USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 66
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No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove thercfrom 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 other person shall exhume a human body,and remove it froin 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 huried. 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 he obtained early enough for the purpose, or is insufficient, a physi- cian 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 re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one towi 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 rentoval 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 obtained hercunder. If the death certificate contains a recital, as required
by section ten of chapter forty-sfx, 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 counter-ign it and transmit it to the clerk of the town for registration. The porson to whom the permit is so given and the physician certifying the canse of death shall thereafter furnish for registration any other neces sary information which can be obtained as to the deceased, or as to the mabber 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 re- ceived a perinit so to do from the board of health or its agent appointed to issue ench 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).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy 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.
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 physi- cian is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and by the actfon 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 .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa 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 fm- portant. 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 dixcase 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 bousework. 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
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.
.....
5
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Thomas J. Downs
(If deceased is a married, widowed or divorced woman, give also maiden name.)
17 Girclestone Road
St.
(If nonresident, give city or town and state)
months
days.
In this community 20 yrs.
mos. ~ days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED Tidowed
or DIVORCED
5a If married, widowed, or divorced len Leary 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.
7 IF STILLBORN, enter that fact here.
AGE
Hours
Minutes
Usual
9 Occupation:
Retired
Industry
City Of Boston
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Newfoundland
13 NAME OF
FATHER
Patrick Downs
Major findings :
Of operations
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant.
Mae Downs
Relation, if any
daughter .. )
(Address)
17 Girdlestone Rd
Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or Itransit permit was issued: William D. Childress (Signature of Agent of Board of Health or other)
agent-
Nov. 2/41
(Official Designation) (Date of Issue of Permit)
19 | HEREBY CERTIFY That I attended deceased from
, 194
31
19
I last saw h ............ alive on.
09 90, 1941, death is said
to have occurred on the date stated above, at.
51
m.
Duration Immediate cause of death. Carcinoma Thank IMPORTANT 6 mg
throat
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
26 Was disease or injury In any way related to occupation of deceased? 40
If so, specify.
(Signed)
(Address) Und
,
M. D.
Day 9/1 1941
21
Holy Cross
Malden
Hvem (City-or Town)
19
4]
Place of Burial, Cremation or Removal
DATE OF BURIAL
Johnof@gmaily)
22 NAME OF
FUNERAL DIRECTOR :
ADDRESS
Winthrop Mass
Received and fled .....
19
(Registrar)
100m-10-'39. No. 8427-e
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
I
Winthrop
(City or Town)
No. 17 Girdlestone Road
S :. 1
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution ..
-
(Specify whether)
years
18 DATE OF
DEATH
Oct.
(Month)
3/
1941
(Day)
(Year)
Years
8
70
Years.
Months.
Days
If less than I day
PARENTS
Of autopsy
Date of.
What test confirmed diagnosis ?
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 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 thercfrom 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 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 de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 physiclan, 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- 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 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 removal 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 certifieate, 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 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 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 burlal 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 observ- 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 by 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 causes death, not the mode of dying, e. g., heart failure. asphyxia. asthenia. etc., Ag 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 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 busi- ness, 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 housekceper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
·
11
17
0%
1.5
50
R-302
Butfolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No.
8406
(If death occurred in a hospital or institution,
..... ....... St. { give its NAME instead of street and number)
2 FULL NAME
Annie
(If deceased is a married, widowed or divorced woman, give also maiden name.)
9.2 ... Shore ... Drive.
....
..................
St.
Winthrop
(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
fem
4 COLOR OR RACE| 5 SINGLE
white
(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
Hyman .... Miller ..
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8 AGE 73 Years Months. Days
If less than 1 day
Hours
Minutes
Usual 9 Occupation:
at home
Industry 18 or Business:
II Social Security No.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Louis Weiselberger
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Austria
15 MAIDEN NAME
OF MOTHER
Hannah
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Austria
17
Informant.
(Address)
Relation, if any
Morris Citron
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
10/8/41
DATE FILED
19
18 DATE OF
DEATH.
Oct 5 1941
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
10/3/41
19
That I attended deceased from
to ...
10/5/41
19.
....
I last saw h ......... alive on
10/5/41
19
death is said
to have occurred on the date stated above, at.
3 P
m.
Duration
Immediate cause of death
.cerebral ... hemorrhage
10/3/41
Due to
acute congestive heart
failure
10/5/41
Due to
arteriosclerosis
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Of autopsy
What test confirmed diagnosis ?
20 Was disease or injury in any way related to occupation ef deceased ?
If so, specify
(Signed)
B .... AUdelson
M. D.
(Address)
B.o.s.t.on
Date ..
10/5/19 41
21 PLACE OF BURIAL.
CREMATION OR REMOVAL Workens Circle Melrose
(Cemetery)
(City or Town)
DATE OF BURIAL
Oct 7 1941
19.
22 NAME OF
FUNERAL DIRECTOR
M Stanetsky
ADDRESS
B.o.s.t.o.n
Received and Bled. 19
(Registrar of City or Town where deceased resided)
50m-10-'39. No. 8427-f
of utalu should be transmitted on Form R-302 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. (See Chap. 46, Sec. 12, G. L.)
1
PLACE OF DEATH
(County)
No .. Hebrew ... Ladies ... Home .... for .... Aged
Miller
(If U. S.
201
War Veteran,
specify WAR)
(a) Residence. No ....
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
Years
PARENTS
Austria
.....
