USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 86
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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 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 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 discase, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 194.5.
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 sare during a last illness from disease unrelated to any form of injury. UEL.
(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 .- 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
PLACE OF DEATH
SUIfolk (County)
M 2-301A 1 winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial .permit with Board of Health or its Agent.
261
2 FULL NAME .. HERBAT J. COLLINS
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. .. 125 Sergent (Usual place of abode)
St. - firthcp
(If nonresident, give city or town and State)
Length of stay: In place of death. .years months. .days.
In place of residence ........... years .months .days.
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF December
DEATH
15
1955
(Month)
(Day)
(Year)
8 SEX
Ljale
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
of DIVORCED Married
4 I HEREBY CERTIFY,
That I attended deceased from
Dec.13/55
19
to December 15. 195.5.
I last saw
him
.alive on December ... 14, 19.55, death is said to
have occurred on the date stated above, at
3:55
...... m.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a). Coronary .... Thrombosis
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation
None
Was autopsy performed?
No
What test confirmed diagnosis?
Electro Cardiogram
5 Was disease or mjury in any way related to occupation of deceased ?.. so, specify John 7 Celeiro not (Signed) (Address) 19 Bennington St. Rovere 51, face nturop 6 Winthrop -- (City or Town)
Date ... Dec. 16 1955
Place of Burial or Cremation
DATE OF BURIAL ...
.Dec.12,19.5.5
19
7 NAME OF
FUNERAL DIRECTOR.
Trebien I Parcella
ADDRESS 876 inthron Ave., Revere, Les.s ...
DEC 16 1955 19
Received and filed
(Registrar)
INTERVAL BE- TWEEN ONSET AND DEATH 4 days
11 IF STILLBORN, enter that fact here.
12
AGE
49 Years
... . Months
2 Days
If under 24 hours
Hours ....
Minutes
13 Usual
Occupation :.
Manager
(Kind of work done during most of working life)
14 Industry
or Business:
Total
15 Social Security No .... 129-10-8.607
16 BIRTHPLACE (City) .. . Brooklym.,N.Y.
(State or country)
WE !! YUN
17 NAME OF
FATHER
William Collins
18 BIRTHPLACE OF
FATHER (City)
Brooklyn, New York
(State or country)
197 Torl
19 MAIDEN NAME
OF MOTHER Elizabeth Linch
20 BIRTHPLACE OF MOTHER (City) Brooklyn, .. Y.
(State or country) New York
21 Informant .... r.C ... (Address) 126 Sargent St., winthrop, Dass.
Ruth 2. Collins
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: - Walter & Kaklig. (Signature of Agent of Board of Health or other)
Healthe Office 12/16/35 (Official Designation) (Date of Issue of Permity J.BV
RI TIONS FR ERTIFICATE ging C| DEATH center tan one ir each (! and (e)
cs not mean odying, such il'e. asthenia. a the disease, cions which
iconditions. il rise to the s.(a) stating ring cause
ins contrib- erath but not disease or csing death.
Chapter 137, 54, requires to print or use or causes on death
50M-5-55-915025
No. winthrop vormnity Hospital
J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT -
(Was deceased a U. S. War Veteran, if so specify WAR)
2
MEDICAL CERTIFICATE OF DEATH
(write the word)
10a If married, widowed, or divorced
Ruth E ... Brown
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
PARENTS
Registered No.
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 forfcit 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 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 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. LIKELY (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. . - Gencral Laws, Chap .. 38) See. 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 buried or the funeral is tofbe 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- g-rules of practice:
Ute 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 discase 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
3/1/42
DATE OF DISCHARGE 10/13/45
RANK, RATING staff Sergeant
ORGANIZATION AND OUTFIT Army, First Coupon 1262 SCU-PC
SERVICE NUMBER 32-013-044
Discharge markel recall
+ PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No. .
104 Highland Ave
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial pormit with Board of Health or Its Agent.
Registered No. 262
J(If death occurred in a hospital or institution, MOUNTis CovVarEzEwTHEwrest. I give its NAME instead of street and number)
2 FULL NAME
Catherine F. Flynn
(If deceased is a married, widowed or divorced woman, give also maiden name.)
41 Bates Ave
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
.years
months
.days. In place of residence
.years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
December 16
(Day)
(Month)
1955 (Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
4 I HEREBY CERTIFY.
That I attended deceased from
55
to ...
Neu 16,
1955
I last saw her alive on
Nec 10,
. 1955, death is said to
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE.
85 Years
Months
Days
If under 24 hours
Hours ...
Minutes
13 Usual
Occupation
re Tired Housekeeper
(Kind of work done during most of working life)
14 Industry
or Business:
Golf Club
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Ireland
17 NAME OF
FATHER
Michael Flynn
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Catherine Leahy
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Treland
21
Informant.
(Address)
41 Bates Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: finite E l'aki
HC Signature Agent of
12/19/55
(Official Designation)
(Date of Issue of Permit)
ACTIONS LEERTIFICATE Living F DEATH enter Jan one bor each () and (c)
es not mean dying, such ire, asthenia, ci the disease, itions which
conditions, vg rise to the (a) stating n'ing cause
ims contrib- 'eath but not , disease or using death.
100M-10-53-910621
6 Holy .... Cross
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL.
December 19
19.55
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS
Winthrop Mass
Received and filed
DEC 19 1955
19
(Registrar)
Scump
ANTE
Due To
CEDENT (b)
CAUSES
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
Senility
Major findings:
Of operations
Date of operation
Was autopsy performed? 200
What test confirmed diagnosis?
Clinical Signs
5 Was disease or injury in any way related to occupation of deceased ?...
If so, specify Del 00 min
(Signed)
220
(Addres Winthrop
Date 12/12
M. D.
Ma Iden
PARENTS
Mae Marsh
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
( if so specify WAR)
(a) Residence. No.
(Usual place of abode)
8
(write the word)
have occurred on the date stated above, at
3-30 P.
m.
INTERVAL BE-
TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING ChaMyocarditis
TO DEATH (a).,
(Chronic (Myocarditis)
MR-301A 1
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 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 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 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 Fwhich bave 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 he held, or from a person appointed to have the care of the i 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 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 ifrom 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 received a permit from the board of health or its agent aforesaid or from the clef (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.
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