USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1956 > Part 34
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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 Gr 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 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 of 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
X
PLACE OF DEATH
Suffolk (County) Winthrop
(City or Town)
56 Beach Road
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.
85
$(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)
(a) Residence. No.
(Usual place of abode)
56 Beach Road
St
(If nonresident, give city or town and State)
Length of stay: In place of death.
.. years
.. months.
days. In place of residence 50,
years
months.
......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
24,
1956
(Month)
(Day)'
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
marche 3
1956
to ...
april
19.06
I last saw has alive on
april 24, 1986, death is said to
have occurred on the date stated above, at
6:15 P. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Myocardial Infarction
(a)
INTERVAL BETWEEN ONSET AND DEATH 2 month
2yrs.
2 months
15 Social Security No ..
None
Boston
16 BIRTHPLACE (City)
(State or country)
Mass.
17 NAME OF
FATHER
Chungey Fenton
18 BIRTHPLACE OF
FATHER (City).
Ticonderoga
(State or country) new york
19 MAIDEN NAME
M. D. OF MOTHER Laura H Hicks
20 BIRTHPLACE OF MOTHER (City) (State or country)
Nova Scotia
21 John J Parks
Informant.
(Address)
56 Beach Rd. Winthroo
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
7 NAME OF
FUNERAL DIRECTOR
180 Winthrop of truthrep fattoof frakesgy
(Signature of Agent of Board of Health or other)
Juattle Mie
4/27/56
(Official Designation
(Date of Issue of Permit)
VIN
RUCTIONS FOR . CERTIFICATE giving OF DEATH not enter than one for each (b) and (c)
does not mean de of dying, heart failure, etc. It means se, or compli- which caused
ions, if any, gave rise to cause (a), the under- cause last.
itions contrib- death but not o the terminal condition given
- Chapter 137, : 1954, requires ans to print or he cause or of death on certificates.
100M - 11-55.916:45
Received and filed APR 30 1956 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCarried
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
John James Parks
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
Years.
16
Months.
8
Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Housewife
14 Industry
or Business
Own Home
OTHER
SIGNIFICANT
CONDITIONS
None.
Was autopsy performed?
No
What test confirmed diagnosis? Clinical
No
(Adó Witterap, Mais .Date 4/26/1956
Winthrop
6 Winthrop
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 27
156
Howard S, Reynolds
ADDRESS.
No
2 FULL NAME
Dorothy ( Fenton) Parks
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Registered No.
A R-301A 1
PARENTS
5 Was disease or injury in any way related to occupation of deceased ?.
If so, specify ....
(Signed)
Heart Disease
Due To
Cardiac Decompensati
(c)
Due To
Coronary Artery
(b)
(Kind of work done during most of working life)
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- te"n, 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 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 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 deaths only as those of persons who, though disabled by recognized disease unrelated to any form of in jury, 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 pr poisor.s) 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. 11
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
.....
X PLACE OF DEATH
Suffolk ....
(County)
RM R-301A 1 Winthrop
(City or Town)
REVERE 5-7-56
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.
Registered No. 86
No. Bay View Rest Home MARGARET J. MUNDY ( Riley ) 2 FULL NAME ..
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. . 5 Bateman Rd., (Usual place of abode)
St.
Revere
(If nonresident, give city or town and State)
Length of stay: In place of death 3 .ycars. months. days. In place of residence
16 .years. months .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF DEATH
(Month)
(Day)
(Year)
Female
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDNADOVED
4 I HEREBY CERTIFY,
September 1019. 48
to
That I
attended deceased from
56
I last saw ler ..... alive on April 26 ... 1956 .. , death is said to
have occurred on the date stated above, at.
1:25
a.m.
INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
87
AGE.
Years
Months
Days
If under 24 hours
.Hours .. .. Minutes
ANTE
Due To
Diabetes
CEDENT (b) CAUSES
Due To Hypertensive Heart (c) Disease
over 8 yrs
15 Social Security No.
none
16 BIRTHPLACE (City)
(State or country)
Boston
Canada Mass.
OTHER
SIGNIFICANT
CONDITIONS
Hypertension and Arteriosclerosis
Major findings:
Of operations
None
Date of operation.
. Was autopsy performed?
No
What test confirmed diagnosis ?.
5 Was disease or injury in any, way related to occupation of deceased? Il so, specify'in (Signed). (Address) ...... Bennington ... St Revere alden
M. D.
Date. April 271956
6 .Holy Cross. Place of Burial or Cremation (City or Town)
DATE OF BURIAL April 20, 1956
19
7 NAME OF FUNERAL DIRECTORArthur .S. Porcella ADDRESS 876 Winthrop Avc., Devoro, "658,
Received and filed APR 30 195 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE |
(write the word)
10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of
James Mundy
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Carcinomatosis
Primary in Right Breast 2 yrs
over
8 yrs
14 Industry or Business:
PARENTS
18 BIRTHPLACE OF
FATHER (City) (State or country) Canada
19 MAIDEN NAME OF MOTHER Catherine Sullivan
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21 Informant. JAMES. ... V ..... MUNDY. (Address) 5 Bateman Rd., Revere, Lass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter S. Maker,g.
(Official Designation)
(Signature of Agent of Board of Health or other) Talla aprecie 4/27/56 (Date of Issue of Permit) X
STRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean de of dying, such failure, asthenia, means the disease, plications which death.
orbid conditions, giving rise to the ause (a) stating derlying cause
nditions contrib- the death but not to the disease or n causing death.
c :- Chapter 137. of 1954, requires cians to print or he cause or causes cath on death cates.
50M-5-55.915025
-41 Wash. Ave.
[(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) ITO
26.1956
April
25
19
13 Usual
Occupation
Retired- Housewife
(Kind of work done during most of working life)
over
8 yrs
17 NAME OF FATHER Joseph Riley
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.
t
a
e
S d
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 rerhoval 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 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.
RECE:
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 derk 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. See, 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 ofpractice:
(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 injuty
(2) Board of Health physicians will certify to such deaths only as those of persons who, thought 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) Medigal Examiners will investigate and certify to all deaths supposably due to Miun. 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.
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