Town of Winthrop : Record of Deaths 1940, Part 65

Author: Winthrop (Mass.)
Publication date: 1940
Publisher:
Number of Pages: 494


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 65


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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No undertaker or other person shall bury a buman body or the ashes tbereof which have been brought into the commonwealth until he bas received a permit so to do from the board of health or Its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body Is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the 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 discase 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 .- 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 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 been given up or changed on account of the disease causing deatb, 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 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


587 /Deacon it


12-301 A Suffolk 0 %(County) Winthrop 1 (City or Towa)


No ... 110 Ban


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 ..


218


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


Christing Charlotte Olson


(If deceased is a married, widowed or divorced woman, give also maiden name.)


Ko Division


St


......


years


months


days.


In this community


yrs.


3


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Finale


4 COLOR OR RACE


white


5 SINGLE


"MARRIED


WIDOWED


or DIVORCED


(write the word)


Single


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


.years


7 IF STILLBORN, enter that fact here.


AGE ..


8 86 Years. 3 Months. Days


If less than 1 day Hours Minutes


Usual


9 Occupation :.


Industry


10 or Business :


11 Social Security No.


12 BIRTHPLACE (City)


(State or country)


13 NAME OF


FATHER


Samuel alsow


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Sweden


15 MAIDEN NAME


OF MOTHER


16 BIRTHPLACE OF


MOTHER (City).


(State or country)


asteland


Sweden


17


Informant Muss Manthe media (neice


(Address)


110BA


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Muss Childress (Signature of Agent of Board of Healthor other He alite Officer 11/30/40 (Official Designation) (Date of Issue of Fermit) (


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


(Month)


(Day)


(Year)


19 HEREBY CERTIFY, 1940 to November 1940 I last saw her alive on Revealed 30, 1940, death is said to have occurred on the date stated above, at. 10 20 A. m. Immediate cause of death.


Duration IMPORTANT


mia


Due to


Cardiac Dumpunten.


Due to


Pulmonary Congestion


Other conditions Hypertensie NeatDen (Include pregnancy within 3 months of death)


- Years


IMPORTANT


PHYSICIAN


Major findings: Of operations ......


Of autopsy.


What test confirmed diagnosis ?.


20 Was disease or injury in any way related to occupation of deceased?


(Signed).


ty Paul &. Crelan


M. D.


(Address) 39 Ry Stes Rood Date Kar 30


1940


21.


Place of Burial, Cremation or, Removal.


Poroton.


DATE OF BURIAL.


December 2


(City or Town)


1940


22 NAME OF


Colin EN. Dennis


ADDRESS


144


Salem St malden


Received and filed 19


(Registrar)


PHYSICIANS .hanid state


information should be carefully anunliad __ AC.Roshould kanatatad EXACTLY is very important. See instructions and extracts from the laws on back of certificate.


100m-2-'40-D-729-8


PLACE OF DEATH


2 FULL NAME.


(a) Residence. No


(Usual place of abode)


Length of stay: In hospital or institution.


(Specify whether)


(If U. S.


War Veteran,


specify WAR).


Walking. mars


(If nonresident, give city or town and state)


30 1940


That I attended deceased from


6 Age of husband or wife if alive


Ostrland- Aireden


artiland


Date of.


Underline the cause to which death should be charged sta- tistically.


Relation, if any


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. definded as required hy 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. La's. 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 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 body and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiv- ing 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 hoard, agent or clerk, as the case may be. a satisfactory written statement containing the facts required hy law to be 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 hy 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 in- sufficient, a physician who is a member of the board 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 hody. 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 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 re- moval of such body has been sooner obtained hereunder. If the death certificate contains a recital. as required by section ten of chapter forty- six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged. such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for 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 he ohtained 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 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 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 interinent 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 hy 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 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, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy 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 morhid 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 been 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 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


12-302


VI ULALA JERNHU UL LIBUJINTILILL UN AUTIN A JUL 1V THIC CHTA UI THỂ CHY UI TWH IR wann uit ucceaseg resided as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


50m-10-'39. No. 8427-f


17


Informant


Thos .... Hoar


Relation, if any .s.o.n


(Address)


above


A. TRUE COPY.


ATTEST:


(Registrar of city of town where death occurred)


DATE FILED


11/8/40


.19.


