Town of Winthrop : Record of Deaths 1941, Part 18

Author: Winthrop (Mass.)
Publication date: 1941
Publisher:
Number of Pages: 546


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 18


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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SPACE FOR ADDITIONAL INFORMATION


RM R-301 A


PLACE OF DEATH


Suffolk County)


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 .. 51


Marchich Community NoMET ( If death occurred in a hospital or institution, No ...


2 FULL NAME Baby.


VAN-WART.


(If deceased is a married, widowed or divorced woman, give also maiden name.) 2 Ocean Vicio SI- ExTention


(a) Residence. No ..


(Usual place of abode)


Length of stay: In hospital or institution.


(Specify whether)


years


months


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICUI.ARS


3 SEX


4 COLOR OR RACE


white


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word) X


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 alivo.


.years


Still BORN


8


AGE X Years Months. X Days


Usual


9 Occupation:


Industry


10 or Business:


11 Social Security No.


12 BIRTHPLACE (City)


(State or country)


13 NAME OF


FATHER


Charles. H. Van Wart


14 BIRTHPLACE OF


FATHER (City)


Chelsea


(State or country)


mass


15 MAIDEN NAME


OF MOTHER


Eva Ragnar


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


n. S.


17 Choo. H Ven Wart


Relation, if any


(aller) (Address) 2 Ocean Vices St Slatina


1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Childrens (Signature of Agent of Board of Health or other) Healthe Office


(Official Designation) (Date of Issue of Permit) 4/41


MEDICAL CERTIFICATE OF DEATH


18 DATE OF DEATH. March 3


1941


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY. That I attended deceased from 19 ........ , to .. 19.


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


19.


death is said


to have occurred on the date stated above, at. m.


Immediate Stillborn


Duration


IMPORTANT


Due to


Amnionistic fluid on


Due to


Other conditions


(Include pregnancy within 3 months of death)


Major findings : Of operations


.Date of ..


Of autopsy


..


as above


What test confirmed diagnosis? Pathological


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


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


If so, specify ..


nous Re Dickinson


. , M. D.


(Signed)


Verthrop learn.


DatMan H 194)


21


Place of Burial, Cremation or Removal. DATE OF BURIAL ...


(City or Teurnk


22 NAME OF


FUNERAL DIRECTOR


ADDRESS


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


information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of


100m-10-'39. No. 8427-e


1


(City or Town)


give its NAME instead of street and number)


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


(If nonresident, give city or town and state)


7 IF STILLBORN, enter that fact here.


Ilf less than 1 day


Hours. .Minutes lungs


PARENTS


(Address)


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physlelan 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 regls- 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 by section one, where same was contracted, the duration of his last illness, when lust 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 whleh has not been huried, until he has received a permit from the hoard of health, or Its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the person dled : 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 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 burled. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may he, a satisfac- tory written statement contalning the facts regulred 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 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 pur- posc, 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 certificatc. 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 carly 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 body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtalned 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 transmlt 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 for- nish 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, See. 45, G. L., (Tercentenary Edition.)


No undertaker or other person shall bury a human body or the ashes thereof which have heen 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 hurled 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 fulfiliment of the purpose of these laws calls for the observ- ance of the following rules of practice :


(1) Attending physicians will certify to such deaths only az 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 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 medleal attendance or whose physician is ahsent from home when the certificate of death is needed.


(3) Medleal Examiners will Investigate and certify to all deaths supposably due to Injury. These include not only deatha caused directly or indirectly by traumatiam (Including resulting septlce- mia), and hy the action of chemical (drugs or poisons), thermal, or clectricai agents, and deaths following abortion, but also deaths from disease resulting from injury or Infaction related to occupa- tion, the suddon deaths of persons not disablad 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. .. g., heart fallure, asphyxia, asthenia, etc. As principai cause name the disease causing death. As related causes, name earller morhld 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 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 busl- ness, report the usual oeeupatlon 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 occupatlon whatever write none.


SPACE FOR ADDITIONAL INFORMATION


M R-303


N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of


DEATH in plain terms, so that it may be properly classified under the International Classification of Causes See reverse side for extracts from the laws relative to the return of certificates, of death.


50m-10-'39. No. 8427-hı


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Now. D. Chil dress (Signature of Agent of Board & Heath or other) Realite Officer 3/26/41 (Official Designation) (Date of Issue of Fermi?)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


march -4-1941


(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.)


arterio


Sclerotic Heart Disease


general arterio Scleroses


20 Accident, suicide, or homicide (specify).


Date of occurrence ..


19


Where did Injury occur ?.


(City of town and State)


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


public place?


(Specify type of place)


Manner of


Collapsed while walking


Nature of


+ died quickly


While at work ?..


.200


. Was there an autopsy? 200


21 Was disease or Injury In any way related to occupation of deceased ?.


200


If so, specify


Hur.f.Buckley


M. D.


(Signed)


(Address)


Braten


War -10-19 41


22


Woodlawn fenstery Place of Burial, Cremation or Removal. (City or Town)


DATE OF BURIAL MM. 27,


194/1


23 NAME OF


FUNERAL DIRECTOR Modell Mr. Scheman


ADDRESS 23 & any are ti


Received and filed 19


A TRUE COPY ATTEST:


(Registrar)


×


1


PLACE OF DEATH


Juliak (County)


Mutterop (City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH


(City or town making return)


52


Registered No .. a hospital or institution,


2 FULL NAME


Oscar Webster


(If deceased is a married, widowed or divorced woman, give also maiden name.) (a) Residence, No. 65 B Williams ST. Melsia St. (Usual place of abode) Length of stay: In hospital or institution (Specify whether)


years


months


days. In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Male


4 COLOR OR RACE| 5 SINGLE


White


MARRIED


WIDOWED


(write the word)


Widowed


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.


