USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 49
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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 dierk 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. JUN 2 GIS DIN
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)
No.
2 FULL NAME
Eana F. Leary
Mccarthy )
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a)
Residence. No ...
(Usual place of abode)
88 Main St
St
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years ......
months.
days. In place of residence 45 years.
... months.
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
June 30 1958.
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
6-16-58
19
June
30
195T
to ...
I last saw het alive on
June 27,
19 J death is said to
have occurred on the date stated above, at
5:30 Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
...
Vapocordial heart
Due To
(b)
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
What test confirmed diagnosis ?.
5 Was disease or injury in any way related to occupation of deceased? If so, specify ...
(Signed)
M. D.
(Address) .....
19.
6
Winthrop
Winthrop
Place of Burial or Cremation DATE OF BURIAL
July 2 19.58
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
Winthrop Mass
ADDRESS
Received and filed
JUL 1 1958
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
Female
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEdowed
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Francis J. Leary
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
61
Years
.Months ..
... Days'
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Clerk
(Kind of work done during most of working life)
14 Industry
or Business:
Printing
15 Social Security No ..
Shanghai
16 BIRTHPLACE (City)
(State or country)
China
17 NAME OF
FATHER
John Mccarthy
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER Irene Ransom
20 BIRTIIPLACE OF
MOTIIER (City)
(State or country)
Kentucky
21
John Leary
Informant
(Address)
88 Main St. Winthrop
1 HEREBY CERTIFY that a satisfactory standard certificate of death wasffled with me BEFORE the burial or transit permit was issued: Malple C. - Pireanser. (Signature of Agent of Board of llealth or other)
5/1/55
V.B.
INS
IFICATE 1g DEATH ter one each nd (c)
Y
ot mean dying, failure, t means compli- caused
f any, ise to (a), under- last.
contrib. but not terminal on given
pter 137, requires print or ause or
eath on
ates.
100M.11-55.916145
301A
1
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD SOVIEL CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or its Agent.
Registered No.
126
88 Main St
§ (If death occurred in a hospital or institution,,
St. { give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
INTERVAL BETWEEN ONSET AND DEATH
400
4%
PARENTS
(City or Town)
(Official Designation )
(Date of Issue of Permit)
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 Phihppine 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, 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
PLACE OF DEATH
Essex
(County)
Danvers
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No.
[(If death occurred in a hospital or institution, No Danvers State Hospital, Hathorne, L'ass. ( give its NAME instead of street and number)
2 FULL NAME .. Herman .... Cootev.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
no
if so specify WAR).
(a) Residence. No.
3 Bellevue Terrace, Winthrop, Mass.
(Usual place of abode)
Length of stay: In place of death. .years. 8 months 9 .days. In place of residence .. .years
.months.
......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
June
23
1.95.8
(Month) (Day)
(Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.)
General Arterios cbrosis.
Fracture of 7, 6,9,10,11
left ribs
5 Accident, suicide, or homicide (specify).
accident.
Date and hour of injury.
October 23, 1958
Where did
Injury occur?
Danvers.
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place? Public Place
Manner of
Injury
Unknown
Nature of
Injury
Facture .... of ..... ribs
While at work?
.no .... Was autopsy performed? no
6 Was disease or injury in any way related to occupation of deceased ?.... Q.
If so, specify
(Signed)
Ralph ...... Foss
M. D.
(Address)
Peabody Mass.
Date ...
6/20 1955
7 winthrop .Gen. Place of Bunar, or Cremation.
in thmap
DATE OF BURIAL .. July .... 1 1958 19
8 NAME OF
FUNERAL DIRECTOR
Kirby .... Funerallomo.
....
ADDRESS Fevere. .. A.s.
Received and filed. ..... JUL-21 1958 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
270
hito
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
l'idowed
11a If married, widowed, or divorced
HUSBAND of
Delia Wheat ley
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
80
AGE
Years
Months.
9 Days
If under 24 hours
Hours
Minutes
14 Usual
Occupation:
Conductor-Retired
(Kind of work done during most of working life)
15 Industry
or Business:
16 Social Security No.
Unknown
17 BIRTHPLACE (City)
(State or country)
Vermont
18 NAME OF
FATHER
Owen Cootey
PARENTS
19 BIRTHPLACE OF
FATHER (City)
Unknown
(State or country)
Ir land
20 MAIDEN NAME
OF MOTHER
Angelin Smith
Unknown
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Vermont
22 Informant (Address) Lathorne, Mas:
Mary [ ... Sheehan
A TRUE COPY.
ATTEST:
Daniel Toomey
(Registrar of Cityfor Town where death occurred)
DATE FILED
July 7, 1958
19
X
1
R-305
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time
25M·8-56-916227
(Specify type of place)
(How did injury occur?)
Unknown
(If nonresident, give city or town and State)
10 COLOR OR RACE
(write the word)
X
Suffolk
(County) Chelsea
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS POVIETEH COPY OF CERTIFICATE OF DEATH
Chelsea
(City or Town making this return)
277 128
Registered No.
§(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
WWII
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
U. S. War Veteran,
if so specify WAR)
(a)
Residence. No ..
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years ...
.months
4
days. In place of residence
years.
.months.
... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
June 29,1958
DEATH
(Month) (Day)
(Year)
I HEREBY CERTIFY
That I attended deceased from
June 25
58
June 29
58
I last saw
hmlive on
June 29
158
death is said to
have occurred on the date stated above, at
12.30A
.. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
"Subarchnoid hemorrhage
INTERVAL BETWEEN ONSET AND DEATH 4 das
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED,
or DIVORCEDrried
10a
didelia drank
HUSBAND
of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
1240 7
Years.
Months.
17
If under 24 hours
Hours ........
Minutes
13 Usual
Occupation :
U. S.Army
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No.
090-09-6821
16 BIRTHPLACE (City).
(State or country)
Bronx, N.Y.
17 NAME OJoseph FATHER
18 BIRTHPLACE OAustria, Hungary
FATHER (City).
(State or country)
19 MAIDEN NAME ry Hunciw OF MOTHER
20 BIRTHPLACE OAustria, Hungary MOTHER (City) (State or country)
21 G. Sedor (wife )
Informantt .. . Banks, Winthrop, Mass.
(Address
A TRUE COPY
ATTEST:
Pocephe a Tyrrelle
(Registrar of City or Town where death occurred)
DATE FILED
June .30,1958
4 Due To (b) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible, after the close of the month in which the death occurred. (Sec Chap. 46, Scc. 12, G. L.) topics of returns of deaths which occtrice if you city of town in case the ucctaste festuca Hu chonici city of wow !! Due To (c)
50.1. 11.55.9:6145
Lewis N.Cahill
(Signed)
M. D.
USNH, Chelsea
Date
6/30/58
19
Arlington Nat. Cem. ,Ft. Meyer, Va. 6
Place of Burial or CremationJuly 7,1958 or Town) DATE OF BURIAL 19
v.m. J.Cox
7 NAME OF FUNERAL DIRESIRont , Mass. ADDRESS
Received and filed. . JUL 11 1958 19
(Registrar of City or Town where deceased resided)
PARENTS
(Address).
yes
Was autopsy performed?
What test confirmed diagnosis ?.
5 W'as disease or injury in any way related to occupation of deceased? If so, specify.
PLACE OF DEATH
302
1
U.S.Naval Hospital No.
John Peter Sedor
(Was deceased a
Korea
Qtrs. 7, Ft.Banks
1
Winthrop, Mass.
St
1
19
to ...
19
OTHER SIGNIFICANT CONDITIONS
Days
RECEIVE .
6
JUL .11900M
ENTERED
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