MEDICAL CERTIFICATE OF DEATH


3 SEX


fem


4 COLOR OR RACE 5 SINGLE


MARRIED


white


WIDOWED


or DIVORCED


(write the word)


18 DATE OF


DEATH


Nov 5 1940


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY.


11/4/40


19


to ....


That I attended deceased from


11/5/40


19


7 ......


(or) WIFE of


(Giye maiden name of wife in full)


WilliamHoar


(Husband's name in full)


.years


6 Age of husband or wife if alive.


7 IF STILLBORN, enter that fact here.


AGE.


Months.


Days


If less than 1 day


Hours


Minutes


Usual


9 Occupation:


Industry


10 or Business:


et ... home


11 Social Security No ...


12 BIRTHPLACE (City)


(State or country)


Ireland


13 NAME OF


FATHER


Patrick Mulcahy


PARENTS


PLACE OF DEATH


SUFFOLK BOSTON ......


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


(City or town making return)


Registered No.


9474


No. St Elizabeth's Hospital


........ .....


St. 1


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


2 FULL NAME


Ellen


Hoar


(If deccased is a married, widowed or divorced woman, give also maiden name.)


56 Bowdoin


Winthrop


St.


(If nonresident, give city or town and state)


years


months


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


5a If married, widowed, or divorced


HUSBAND of


I last saw h ........... alive on


11/4/40


to have occurred on the date stated above, at.


6 Am.


Duration


.....


1dy


Due to


arterio sclerosis


?


general diabetes mellitus 3 yr


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 In any way related to occupation of deceased ?


If so, specify


(Signed)


J F Casey


M. D.


(Address).


Bo.s.ton.


Dat 2 1/5/ 19 40


.........


21 PLACE OF BURIAL.


CREMATION OR REMOVAL


Holy Cross Malden


(Cemetery)


(City or Town)


DATE OF BURIAL


Nov 7 1940


19


22 NAME OF


FUNERAL DIRECTOR


R C Kirby


ADDRESS


Boston


Received and filed. 19


(Registrar of City or Town where deceased resided)


PHYSICIAN


Underline the cause to which death should be charged sta- tistically.


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


15 MAIDEN NAME


OF MOTHER


Mary Egan


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland"


1


(City or Town)


(If U. S.


War Veteran,


specify WAR)


219


(a) Residence. No ...


(Usual place of abode)


Length of stay: In hospital or institution.


(Specify whether)


.......


widowed


19.


, death is said


Immediate cause of death ..


coronary thrombosis


S


74 Years.


0


DEC14000M


M ?- 302


50m-10-'39. No. 8427-f after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS


PLACE OF DEATH


....


SUFFOLK (County) BOSTON


(City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


(City or town making return)


20


give its NAME instead of street and number) No.


2 FULL NAME


(If deccased is a married, widowed or divorced woman, give also maiden name.)


92 Johnson Ave


St.


Winthrop Mass


(If nonresident, give city or town and state)


years


months


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


4 COLOR OR RACE 5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


married


male


white


5a If married, widowed, or divorced Aurelia .... S.cno.p.e.r ...


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


to have occurred on the date stated above, at.


9/35P


m.


Duration


Immediate cause of death. diabetes mellitus


4 mos


broncho pneumonia


4 dys


Due to gangrene left foot


2 mos


Usucl


9 Occupation:


professor


Industry


10 or Business:


Boston University


II Social Security No.


12 BIRTHPLACE (City)


(State or country)


Germany


13 NAME OF


FATHER


Theodore Plath


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Germany


15 MAIDEN NAME


OF MOTHER


Ernistine Kottke


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Germany ...........