AGEY


affer. 60 yrs.


If less than 1 day


Hours


Minutes


Usual


U. P.a.


9 Occupation:


Industry 10 or Business:


11 Social Security No ..


none


12 BIRTHPLACE (City)


(State or country)


Manchester


13 NAME OF


FATHER


Francis


PARENTS


14 BIRTHPLACE OF


FATHER (City)


Lowle


(State of country)


mass


15 MAIDEN NAME


OF MOTHER


alemia quisont


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


714


17 Brandof Rullo Wel Relation if any


Informant (Address)


of Death.


a


Per ner. arthurones (Dukeman-


information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF


No en route to truturas commento Hasestado


.St. \ give its NAME instead of street and number)


(If U. S.


War Veteran,


specify WAR)


(If nonresident, give city or town and state)


Unknown


8 Wennears 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 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 onc, where same was contracted, the duration of his last illness, when last scen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Scc. 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 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 hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving 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 body is buried. No such permit shall be issued until there shall have heen de- livered to such board, agent or clerk, as the case may he, a satisfac- tory written statement containing the facts required hy law to he returned and recordcd, which shall he 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 he 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 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 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 removal of such body has heen 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 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- nlsh 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., as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.


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 permits, or if there is no such hoard, from the clerk of the town where the hody is to be buried or the funeral is to he 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 samc ;... - General Laws, Chap. 38, Sec. 6.


... Hc 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 man- ncr of death .- General Laws, Chap. 38, Scc 7.


The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.


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 deatbs 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 Health physicians will certify to sucb deatbs only as those of persons who, though disabled hy recognized disease un- related to any form of injury, bave died without recent medical attendance or whose physician is absent from bome 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 hy traumatism (including resulting septice- mia), and by 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 occupa- tion, 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 hy a steam railway ac- cident." "Pistol shot wound of the chest with associated hemor- rhagc, homicidal." "Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of cther administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."


If disease or injury was related to occupation, specify. If inves- tigation shows the death to liave heen due to disease, specify: (1) Under cause, its known or presumahle nature; and (2) under man- ner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal ganglia) (found dead in hed)." "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


Did not bury body until March 27, As City of Chelsea were trying to locate relatives.


ORM R-301 A"


N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of is very important. Sec 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 information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


PLACE OF DEATH


Suffolk (County)


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.


53


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


2 FULL NAME


Carrie (Prince)


...... Cushman


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


52 Thornton Park


XSIX


(If nonresident, give city or town and state)


In this community


yrs.


mos.


days.


(Specify whether)


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Female


4 COLOR OR RACE


White


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Widowed


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Frank Cushman


(Husband's naine in full)


6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here.


8


AGE


88 Years


3


Months.1.9 .... Days


Hours


.. Minutes


Usual


At home


9 Occupation:


Industry


10 or Business:


11 Social Security No.


12 BIRTHPLACE (City)


Boston


(State or country)


Massachusetts


13 NAME OF


FATHER


John Prince


14 BIRTHPLACE OF


Boston


FATHER (City)


(State or country)


Massachusetts


15 MAIDEN NAME


OF MOTHER


Annie Gould


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


New Hampshire


17 John P. Cushman


Relation, if any son


(Address) 73 Otis St. Wint hrop Mass


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Nu. D. Childrenng (Signature of Agent of Board of Health or other) Health officer 3/6/41 (Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


March 5.


1941


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY. That I attended deceased from


19.4 ..... , to ..


1941


I last saw h .... 2 ...... alive on ..


Mach 5, 19h, death is said


to have occurred on the date stated above, at 5-P


m.


Immediate cause of death .... Cerebral Hemorrhage


Duration IMPORTANT 2 days. Č


Due to


Criterio - Scleros 15


...


Due to


Other conditions


(Include pregnancy within 3 months of death)


Major findings :


Of operations


PHYSICIAN Underline Date of. Of autopsy the cause to which death should be charged sta- What test confirmed diagnosis ?


tistically.


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


If so, specify ....


Coward Y. Strangev.


(Address).


200 Was Cung 17 Date 3-6-1941


21 Mt. Auburn Cemetery! Place of Burial, Cremation or DATE OF BURIAL


Cambridge


Marchal8 1gy fr Town)


19.5.


22 NAME OF


Charles R. Bennison


FUNERAL DIRECTOR


ADDRESS


winthrop Mass


Received and filed.


MAR 7 1941


19


(Registrar)


100m-10-'39. No. 8427-e


1


Winthrop


(City or Town)


No 52 Thornton Park


XSE.


Registered No.


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


(a) Residence. No


(Usual place of abode)


Length of stay : In hospital or institution ..


years


months


days.


years


If less than 1 day


PARENTS


Haverhill


(Signed)


>


.


M. D.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical officer shsii 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, Scc. 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 heen 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 hoard, from the cierk 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 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 body is huried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfao- tory written statement containing the facts required by 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 by law, or In lieu thereof a certificate as bereinafter 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 by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused hy violence, the medical exam- iner 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 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 removai shall constitute a permit for such removal ; provided, that such body shail be returned to the town from which it was removed within thirty- slx hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contalns 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 permlt. The board of health, or its agent, upon receipt of such statement and certificate, shali forthwith countersign it and tranzmit it to the clerk of the town for registration. The person to whom the permit is so given and the physiclan certifying the cause of death shall thereafter fur- nish 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, See. 45, G. L., (Tercentenary Edition.)




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