USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 11
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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 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 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 ....
X
R-301A 1
PLACE OF DEATH
Suffolk (County)
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.
33
St. { give its NAME instead of street and number) No. WinthropCommunity Hospital
2 FULL NAME Eleanor R. Leary
(If deceased is a married, widowed or divorced woman, give also maiden name.)
37 Emerson Road
St
(If nonresident, give city or town and State)
Length of stay: In place of death.
.......... years ..
months ... 2.4days. In place of residence.
3.2years
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
February
5
1957
(Month)
(Year)
(Day)
4 I HEREBY CERTIFY,
That I attended deceased from
april
.. ,
19.50
to 05
February
1957
I last saw helalive on
5 February, 1957, death is said to
have occurred on the date stated above, at 4:18 pm.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Myocardial Infarction
(a)
INTERVAL BETWEEN ONSET AND DEATH 3 wks
Cardiovascular renal disease Due To (b) with hypertension
15 yrs
Due To
(c)
OTHER
Hemiplegia left.
SIGNIFICANT
CONDITIONS
8 2 /2 Yrs
Was autopsy performed?
no
What test confirmed diagnosis?
clinical
5 Was disease or injury in any way related to occupation of deceased? no if son specify.
Arthur C. Murray
M. D.
Winthrop, Mas Date: 7 Feb
1957
Malden
Holy Cross Cemetery 6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL.
February8
195.7
7 NAME OF
FUNERAL DIRECTOR.
A.M. Kelly
ADDRESS223 Mass, Avenue, Arlington
Received and filed
FEB ~
..... 1957
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED Widow
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of .....
(Give maiden name of wife in full)
(or) WIFE of Cornelius A. Leary
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE.6.7 Years.
5.Months ....... 8.Days®
If under 24 hours
Hours ...
Minutes
13 Usual
Homemaker
(Kind of work done during most of working life)
14 Industry
or Business:
Own Home
15 Social Security No ...
none.
16 BIRTHPLACE (City) ... Boston
(State or country)
Massachusetts
17 NAME OF
FATHER
James McEnaney
PARENTS
18 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
Massachusetts
19 MAIDEN NAME
OF MOTHER Lucy Martin
20 BIRTHPLACE OF
Boston
MOTHER (City)
(State or country )
Massachusetts
21 Informant Eleanor M. Leary
Address) 37 Emerson Road , Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was fied with me BEFORE the burial or transit permit was issued: Marker . perrault
(Signature of Agent of Board of Health or other)
partie tercer
(Official Designation)
(Date of Issue of Perniit)
2/7/97
· Ex1
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each b) and (c)
oes not mean of dying, heart failure, tc. It means e, or compli- which caused
>
ns, if any, ave rise to cause (a), the under- ause last.
ions contrib- death but not the terminal ndition given
Chapter 137, 1954, requires ns to print or e cause or of death on rtificates.
Registered No.
S(If death occurred in a hospital or institution,,
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
NO
if so specify WAR)
(a) Residence. No.
(Usual place of ahode)
Winthrop
Occupation
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 fourte eighteen hundred and ninety-eight and July fourth, nineteen hundred and tv d the Mexican border service of nineteen hundred and sixteen and ninetee adred 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 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
.....
FEB 81957 PM
9
RIM
V ..
F
6
MIN
:4
OWN
RECEIVED
48375
6
ROB MASS.
OFFICE
Y
PLACE OF DEATH
Suffolk (County)
CENSE
Winthron (City or Town)
No
Winthrop Community Hospital
Baby Boy Miranda.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
88 Orchard St.
St
Medford
(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
3 DATE OF
Fer.
2- 1957
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
That I attended deceased from
Feb. 6
57
to ..
Fet 7-
19:57
I last saw himalive on
Fer, 7
19.57 death is said to
10
have occurred on the date stated ahove, at
10.9
m.
INTERVAL BETWEEN ONSET AND DEATH
-
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
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 ..
... Years.
Months ....
Days
Hours ........ Minutes
13 L'sual
Occupation :
(Kind of work done during most of working life)
14 Industry or Business :
15 Social Security No.
16 BIRTHPLACE (City)
Winthrop
(State or country)
17 NAME OF
FATHER
Charles Mirando
18 BIRTHPLACE OF
FATHER (City)
Fast Porton
(State or country)
Moss.
19 MAIDEN NAME
OF MOTHER
Rore Marie Watson
20 BIRTIIPLACE OF
Chelsea
MOTHER (City) (State or country)
21 Charles Miranda
Informant
(Address)
28 Orchard St. Medford
I HEREBY CERTIFY that a satisfactory standard certificate of death wis filed with me BEFORE the burial or transit permit was issued:
(Signature of, Agent of Board of Health or other)
Malên
(Official DesignationY
2/8/57
(Date of Issue of Permit) X
RUCTIONS FOR , CERTIFICATE giving OF DEATH not enter than one for each (b) and (c)
does not mean le of dying, heart failure, etc. It means se, or compli- which caused
ons, if any, gave rise to causc (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 ertificates.
100M.11.55.916145
(Signed) Charles melni mo. M. D.
(Address) 305 Havre St. E.F. 2/8 19.57
St. Michael's
Poston
6 Place of Burial or Cremation
(City or Town)
DATE OF BURIAL Feb. 9 ,57
7 NAME OF FUNERAL DIRECTOR Frederick J. Marrath East Boston
ADDRESS
Received and filed FEB - 1957 19
(Registrar)
PARENTS
To be filed for burial permit with Board of Health or its Agent.
31
Registered No.
((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,
no
if so specify WAR)
(a) Residence. No. (Usual place of abode)
Aledfort 3-7-57
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
I R-301A 1
(h)
Due To
Congenital
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Lleft Palate.
Was autopsy performed ?.
Yes.
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased? no
If so, specify
5axe 15 met under 24 hours
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Patent atrial Septem.
(a)
AtRial
SEPTum
2 FULL NAME
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 hy 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 he 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 orily as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
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