17 wife


Informant.


(Address)


A TRUE COPY.


ATTEST:


(Registrar of city or town where death occurred)


DATE FILED


11/8/40


- 19


18 DATE OF


DEATH


Nov 5 1940


(Month)


(Day)


(Year)


10/7/40


19


.. , to ..


11/5/40


19.


I last saw h ...... M.alive


11/5/40


19 ..


..... ,


death is said


6 Age of husband or wife if alive.


34


Years


7 IF STILLBORN, enter that fact here.


AGE


8


55


Years


5


Months


22 Days


If less than I day


Hours.


Minutes


Due to


Other conditions


(Include pregnancy within 3 months of death)


PHYSICIAN


Major findings :


Of operations


Of autopsy


What test confirmed diagnosis ?.


20 Was discase or Injury In any way related to occupation of deceased ?


If so, specify


J A Holmes


(Signed)


M. D.


(Address) ..


Bo.s.t.o.n.


Date 11/6/1940


21 PLACE OF BURIAL ..


CREMATION OR REMOVAL


Winthrop


Winthrop


DATE OF BURIAL


(Cemetery


Nov 9 1948


19


22 NAME OF


FUNERAL DIRECTOR


H S Reynolds


ADDRESS


Winthrop


Received and filed.


19


(Registrar of City or Town where deceased resided)


L


N E Deaconess .... Hospital


S: 1


Er Otto


Plath


(If U. S. War Veteran, specify WAR)


(a) Residence. No ...


(Usual place of abode)


Length of stay: In hospital or institution.


(Specify whether)


(If death occurred in a hospital or institution, -


Registered No.


9482'


1


Relation, if any


(City or Town)


Underline the cause to which death should be charged sta- tistically.


Date of.


19


I HEREBY CERTIFY.


That I attended deceased from


NR-305


of death shoukl &c transmitted on Form &-305 to the clerk of the city or town in which the deceased resided as soon as possible after the close of the month in which the death occurred. (Sec Chap. 46, Sec. 12, G. L.)


25m-10-'39. No. 8427-g


PARENTS


15 MAIDEN NAME


OF MOTHER


Hannah F Reed


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Belmont Mass


17 Informant. (Address)


wife


A TRUE COPY.


D


ATTEST:


(Registrar of city_or town' where death occurred)


11/14/40


DATE FILED


19


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Nov 11 1940


(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.) Coronary Sclerosis treated therefor


20 Accident, suicide, or homicide (specify)


Date of occurrence. 19


Where did


Injury occur?


(City or town and State)


Did injury occur in or about the home, on farm, in industrial place, or in public place ?


(Specify type of place)


Manner of Injury


Nature of Injury


While at work?


.Was there an autopsy ?


na


21 Was disease or lajury lo any way related to cecupatlon ci deceased ?.


If so, specify.


(Signed)


Timothy Leary


. M. D.


(Address) Boston


Date 7/7718 40


22 Winthrop


Winthrop


Place of Burial, Cremation or Removal.


(City or Town)


DATE OF BURIAL


Nov 13 1940


19


23 NAME OF


FUNERAL DIRECTOR


H S Reynolds


ADDRESS


Winthrop Mass


Received and filed 19


(Registrar of City or Town where deceased resided)


V


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Male


4 COLOR OR RACE 5 SINGLE


MARRIED


WIDOWED


(write the word)


white


or DIVORCED


5cr If married, widowed, or divorced


Marion Carver


HUSBAND c!


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


57


Years


6 Age of husband or wife if alive


7 IF STILLBORN, enter that fact here.


8 AGE 57 Years Months. Days


Il less than 1 day


Hours


Minutes


Usual


9 Occupation:


school teacher


Boston Public Schools


Industry


10 or Business:


11 Social Security No.


12 BIRTHPLACE (City)


(State or country)


Garland Me


13 NAME OF


FATHER


Arthur M Stewart


14 BIRTHPLACE OF FATHER (City) (State or country)


Maine


I


PLACE OF DEATH


...


