Town of Winthrop : Record of Deaths 1919-1921, Part 202

Author: Winthrop (Mass.)
Publication date: 1919
Publisher:
Number of Pages: 1192


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1919-1921 > Part 202


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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R-301


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


Winthrop (City or Town)


1 PLACE OF DEATH


County


Infatti


State


massi


Registered No.


172


St.,.


b


Ward


(If death occurred in a hospital or institution, give its NAME instead of street and number)


2 FULL NAME


mary Elaina Fram


(If in the Army or Navy of the United States, give rank, organization, etc.)


(a) Residence.


No.


3 Summit- fax.


St.


Lì Ward.


(If non-resident give city or town and State)


Leogth of resideoce in city or towo where death occurred


years


7


mooths


days.


How long io U. S., if of foreign birth ?


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


(Month)


(Day)


(Year)


17 I HEREBY CERTIFY, That I attended deceased from


Salen


19


that I last saw b


alive on


attende)


19


and that death occurred, on the date stated above, at. 12.30 Am.


The CAUSE OF DEATH was as follows:


Tuberculosis 1) Lungo


0


.(duration)


2 yrs


mos ..............


.ds.


CONTRIBUTORY


(SECONDARY)


Mundial Stoffer y Enplads C)


ds.


18 Where was disease contracted " if not at place of death ?


Did an operation precede death ?


no


Date of.


Was there an autopsy ?


no


What test confirmed diagnosis ts


Reported to Jours as y. B.


(Signed)


(Address) 174


14


1921


Date


(Month)


(Day)


(Year)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


Evergreen


(Cemetery)


(City or town)


.....


DATE OF BURIAL Mr. 23"


ADDRESS


15 Nov 30 1921


Filed


(Month) (Day) (Year)


REGISTRAR


21 I HEREBY CERTIFY that a satisfactory stao- dard certificate of death was filed with me BEFORE the boriaf or transit permit was issued S. A. Mowy.


Official position


Health office per


Date of


Permit


11/15/20


No 355


00.


3 SEX y PARENTS 14 in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH (h) Name of employer instructions and extracts from the laws on back of certificate.


4 COLOR OR RACE


W


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Jungle


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


6 DATE OF BIRTH


body


16


1877


( Month)


(Day)


(Year)


7 AGE 44 Years


3 Months


2 7 Days


If LESS thao 1 day, ........ hrs. or ....... min.


If STILLBORN, eoter that fact here


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particolar kind of work


Retired School Tracker


9 BIRTHPLACE (City)


(State or country)


0 mars


10 NAME OF


FATHER


Charles H. Deans


11 BIRTHPLACE OF


FATHER (City) ....


(State or country)


12 MAIDEN NAME


OF MOTHER


mary Harris


13 BIRTHPLACE OF


MOTHER (City)


(State or country)


mass


Informant ....


Anna L. Diam


(Address) 103 Summit Ave Without mass


20 UNDERTAKER


SE Kingsburg


The Commonwealth of Massachusetts


No.


103


Summit- Ave.


City or Town


(Usual place of abode)


13


1921


Signed by order of


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


[Approved by U. S. Census and American Public Health Association]


Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As cxamples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," cte., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the house- hold only (not paid Housekcepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should bo taken to report spe- eifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, IFouscmaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness, If retired from business, that fact may be indicated thus: Farmer (retircd, 6 yrs.). For persons who have no occupation whatever, writo None.


Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time aud causation), using always the same accepted term for the same diseasc. Examples: Cere- brospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of .. ...


... (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (sceondary or inter- current) affection necd not bo stated unless important. Example: Mcasles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (inercly symptomatic), "Atrophy." "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital," "Senilc," ete.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shoek," "Uremia,""Weakness," etc., when a definite discase can be asecrtained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," ete.


State cause for which surgical operation was undertaken.


(Recommendations on statement of cause of death approved by Com- mittce on Nomenclature of the American Medical Association.)


Bronchopneumonia: If primary cause, write the word "pri- mary" ; if secondary, give primary cause.


Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician 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 tho name of the deccascd, his supposed age, the disease of which he dicd [defined so that it ean be classified under the international classification of causes of death], where contracted, the duration of his last illness, when last seen alive by the physician, and the date of his death. . . . - Revised Laws, Chap. 29, Secs. 10 and 1. as amended by Acts of 1910, Chap. 822.


No undertaker or other person shall bury a human body . . . until he has received a permit from the board of health or its agent, . . . or . . . from the elcrk of the eity or town in which the person died; . . . no such permit shall be issued until there shall have been delivered to such board, agent or clerk, . . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which ... shall be accompanied by a satisfactory certificate of the at- tending physician, if any, as required by law, or in lieu thereof a certifi- cate 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 insuffielent, the chairman of the board of health, if a physician, or any physician employed by sald board or by the seleetmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner only shall make such certificate. . . . The person to whom the per- mit is so given and the physician who certifies to the cause of death shall thercafterfurnish 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 elerk or registrar may require. - Reviscd Laws, Chap. 78, Sec. 38.


