USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 1
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بهابيدي
கருவூ ராஷ் மர்விடுதிரி ஒருகர் வம்.முப்பத்தி பாடு வர்
தார் பெறும்
1111110年のマイ1
من الاسود
11114
--- - -------
牛1 ح صرية
-..
-
专中中中日す2号
தூது
---------
க்கன்
J. L. FAIRBANKS DIV. Thomas Groom & Co. Stationers 105 State St., Boston
To duplicate this book order No. 1773 -8 0 U.7
RM R-303-A
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to Insert a reoltai to that effeot extracts from the laws relative to the return of certificates of death.
PARENTS
15 MAIDEN NAME
OF MOTHER
Sarah Kopolovitz
(Ok)
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Lena Zinnerman
Relation, if any ( \ direx) 50 Trident Ave-Vinteren
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued : Matter & Malack
Signature of Agent of Board of Healthfor other
1/2/5/
(Official Designation (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDMarried
5a If married, widowed, or divorced
HUSBAND of
Lena Kopolovitz
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If alive years
7 IF STILLBORN, enter that fact here.
8
AGE.
72 Years
.Months.
Days
-
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Vroce Cutter (retired)
Industry
10 or Business :
11 Soolal Security No ... 0.21-03-2614.
12 BIRTHPLACE (City)
(State or country)
Russia
20 Accident, sulolde, or nomlolde (specify)
dacadal
Date of occurrence.
Jam-1 -
1951
Where did
Injury ooour ?
(City or town and State)
Did Injury poour In or about home, on farm, In Industrial place, or I
publi
place ?
Beach
(Specify type of place)
Manner
Injury
Nature of
Beach Jen-1-1951
Injury
While at work ?.
Was there an autopsy ?.
21 Was disease or injury In any way related to oooupation of deceased ?
If so, speolfy
Hun Gridelen Kid
(Signed)
M. D.
(Address)
Jan-2-1987
22
Hand in Hand, West Roxbury
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
January 2, 1950
23 NAME OF
FUNERAL DIRECTOR Benjamin F. Solonoi
ADDRESS
420 Harvard St-Brookline
Received and filed 19
.
1
(Registrar)
1
PLACE OF DEATH
Sullock. (County)
The Commantoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or Its Agent.
1
Registered No.
St. { { If death occurred in a hospital or institution, ( give its NAME instead of street and number)
Samuel Zimmerman
(If deceased is a married, widowed or divorced woman, giver also maiden name.)
(a) Residence. No.
50 Trident ave Winthrop
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or institution.
( Before death)
(Specify whether)
years
months
days.
In this community 20 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
18 DATE OF
DEATH
January -
(Month)
1-1951
(Day)
(Year)
19 | 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.) External S'internal Newsshagen Turated Wendy A heck
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF DEATH in plain terms,
-
Winthrop (City or Town)
Nogenannte to mass. Leveral Hospital
2 FULL NAME
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
no.
50m. (f) .6-43-12056
13 NAME OF
FATHER
Abraham Shepard Zimmerman
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
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 destlı, 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 hia death ... Gen. Laws, Chap. 16, 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 toarine corps of the United States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as læearly 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 sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall inchide the ('hina relief ex- pedition and the l'hilippine insurrection, which shall, for said purposea, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can bonler 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 tuwn, or remove therefrom a human body which has not been buried, until he has received a perinit froin 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 slisii exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the recelving tomb to another in the same cemetery, until he has received a permit from the board of heahh or ita agent aforesald or from the clerk of the town where the tindy 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 he returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physlelan, 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 physi- cian 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 re- quired of the attending physician. If death Is caused by violence, the medical examnlner shall make such certificate. If such a permit for the removal of a human body, not previously Interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session 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 re- moval, 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-xix, that the deceased served in the army, davy or marine corps of the United States in any war in which
it has heen engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forihwith countersign it and transmit it to the clerk of the town for regis. tration. The person to whom the permit is so given and the physician cet- tifying 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 umauer or cause of the death, which the clerk or registrar may re- quire .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a perioit 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 hield, or from a per- son appointed to have the care of the cenietery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
Medical examiners shall mske examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body liea and take charge of the same; ... - General Laws, Chap. 3S, Sec. 6.
.. . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- General Lawa, Chap. 38, Sec. 7.
. . The medical examiner certifies the cause and manner of death to the best of hia knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persona to whom they have given bedside care during a last illness from disease unrelated to any forin of injury.
