 NAME OF
FATHER James Elliott
14 BIRTHPLACE OF
FATHER (City)
. Goshen. Jur
(State or country)
Pennsylvania
15 MAIDEN NAME
OF MOTHER
Mary H James
16 BIRTHPLACE OF
MOTHER (City)
West Chester
(State or country)
Pennsylvania
17 Informant Crank I Elliott
-Relation. if.any (Address) west Emmerson AV8.
·
I HEREBY CERTIFY that a satisfactory standard certificate of death was fied with me BEFORE the burial of transit permit was Issued : Thalter & Kakvier.
(Signature of Agent of Board of health or other) Sealla Office 3/6/51
(Official Designation) (Date of Issue of Permit)
20 Accident, suloide, or homiolda (specify).
Presemações accidental
Date of ooourrenoe.
aboutwhen-2-1951
Where did
Injury ooour ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publio
plaoo ?
(Specify type of place)
Injury
Manner # red dead in her ( as ) illett
Nature of
apartment
Injury
While at work ?.
Was there an autopsy ?.
no
21 Was disease or Injury In any way related to oooupation of deceased ?
if so, specify.
(Signed)
M. D.
(Address)
22
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL.
March
6
151
23 NAME OF
FUNERAL DIRECTOR
o Forvard S Thisnaldo
ADDRESS
Winthrop miles
Received and flied
MAR 7 1951
19
(Registrar)
50m-(i)-1-45-15510
extracts from the laws relative to the return of certificates of death. so that it may be properly classified under the International Classification of Causes of Death. See reverse side for If deceased was a U. S. War Veteran. G. L. Chap. 46, Section 10, requires physicians to insert a recital to that offeot
2 FULL NAME
Helen E, Weyer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
22 Washing tin are Wettersip
(If nonresident, give city or town and State)
about march -2-1951
(Day)
(Year)
18 DATE OF
DEATH
( Month)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows) (If an injury was involved, state fully.)
9 Occupation :
10 or Business :
PARENTS
1951
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physiolan or registsred hospital medloai offiosr shsil forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertsker or other authorized person or of sny member of the family of the lecrased, furnish for registration a standard certificate of death, stating to the best of his knowledge and bellef the naine of the deceased, his supposed sge, the disease of which he died, defined as required by section one, where same was contracted. the duration of his last Illueas, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 16, 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- teeu, 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, Invert in the certificate a recital to that effect, speci- fying the war. and shall also certify in such certificute both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion sud of aections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall Include the China relief ex- pedition and the Philippine insurrection, which shall, for aaid purposes, be deemed to have taken place between February fourteentil, eighteen bundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a perinit iroin the board of health, or its agent appoluted to issue such permits, or If there is no such board, from the clerk of the town where the person dled; and no undertaker or other person shall exhumne 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 aforesald 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 sccoinpanled, In case of an original interment, by a satisfactory certificate of the attending physiclan, if any, as required by law, or in lieu thereof a certificate as hereluafter 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 vlolence, the medical cxainlner shall make such certificate. If such a permit for the removal of a human body, not previously Interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such renioval 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 sucb re- moval, unless a permit In the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contalus a recital, as required by section ten oi chapter forty-xlx, that the deceased served in the army, tavy or marine corps of the United States in any war in which
it has heen 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 regis- tration. The person to whom the permit Is so given and the physician cer tifying the cause of death altull 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 re- quire .- Chap. 114, Sec. 45, G. L., ('Tercentenary Editlon).
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 per son appointed to have the care of the cemetery or burial ground in which the interment is niade. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
Medical examiners shall make examination upon the view of the dead bodies of only such persous 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 lles and take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
. . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and realdence, if known; otherwise a description as full as may be, with the cause and manner of death .- General Laws, Chup. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the obaervance of the following rules of practice :
(1) Attending physiolans 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 forin of injury.
(2) Board of Health physlolans will certify to such deaths only aa those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or wbose phyaf- cian is absent fromn home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably dus to injury. These include not only deatba caused directly or in- directly by trauinatism (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, ths sudden deaths of persons not disabled by recognized diseass, and those of persons found dead.
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