USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 55
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PLACE OF DEATH
4 COLOR OR RACE
White
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution Hospital
years
St. {
(If U. S. War Veteran, specify WAR)
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 regis- tration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required hy section onc, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall hury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not been huried, 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 hody and remove it from a town, from one cemetery to another, or from onc grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforcsaid or from the clerk of the town where the hody is buried. No such permit shall be issued until there shall have heen de- livered to such hoard, agent or clerk, as the case may he, a satisfac- tory written statement containing the facts required by law to hc returned and recorded, which shall be accompanied, in case of an original interment, hy 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 hoard of health, or employed by it or hy the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 he obtained early enough for the purpose, the certificate of death made as ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal ; provided, that such hody 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 hody has heen sooner ohtaincd hereunder. If the death certificate contains a recital, as required hy 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 hoard of health, or its agent, upon receipt of sueh 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 fur- nish 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 .- 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 hrought into the commonwealth until he lias received a permit so to do from the hoard of health or its agent appointed to issuc such permits, or if there is no such board, from the clerk of the town where the hody 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 madc .... Chap. 114, Sec. 46, G. L., (Tercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- anee of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of llealth physicians will certify to such deaths only as those of persons who, though disahled hy recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is ahsent 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 septice- mia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, but also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, 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 occupation had heen given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may he 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 hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
NR-301 A Suffolk
PLACE OF DEATH
(County)
1
Winthrop
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No ..
1.89
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Margaret S. Cassidy
(If deceased is a married, widowed or divorced woman, give also maiden name.)
149 Washington Ave
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
..... Re.s.t ..... Home
(Specify whether)
years
2 months
days.
In this community 50 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
5a If married, widowed, or divorced
HUSBAND of
(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.
AGE.
8
.84
Years.
.10 Months.
1.0.Days
If less than 1 day
Hours
.Minutes
Usual
9 Occupation :.....
a.t .... home
Industry
10 or Business:
11 Social Security No .....
.none
12 BIRTHPLACE (City)
(State or country)
Boston ...... Mas.s.
PARENTS
15 MAIDEN NAME
OF MOTHER
Anne Cox
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
.17 Dr arthur 6. Caccida
Relation, if any (nepeut
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Ww. D. Eviel drest &.
(Signature of Agent of Board of Health of other)
10/5/40
(Official Designation) (Date of Issue of/Permity
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
October
4th
1940
(Month)
(Day)
(Year)
19 ( I HEREBY CERTIFY, That I attended deceased from 4 100
19.5 .... 7, to ...
19
40
Aast saw h ... e.r ..... alive on.
have occurred on the date stated above, at. -
Immediate cause of death.
Duration IMPORTANT Muyo
Due to
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations.
Date of
Of autopsy.
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
4 husdyr La Date 10/4/ 1940
(Address)
21 Old Calvary
Boston
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ...
October 7th
1940
.19
22 NAME OF
FUNERAL DIRECTOR
WI Cassidy
ADDRESS
1.60 Harrison Ave Boston
Received and filled GOG 19
(Registrar)
is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
100m-2-'40-D-729-a
Informant.
Herself
(Address)
13 NAME OF
FATHER
Michael Cassidy
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
Underline the cause to which death should be charged sta- tistically.
M. D.
No.
125. Cliff
Ave
(a) Residence. No ..
(Usual place of abode)
(If U. S.
War Veteran,
specify WAR)
.. , 19 .. (death is said to P m.
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 hest 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 hy 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 hody in a town, or remove therefrom a human body which has not heen 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 receiv- ing tomh 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 hody is buried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may hc, a satisfactory written statement containing the facts required hy law to be returned and recorded, which shall he 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 he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the hoard of health, or em- ployed hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy 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 he 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 hody shall he 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 re- moval of such hody has heen sooner obtained hereunder. If the death certificate contains a recital, as required hy 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 heen engaged, such recital shall appear upon the permit. The hoard 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., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been hrought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permlts, or if there is no such board, from the clerk of the town where the body is to he huried 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 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy 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 disahled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Causc of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, 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 occupation had heen given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at home. For a woman whose only occupation was that of homc 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
MM R-301 1
N. B .- WKHE PLAINLI, WITH UNI ADIG ULUI- is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
1 PLACE OF DEATH 3 SEX Female Industry 10 or Business: PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state AGE. 55 Years.
200m-10-'39. No. 8427-d
I HEREBY CERTIFY that a satisfactory standard certificate of death was tiled with me BEFORE the burial or fransit permit was fssuod:
ASignature of Agent of Board of Hermin of other) Seattle Officer 10/6/40 (Official Designation) (Date of Issue of/ Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
Oct
(Month)
5th.
1940
(Year)
(Day)
19 | HEREBY CERTIFY. That I attended deceased from 1937, to Wet. 5 ., 19.5650
I last saw hand. .. alive on.
Qcx 5
, 1940 death is said
to have occurred on the date stated above, at ..... /filQ14.m.
Immediate cause of death .....
Coronary Thrombosis
Duration
.... ..... .
Due to
Hypertensive - Coronado
antly treat adliscade
...
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis?
20 Was disease or Injury lo any way related to occupatloo of deceased ?
If so, specify A Queles Liberacau, M. D.
(Signed)
.....
(Addre
3) 26 Wane Way Que Date Det. 51940
21
Winthrop Cemetary Everett mass.
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL October.
6
.... ........ .
1940
FUNERAL DIRECTOR
ADDRESS
10 Washington St. for
Received and filed ..
13.
Å TRUE COPY ATTEST:
(Registrar)
14 yrs.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
DEATH
....
Widower
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Morvis Bramson
(Husband's name in full)
6 Age of husband or wife if clive.
years
7 IF STILLBORN, enter that fact here.
If loss than 1 day
Hours.
Minutes
Usual
9 Occupation:
House wife
Il Social Security No ..
12 BIRTHPLACE (City)
Russia
(State or country)
13 NAME OF
FATHER
Jacob Tratenberg
14 BIRTHPLACE OF
FATHER (City)
Russia
(State or country)
15 MAIDEN NAME
OF MOTHER
Pauline gesfin
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Mae goldberg.
Relation, if any
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
(City or town making return)
Registered No
190
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ... 36 Wave Way
tue
St.
winthrop, Mass
(Usual place of abode)
length of stay: In hospital or institution 200
(Specify whether)
months
days.
In this community
mos.
days.
Ifrs. Froda 2vamson
(If U. S.
Wor Vetormm.
specity WAR)
(If nonresident, give city or town and state)
22 NAME OF
Manuel Stanetaby
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
Informant
(Address)
13 Shore Drive
winthrop mass.
(daughter
Suffolk County) winthrop (City or Towik Winthrop Community hospitalst No ..
Months
Days
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 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 contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall hury 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 issuc 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 tomh to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the hody is huried. No such permit shall be issued until there shall have heen de- livered to such hoard, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to he returned and recorded, which shall he 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 hy it or hy the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 ahove provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal ; provided, that such hody 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 heen sooner ohtained 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 hoard 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 fur- nish 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 .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall hury 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 he huried 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, Scc. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ohserv- ance 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 ill- ness 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 hy recognized disease un- related 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 septice- mia), 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 occupa- tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which eauses death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, ete. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every person aged 10 years or over. If the occupation had heen given up or changed on account of the discase causing death, report the usual occupation prior to illness. If the deceased had retired from husi- ness, report the usual occupation prior to retirement. Children not gainfully employed may he 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 hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
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