Date of.
Underline the cause to which death should be charged sta- tistically.
קי,
١
R-302
Auffolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No ....... $790
(If death occurred in a hospital or institution, NewEngland ... Hospital ... f.o.r ..... W ... &C .... St. ( give its NAME instead of street and number)
2 FULL NAME
Baby.
Stevong
(If deceased is a married, widowed or divorced woman, give also maiden name.)
11 Locust
St.
Winthrop
(If nonresident, give city or town and state)
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
Or DIVORCED
(write the word)
single
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
Years
6 Age of husband or wite if alive.
7 IF STILLBORN, enter that fact here.
8
AGE
Years
Months.
...... Days
16 less than
Hours
1) day .Minutes
Usual
9 Occupation:
Industry IS or Business:
II Social Security No.
12 BIRTHPLACE (City)
(State or country)
Boston Mass
13 NAME OF
FATHER
Charles Stevens
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Charlestown Mass
15 MAIDEN NAME
OF MOTHER
Grace Eldridge
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston
17 Informant. (Address)
mother .. (
TRUE COPY.
Francis
......
(Registrar of city or town where death occurred)
DATE FILED
10/22/41
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Oct 15 1941
19 I HEREBY CERTIFY.
That I attended deceased from
10/35/41
19
to 20/15/41
19.
...
I last saw h. ...... malive on. 10/15/41 , 19. death is said
to have occurred on the date stated above, at ....
9115₽
Duration
Immediate cause of death. prematurity
toxemia of mother with
Due to
premature separation of placents
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Underline the cause to which death
Date of.
Of autopsy
prematurity
should be charged sta- tistically.
What test confirmed diagnosis ?
20 Was disease or lojary In any way related to occupation of deceased ?
If so, specify.
E E Renning
M. D.
....
(Address) ..
Boston
DatoLO
19
21 PLACE OF BURIAL. CREMATION OR REMOVAL ..... S.t .... Michael .!. s .... Boston (Cemetery) (City or Town)
DATE OF BURIAL
Oct 20 1941
19
22 NAME OF
FUNERAL DIRECTOR
Rc Kirby
ADDRESS
Boston
Received and fled 19
(Registrar of City or Town where deceased resided)
×
of death should be transmitted on Form R-302 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. (See Chap. 46, Sec. 12, G. L.)
50m-10-'39. No. 8427-f
PLACE OF DEATH
(County)
Boston (City or Town)
No.
202
(If U. S. War Veteran, specify WAR)
(a) Residence. No ......
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
.....
ATTEST:
.........
Relation, if any
PARENTS
(Signed)
R-302
VI utauf should be transmitted on Form K-302 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 oscurred. (See Chap. 46, Sec. 12, G. L.)
50m-10-'39. No. 8427-f
17
Informant
Francis
Brown
Relation, if any UGLIER
(Address)
92 Irland Rd.
A TRUE COPY.
ATTESTI
iurlon
(Registrar of city or town where death occurred)
DATE FILED October 31, 19 /12-
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
October
27.
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
That I attended deceased from
19.
.. , to.
19
I last saw h ............ alive on
19.
death is said
to have occurred on the date stated above, at.
... m.
Immediate cause of death ....
Jacon te
of lef: forehead in orbit
Fractured shall with associa
Due to
ted brain ininnica
Due to
Accident
1I Social Security No ....
025-16-1152
12 BIRTHPLACE (City)
Brighton
(State or country) ass.
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Of autopsy
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to occupation of deceased ?
If so, specify.
(Signod)
Inrence F. Grgick
M. D.
(Address)
Dato
19
21 PLACE OF BURIAL. CREMATION OR REMOVAL woodlawn (Cemetery)
w.c.r.e.t.t.
DATE OF BURIAL no enjor 1.
.19 ....
22 NAME OF
FUNERAL DIRECTOR pan : 4. Brom
ADDRESS
107
717 ............... autor
Received and filed
19
(Registrar of City or Town where deceased resided)
×
1
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Married
5a lf married, widowed, or divorced HUSBAND of
Clair Fora:
(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 hero.
8 AGE.27 Years 8 Months .. Days
If less than 1 day Hours. Minutes
Usual
9 Occupation:
ac inist Helper
Industry 10 or Businessı
13 NAME OF
FATHER
Edwin G. Brown
14 BIRTHPLACE OF
FATHER (City)
East Boston,
(State or country)
Mass.
PARENTS
PLACE OF DEATH
Essex
(County)
Saugus,
(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)
Registered No.
139
No .. Trafic Circle on Bonte
St.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Edwin Francis Brown
(If deceased is a married, widowed or divorced woman, give also maiden name.)
22 Inland Road, Minthro
........
St.
(If nonresident, give city or town and state)
years
months
days.
In this community
yrs.
mos.
day3.
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
203
(If U. S.
War Veteran,
specify WAR)
197
wwwite
22
Duration
Underline the cause to which death should be charged sta- tistically.
15 MAIDEN NAME
OF MOTHER
Francis Tucher
18 BIRTHPLACE OF
MOTHER (City)
Germary
(State or country)
Date of.
(City or Town)
....
1
....
R-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.) We wywtn Juuuid be transmitted of Ford K-502 to the clerk of the city or town in which the deceased resided as soon as possible PARENTS
PLACE OF DEATH
Essex
(County)
Sau us,
(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)
Registered No.
§ (If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
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