Medieal examiners shall, in all eases, certify to the city or town clerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise a description of such person as full as may be, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are supposed to have come to their death by violence. - Revised Laws, Chap. 24, Sec. 8.


RULES OF PRACTICE


The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they havo 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 discuse 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 sup- posably due to injury. These inelude not only deaths eauscd directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or cleetrical 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 disoase, and those of persons found dead.


M R-301


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH


(City or Town)


1 PLACE OF DEATH


County


Suffolk


State


Mass


Registered No.


173


City or Tow


No ..


75, Somerset


.St., Ward


(If death occurred in a hospital or institution, give its NAME instead of street and number)


2 FULL NAME


Julia Word Campbell


....


(If in the Army or Navy of the United States, give rank, organization, ete.)


(a) Residence,


( Usualplace of abode)


Length of residence in city or town where death occurred


years


months


Ward.


days.


How long in U. S., if of foreign birth ?


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE


White


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Widowed


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


Irving W.


6 DATE OF BIRTH


( Month)


"(Day)


(Year)


7.2


Months


11


Days


27


1 day, ........ hrs. or ....... min.


If STILLBORN, enter that fact here


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work


Ar Home.


9 BIRTHPLACE (City)


(State or country)


Halifax Vd.


Charles P Word


11 BIRTHPLACE OF


FATHER (City).


England


(State or country)


Victoria Caloiré


12 MAIDEN NAME


OF MOTHER


13 BIRTHPLACE OF


MOTHER (City)


(State or country)


Halifax


N.S.


Date.


14 Mr. Howard


75 Jomercer Aus


15 Filed .. Nov 301921 (Month) (Day) (Year)


REGISTRAR


21 I HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued :. S. U. Maury


Official position


of Healthel fici permit 1/22/2/


Permit


No. 356


17 I HEREBY CERTIFY, That I attended deceased from 1911 19 Mr 20 , 19. to ...


2 that I last saw han alive on IN 18 192, and that death occurred, on the date stated above, at 9 A


If LESS than


The CAUSE OF DEATH was as follows:


m. Carcinoma of both Breato


(duration)


10


.yrs ...


mos ...............


.ds.


CONTRIBUTORY


(SECONDARY)


(duration)


.yrs ..............


mos ........... .ds.


18 Where was disease contracted


if not at place of death?


Did an operation precede death ?. no Date of.


Was there an autopsy ?


no


What test confirmed diagnosis ?


Incenso confie 4 cm.


(Signed)


Biomedical


M.D.


(Address).


174 W michal/21


Wany


21


1.1921


(Month)


(Day)


(Year)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


Winthrop


(Cemetery)


"City or town)


DATE OF BURIAL Nov 22021


ADDRESS 20 UNDERTAKER Frank E. Brown East Boston


. 50,000.


3 SEX Female 7 AGE 10 NAME OF FATHER PARENTS Informant. (Address) instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH (b) Name of employer


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


(Month)


20


1921


Day)


(Year)


24- 1848


Years


No.


75 Somerset Ave St.


(If non-resident give city or town and State)


nov. 20. 19 : REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


[Approved by U. S. Census aod American Public Health Association]


.


Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can he known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will he sufficient, e. g., Former or Planter, Physicion, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary firemon, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry. and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Solesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm loborer, Laborer - Cool mine, etc. Women at home, who are engaged in the duties of the house- hold only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should he taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at heginning of illness. If retired from husiness, that fact may he indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death. - Name, first, the DISEASE CAUSING NEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cere- brospinal fever (the only definite synonym is "Epidemie cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualificd, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of .... . (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heort disease; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not he stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma,""Convulsions,""Debility" ("Congenital," "Senile," ete.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,"""Weakness," · etc., when a definite disease can he ascertained as the cause. Always qualify all diseases resulting from childhirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.


State cause for which surgical operation was undertaken.


(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)


Bronchopneumonia: If primary cause, write the word "pri- mary" ; if secondary, give primary cause.


Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician 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 helief the name of the deceased, his supposed age, the disease of which he died [defined so that it can he classified under the international classification of causes of death], where contracted, the duration of his last illness, when last scen alive by the physician, and the date of his death. . . . - Revised Laws, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chop. 322.


No undertaker or other person shall bury a human body .. . until he has received a permit from the board of health or its agent, . . . or ... from the clerk of the city or town in which the person died; . . . no such permit shall be issued until there shall have been delivered to such board, agent or clerk, . . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which ... shall be accompanied by a satisfactory certificate of the at- tending physician, if any, as required by law, or in lieu thereof a certifi- cate 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, the chairman of the board of health, if a physician, or any physician employed by said board or by the selectmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner oniy shall make such certificate. .. . The person to whom the per- mit is so given and the physician who certifies to the cause of death shall thereafter furnish for registration any other necessary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Reviscd Laws, Chop. 78, Sec. 38.


