USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 4
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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, 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 .- Gen. Laws, Chap. 38, Sec. Y.
No undertaker or other person 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 ceme- tery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment 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 un- related to any form of injury, have died without recent medical attend- ance 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.
RM R-303 B
Suffolk
(County)
monthup (City or Town) No. 80 Someractage
The Commonwealth 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.
Registered No .. 9
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAM
(If deceased is a married, widowed ór divorced @roman, five also maiden name.)
Almot Nova Scotia
Ward,
(If nonresident give city or town and state)
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Sa If married, Whowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of (Husband's name in full)
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.) Winesel Flame Bw. Said to have been coup in a
6 IF STILLBORN, enter that fact here.
7 18 Years Months .Days
If less than 1 day .Hours .Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. . 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
Farmer
10 Date deceased last worked at this occupation (month and year)
11 Total time (years) spent in this occupation ..
12 BIRTHPLACE (City)
(State or country) naveia Dealer
13 NAME OF FATHER
PARENTS
14 BIRTHPLACE OF FATHER (City)
(State or country)
15 MAIDEN NAME OF MOTHER
16 BIRTHPLACE OF MOTHER (City) (State or country)
1
17 Informant (Address)
Sumien
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial, or transit permit was issued: Min. 2.
(Signature of Agent of Board of Health or other)
1/8/94
(Official Designation) (Date of Issue of Permit)
(See reverse side for description for unknown person)
20 IN WHAT CITY OR TOWN
WAS INJURY SUSTAINED?
M. D.
192
21 PLACE OF BURIAL, CREMATION OR REMOVAL TURIU VINIL (Cemetery) (City or town)
DATE OF BURIAL
22 NAME OF
UNDERTAKER
ADDRESS
Received and filed.
JAN 1 / 134 ............. 9
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of MARGIN RESERVED FOR DINDING
of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
PLACE OF DEATH
1
Baltzer
(If U. S. War Veteran, specify WAR)
(a) Residence.
No ..
(Usual place of abode)
Length of residence in city or town where death occurred
Jrs.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan-
6-1934
(Month) (Day)
(Year)
(Signed)
- (Address)
5m-2-'30. No. 7997-c
.Ward
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, 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 regis- tration 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 con- tracted, 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.
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 under- taker 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 interment, 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 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 registration. 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., as amended.
No undertaker or other person 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. as amended
Medical examiners shall make 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 lies and take charge of the same ;...- General Laws, Chap. 38, 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; other- wise a description as full as may be, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 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
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, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident. " " Pistol shot wound
of the chest with associated hemorrhage, homicidal."
" Asphyxiation
by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture. of the skull with associated internal injury sustained under circumstances 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, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal 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
RM R-303 B
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
PLACE OF DEATH No
(City or Town) 80 Juncaractère
Muth
Ward
To be filed for burial permit with Board of Health or its Agent.
Registered No. 10
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
masel Baltzer
(If deceased is a married, widowed of divorced woman, give also maiden name.)
Wile
(a) Residence. No .. (Usual place of abode) Length of residence in city or town where death occurred yrs. Ward, mos. 7 days. How long in U. S., if of foreign birth? yTs.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, or divorced HUSBAND of
(er) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE :.
7 5.3 Years Months
Days
If less than 1 day Hours. .. Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, Trace venecia sawyer, bookkeeper, etc.
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc. .
10 Date deceased last worked at this occupation (month and year)
11 Total time (years) spent in this occupation.
1
12 BIRTHPLACE (City) (State or count
13 NAME OF
FATHER
14 BIRTHPLACE OF FATHER (City) .....
(State or country)
15 MAIDEN NAME OF MOTHER
1
16 BIRTHPLACE OF MOTHER (City) (State or country)
Informant (Address)
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 of other)
Health (Official Designation) (Date of Issue of Permit)/ 1/2/34
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
6-1934
(Month)
(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.) ral Fhome
Said to have been caught
tweeling it winther Dan J
Tasunathe recedental
(See reverse side for description for unknown person)
20 IN WHAT CITY OR TOWN
WAS INJURY SUSTAINED?
(Signed)
, M. D.
(Address)
21 PLACE OF BURIAL, CREMATION OR REMOVAL Milieuè (Cemetery)
DATE OF BURIAL
1
(City or town) 1934
22 NAME OF
UNDERTAKER
ADDRESS. .
Received and filed. 19
JA# 1 1934
(Registrar)
MARGIN RESERVED TOR DINDING
5m-2-'30. No. 7997-c
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
(If U. S. War Veteran,
specify WAR)
(If nonresident give city or town and state)
mos. days.
(Give maiden name of wife in full)
PARENTS
Porte 6- 1934
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, 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 regis- tration 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 con- tracted, 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.
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 under- taker 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 interment, 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 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 registration. 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., as amended.
No undertaker or other person 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 ....- Chop. 114. Sec. 46. G. L. as amended
Medical examiners shall make 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 lies and take charge of the same ;...- General Laws, Chap. 38, 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; other- wise a description as full as may be, with the cause and manner of death. -- General Laws, Chap. 38, Sec. 7.
. . The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 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
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, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances 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, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal 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
RM R-305
Suffolk
(County)
Boston
(City or Town) No Ma.s.s ... GeneralHospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
149
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME.
Benjamin ... S
Thompson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
(Usual place of abode)
81 .Shore ... Drive
.St.,.
Ward,
Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
M
4 COLOR OR RACE
(write the word)
married
5a If married, widowed, or divorced HUSBAND of
Ida. Mintz
(Give maiden name of wife in full)
(er) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE 50 Years
Months .Days
If less than 1 day Hours. -Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
moat .. cutter
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
10 Date deceased last worked at
this occupation (month and
year)
Jan .5 .1934
spent in this
occupation 35
12 BIRTHPLACE (City) (State or country)
Russia
13 NAME OF
FATHER
Abraham D Thompson
14 BIRTHPLACE OF
FATHER (City)
PARENTS;
15 MAIDEN NAME
OF MOTHER
Freeda Lazarus
16 BIRTHPLACE OF MOTHER (City) (State or country)
Russia
17
Informant
(Address)
Ida Thompson
Winthrop
A TRUE, COPY. A
.ATTES
(Registrar of city or town where death oscurred)
DATE ·FILED
Jan 9
1934
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jen
6
1934
(Month)
(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)
acute cardiac failure chronic cardiac acute gastritis Said to have become distressed
after eating a meal at home
20 If death was due to external causes (VIOLENCE) fill in the following : Accident, Suicide or Homicide ?
Date of injury. 19
Where did injury occur ?
Manner of
Injury.
Nature of
Injury
21 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
W J Brickley
(Address)
Boston
Date 1/6/
1934
22 PLACE OF BURIAL,
CREMATION OR REMOVAL
Pride of Boston Woburn
(Cemetery)
7
DATE OF BURIAL
Jan
(City or town)
19
34
23 NAME OF
UNDERTAKER
J H Lovine
ADDRESS
Dorchester
Received and filed. 19
TEB :
1934
(Registrar of City or Town where deceased resided)
MARGIN RESERVED FOR DINDING
25m-2-'30. No. 7997-e
1
PLACE OF DEATH
st.,
.Ward
11
(If U. S.
War Veteran,
specify WAR)
M. D.
(City or town and State)
Russia
(State or country)
11 Total time (years)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
RM R-301 A
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. 100m-9-'30. No. 9954. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS
1
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No ..
33 Bellevue Av
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
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