(County) | BOSTON


(City or Town)


No. 394 Mass Ave


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH


L


(City or town making return)


Registered No ..... .9640


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


2 FULL NAME


Percy R


Stewart


(If deceased is a married, widowed or divorced woman, give also maiden name.)


11 Prescott


St.


Winthrop


.....


.....


.....


months


days.


(If nonresident, give city or town and state)


In this community


yrs.


mos.


days.


(If U. S.


War Veteran.


specify WAR)


221


(a) Residence. No.


(Usual place of abode)


Length of stay: In hospital or institution


(Specify whether)


years


Relation, if any


marrie


6


DEC140MM


MR-301 A -


1


PLACE OF DEATH


Suffolk "inty) Winthrop (City or Town) 52 Locust


The Commaumralth 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,


222


Registered No.


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


(If U. S.


War Voteran,


specify WAR)


W.


St


(If nonresident, give city or town and state)


Length of stay: In hospital or institution.


20


(Specify whether)


years


months


days.


In this community /0 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


female


4 COLOR OR RACE


white


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word) Window


Sa If married, widowed, or divorced HUSBAND of


(or) WIFE of ..........


(Give maiden name of wife in full)


foreph Cohen


(Husband's name in full)


6 Age of husband or wife if alive ...


years


7 IF STILLBORN, onter that fact here.


8


AGENT


... Years.


.. Months.


....... Days[


If less than 1 day


.. Hours.


.Minutes Due to.


Usual


9 Occupation :..


Cet toue


Industry


10 or Business:


11 Social Security No ....... hone


12 BIRTHPLACE (City)


(State or country)


Russia


13 NAME OF


FATHER


Beryl Bower


14 BIRTHPLACE OF


FATHER (City) ...


(State or country)


Russia


15 MAIDEN NAME


OF MOTHER


Pose (unknown)


16 BIRTHPLACE OF


MOTHER (City) ....


Russia


(State or country)


17 Edward Cohen


Informant .... (Address) 94 cellantic live. Revere


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Hm. Silohildeeco 1.5


(Signature of Agent of yoard of Health or other)


Dec. 6140


(Official Designation)


(Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


December 5.


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I aitended deceased from


10


19 .. 38,


to Die


19 40


I last saw h.


Or alive on


orc 5


19 ...... death is said to


have occurred on the date stated above, at 10.30 p.


Immediate cause of death ......


Duration IMPORTANT 2 years


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 ipjury in any way related to occupation of deceased ?.


If so, specify fur touen


(Signed) ...


(Address) 108 Meridian 526 Date 12/6


M. D.


..... 19.55J


Relation, if any sou) 21 .. Ohel Jacob Cuchan- Woburn Place of Burial, Cremation or Removal, (City, or Town)


DATE OF BURIAL


December 6,


19%


22 NAME OF FUNERAL DIRECTOR Monis te Por tucanal Novo ADDRESS 151 Washington ave. Chelsea


Received and filed. 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 N. B -WRITE PLAINLY, WITH UNFADING BLACK ING-THIS IS A PERMANENT RECORD. Every Item of PARENTS 100m-2-'40-D-729-a


No


2 FULL NAME


ferie Cohen-rée Bauer


St.


(If deceased is a married, widowed or divorced woman, give also maiden name.) 52 Locust


(a) Residence. No.


(Usual place of abode)


1940


Due to.


Underline the cause to which death should be charged sta- tlstically.


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, definded 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.


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 otber person shall exbume 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 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, bis certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If deatlı is caused by violence, tbe medical examiner shall make sucb 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 sball constitute a permit for such removal; provided, that such body sball 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 re- moval of such body has been sooner obtained hereunder. If the deatb 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 sucb 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 deatb, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).




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