Medical examiners shall, in all cases, certify to the city or town clerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise a description of such person as full as may he, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are supposed to have come to their death by violence. - Tcvised Laws, Chop. 24, Sec. 8.


-RULES OF PRACTICE


The fulfilment of the purpose of these laws calls for the observance of the following 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 sup- posably due to injury. These include not only deaths caused dircetly 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.


M R-303


The Commonwealth of Massachusetts


MEDICAL EXAMINER'S CERTIFICATE OF DEATH


12,000


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


1 PLACE OF DEATH


(ISSUED UNDER THE PROVISIONS OF REVISED LAWS, CHAPTER 24)


County ..


Suffolk


City or Town


Winthrop


Florence 2


ff death gecurred in a hospital or institution, give its NAME instead of street and number)


Mc Michael


(If in the Army or Navy of the United States, give rank, organization, etc. )


(a) Residence. No (Usual place of abode) Leogtb of residence io city or town where dealb occurred years


mooths


days


How loog in U. S., if of foreign birth?


years


mooths


days


PERSONAL AND STATISTICAL PARTICULARS


3 SEX 14 COLOR OR RACE


Itrute


5 SINGLE, MARRIED, WIDOWED OR


DIVORCED (write the word)


Itidour


5a If married, widowed, or divorced HUSBAND of (or) WIFE of


Late Willie B. Mehri have


July


(91 onth){


(Day)


Days 12


If LESS than 1 day ... ... hrs. or .mio.


8 OCCUPATION OF DECEASED (a) Trade, professioo, or particular kind of work (b) General nature of iodustry,


9 BIRTHPLACE (City)


(State or country)


10 NAME OF FATHER Walter H. Sturtevant


11 BIRTHPLACE OF


FATHER (City).


(State or country)


texter


maine


12 MAIDEN NAME


Chronic E. Knoutton


13 BIRTHPLACE OF


MOTHER City)


(State or country)


4. H.


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH.


non


21


1921


(Year)


(Month)


(Day)


17 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows :


Natural Causes: Presumably Cardio- vascular disease (Coman Selernis.) [ Sudden death. ]


(See reverse side for description for unknown person)


18 Where was injury sustained if not at place of death ?.


(Sigoed)


Large Burger Magath


(Address


Medical Examiner for ..


Suffolk


Date


22 1921


(Month) (Day) ( Year)


19 PLACE OF BURIAL, CREMATION, or REMOVAL


horthy Edgecomb Mairie


(Cemetery)


(City or town)


DATE OF BURIAL hors 23 /12/ (Month) (Day) (Year)


20 UNDERTAKER


C. a. Rolling


ADDRESS


E Boly


-


21 Burial permit issued by .... ... J.G. Maury


Official Health Officer 22 Date of position


issue. 11/23/21


Permit


No ..


357


should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF DEATH in plain terms, N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information (c) Name of employer


MARGIN RESERVED POR BINDING


2 FULL NAME 6 DATE OF BIRTH 7 AGE 63 Years OF MOTHER PARENTS 15 for extracts from the laws relative to the return of certificates of death. so that it may be properly classifiled under the International Classification of Causes of Death. See reverse side business, or establisbmeot io which employed (or employer)


14


Informant


SturTwant


(Address) 200 (Pleasant SV. Wirth, to


Filed


nov.30- 1921


(Month) (Day) ( Year)


REGISTRAR


State


250 Pleasant-


Registered No.


174


St.,


Ward


200


Pleasant


St.,


Ward.


( If non-resident give city or town and State)


If STILLBORN, enter that fact here


If STILLBORN, state period of uterogestalioo.


months


15058 (Year)


Months


4


it Kterne


Dat Parere masa


. M.D.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician 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 deccased, furnish for registration a stand- ard 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 so that it can be classified under the international classification of causes of death], where contracted, the duration of his last illness, when last scen alive by the physician, and the date of his death. . . . - Revised Laws, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chap. 322.


No undertaker or other person shall bury a human body . until he has received a permit from the board of health or its agent, . . . or . from the clerk of the city or town in which the person dicd; . no such permit shall be issued until there shall have been delivered to such board, agent or clerk; . . . a satisfactory written state- ment containing the facts required by law to be re- turned and recorded, which . .. shall be accompanied by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as herein- after 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, the chairman of the board of health, if a physician, or any physician employed by said board or by the selectmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner only shall make such certificate. .. . The person to whom the permit is so given and the physician who certifies to 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. - Revised Laws, Chap. 78, Sec. 38.




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