(2) Board of Health physicians will certify to such deatha only aa those of persons who, though disabled by recognized disease urrelated to any form of injury, have died without recent medical attendance or whose physi- cian is absent fromn hoine when the certificate of death ia needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths caused directly or In- directly by traumatism (including resulting septicemia), and by the action of chemical (druga 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify : (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, tbe mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gaa bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, hoinicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether adininistered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstancea unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause it's known or presumable nature; and (2) omder manner, indicate the circum- stances leading to medico-legal inquiry. For example: "Hemorrhage spon- taneous of the brain (hasal ganglia) ( found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
PLACE OF DEATH
sulfalk. (County)
Bratom
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.
2
(City or Town)
No. nach
Baby Girl Proto
(If deceased is a married, widowed or divorced woman, give also maiden name.)
-
(Was deceased a U. S. War Veteran. if so specify WAR)
st. E . Bay
(If'nonresident, give city or town and State)
Length of stay: In place of death
years months. days. In place of residence .years
months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX F
9 COLOR OR RACE
w
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
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 0 Years 0 Months . . 0 Days
If under 24 hours
Hours
& Minutes
13 Usual Occupation :
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City) (State or country)
17 NAME OF FATHER Louis Proto
18 BIRTHPLACE OF Salerno
FATHER (City) (State or country)
Taly
19 MAIDEN NAME OF MOTHER Sanção Barbacaso
20 BIRTHPLACE OF MOTIIER (City) (State or country)
Boston
21 Informant (Address) 57 Minm &t. Co/B.
I HIEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter J. Walker Signature of Avent of Board of Ilerin other)
Healthe office (Official Designation) (Date of Issue of Permit)
1/5 51
(Registrar)
51 (Year)
4 I HEREBY CERTIFY,
That I attended deceased from
1-2-51 19
...
to. ..
1-2-5!
19
I last saw her alive on 1-2-5%, 19
, death is said to
have occurred on the date stated above, at
9:35R m INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
asplascia les ne fér
ANTE
Due To anomaly of
CEDENT (b) CAUSES card 1
aberrant vessel-Torn dice to look around left amble and Robin.
ankle
OTHER SIGNIFICANT CONDITIONS
Major findings: Of operations.
Date of operation Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify En laplan mw M. D.
(Signed) (Address) 86/ CancelinstEn Date 1-2-20 19
6 Plate of Burial or Cremation
(City or Town)
DATE OF BURIAL 1-6-5/ 19
7 NAME OF
ADDRESS AVversa.st-&
Received and filed
- 2.1. 20 .... JAN 5 .001
19
[(If death occurred in a hospital or institution, . St. } give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME.
(a) Residence. No .. (Usual place of abode)
3 DATE OF DEATH
1- (Month)
2 - (Day)
50M (B). 12.49.900722
FORM R-301A 1
INSTRUCTIONS FOR MEDICAL CERTIFICATE In giving AUSE OF DEATH do not enter more than one cause for each of (a), (b) and (c)
This does not mean : mode of dying, such heart failure, asthenia, . It means the disease. complications which used death.
Morbid conditions. any, giving rise to the ore cause (a) stating underlying cause t.
Conditions contrib- ng to the death but not ated to the disease or dition causing death.
PARENTS
-
ثلابندر
Louis Vesto
Registered No.
swetlana
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 cxhume 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 perinit. 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 of 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 froni 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 dore 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
ORM R-302 1
PLACE OF DEATH
Middlesex (County)
Cambridge (City or Town)
No. Holy Ghost Hospital
.......
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME .... Frank Mccluskey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
(a) Residence. No.
206 Lincoln Street
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. ........ ... years. months. 1.7days. In place of residence. 26 years .. months ... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Jan.
4
1951
(Month)
(Day)
(Year)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED Married
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY,
That I
attended deceased from
Dec. 18, 1950
to ...
Jan ....
4
I last saw h ... j.m ... alive on ... Jan ....
4
19.
51 death is said to
have occurred on the date stated above. at.2 ..... 3.0 ......... m.
INTERVAL BE-
(Husband's name in full)
DISEASE OR CONDITION DIRECTLY LEADING
TO DEATH
(a)
Thrombosis of left
Paplitral artery
1 mo
12
AGE.7.2
Years
Months.
Days
If under 24 hours
Hours ...
Minutes
13 Usual
Unknown
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
Unknown
15 Social Security No ..
Unknown
16 BIRTHPLACE (City)
(State or country)
Ireland
17 NAME OF
FATHER
Patrick Mccluskey
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Ann Dolan
20 BIRTHPLACE OF
MOTHER (City)
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