USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 62
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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 For 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
PLACE OF DEATH
Suffolk
(County)
Winthron
(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.
185
Winthrop Community Hospital
Constance E Field
(If deceased is a married, widowed or divorced woman, give also maiden name.)
110 Grovers Ave.
St.
(If nonresident, give city or town and State)
25
Length of stay: In place of death
years.
months
days. In place of residence.
....... years
months __
_. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Sept
(Month)
(Day)
25
1957
(Year)
8 SEX
Female White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
4 I HEREBY CERTIFY,
That I attended deceased from
1954.
to ...
sept 25
57
Vlast saw halive on
14 25
... 1957, death is said to
have occurred on the date stated above, at
10.35P
.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) CEREBRAL HEMORRHAGE
INTERVAL BETWEEN ONSET AND DEATH 1DAY
Due To
HYPERTENSION
(b)
8 ys
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
020
What test confirmed diagnosis ?_
5 Was disease or injury in any way related to occupation of deceased ? 20 If so, specify ..
(Signed) Fmy o' Regan , M. D.
(Addr 113 Pleasant Wally Date 9/25
6 inthron
Winthrop
Place of Burial or Cremation DATE OF BURIAL
(City or Town) Sent 28 1957
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed SEP 27 357 19
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City).
Unable to obtain
(State or country)
Unable to obtain
19 MAIDEN NAME
OF MOTHER Isbell Young
20 BIRTHPLACE OF
Unable to obtain
MOTHER (City)
(State or country) Unable to obtain
21 · arcia S Fulton
Informant
(Address)
13 Chesley Ave. Newtonville
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with/me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other).
9/27/27
(Official Designation)
(Date of Issue of Permit)
INS FICATE g
EATH ter one ach d (c)
ot mean dying, failure, t means compli- caused
any, ise to (a). under- last.
ontrib -- but not terminal n given
ter 137, equires print or use Or ath on tes.
SOM-3-36-917573
PERSONAL AND STATISTICAL PARTICULARS
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 75
4
Years.
Months
6
Days
If under 24 hours
_Hours ...... Minutes
13 Usual
Occupation:
Clerk ( RET. ]
(Kind of work done during most of working life)
14 Industry
or Business:
Edison Electric Co.
012-07-6242
15 Social Security No ..
Bristol
16 BIRTHPLACE (City)
(State or country)
England
17 NAME OF
FATHER
Vincent Field
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,
if so specify WAR).
(a) Residence. No ..
(Usual place of abode)
7
No.
2 FULL NAME
01A 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 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 only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury. L.
(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. SEP 271957 EM
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
.301A 1
IONS
TIFICATE
ng DEATH nter i one each and (c)
not mean t dying, ! failure, It means r compli- caused
if any, rise to 1. (a), under- 1
last.
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Hyaline Membrane syndrome
Was autopsy performed? What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased ? If so, specify
(Signed) Domini Thomas Suffer M. D.
(Address) 21 Brex LTEn Date Left = 5 1957
6
Place of Burial or Cremation
DATE OF BURIAL 9/26/57 19
7 NAME OF
FUNERAL DIRECTOR
Inne I Russell
ADDRESS 1415 Marchetu anz.
Received and filed
SEP 2 ---- 19
(Registrar)
8 SEX M
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
of 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
3_Days
If under 24 hours
.. Hours ....
Minutes
13 Usual
Occupation :
Infant
(Kind of work done during most of working life)
14 Industry
or Business :
15 Social Security No ...
Winthrop
16 BIRTHPLACE (City)
(State or country)
MASS
5 daly S 17 NAME OF
John Waple
FATHER
18 BIRTHPLACE OF
Boston Washington
FATHER (City)
(State or country)
MASS- D.C.
19 MAIDEN NAME
OF MOTHER
Catherine O'LEARY
21 Informant (Address)
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
MASS.
John Staple
17 Spadly et. F. Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: ValorE Sirvanue (Signature af Agent of Board of Health or other)
Sept 25, 1951
(Official Designation) Date of Issue of Permit)
To be filed for burial permit with Board of Health or its Agent.
CERTIFICATE OF DEATH
Registered No. 186
[(If death occurred in a hospital or institution, St. [give its NAME instead of street and number) No.
2 FULL NAME
Baby Boy Waple
(If deceased is a married, whlow cu of divorced woman, give also maiden name.)
(a) Residence. No Parents' address) 17 Grady Ct st East Boston (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death. years months 5 days. In place of residence .. years
months. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF September
DEATH
25
1957
(Month) (Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Sept.20
19.57
19
57 to Sept.
25
I last saw h ...... alive on
19.
Sept . 25
57,
death is said to
have occurred on the date stated above, at
1.00 An.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Pneumonia
INTERVAL
BETWEEN
ONSET AND
DEATH
1 day
Due To Prematurity
(b)
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
Kesk" 11-2.5%
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
Hosp Winthrop, Mass
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Mass
PERSONAL AND STATISTICAL PARTICULARS
PARENTS
East Boston
New Calvary
Boston (City or Town)
SOM-5-36-917573
I contrib .. 1 but not 1 terminal on given
Ipter 137, I requires print or ause or eath ates.
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 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 intetment 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
,
PLACE OF DEATH
Suffolk (County)
(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.
187
[(If death occurred in a hospital or institution, St. [give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
(Usual place of abode)
16 adams
St
Minthook.
(If nonresident, give city or town and State)
Length of stay: In place of dea h 35 years - months .days. In place of residence 5 5 years - years -months days.
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