USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 79
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SPACE FOR ADDITIONAL INFORMATION
IR-301 A
Suffolk (county )
(City or Town) 45 Forrest
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.
235 ...
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
DORA
BLUMENTHAL
(If deceased is a married, widowed or divorced woman, give also maiden name.)
45 Forrest
.St., ..
......
.. Ward,
Winthrop
(If nonresident, give city of town and state)
Length of residence in city or town where death occurred yrs.
mos.
days.
How long in U. S., if of foreign birth?
4 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4 COLOR OR RACE
white
5 SINGLE
(write the word)
widowed
MARKIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of Jacoline Blumenthal (or) WIFE of (Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 6/
AGE Years .Months Days
If less than 1 day Hours ...... .Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ...
Housework
9 Industry or business in which
work was done, as silk mill,
zaw mill, bank, etc.
athome
10 Date deceased last worked at
this occupation (month and
year)
Russia
11 Total time (years) spent in this occupation.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Usher Freedman
PARENTS
15 MAIDEN NAME OF MOTHER (Cannot be learned)
16 BIRTHPLACE OF
MOTHER (City)
Russia
(State or country)
17 Informant Harry Blumenthal (Son) (Address) 73 Junion Av. naticla
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Mu-D- Children (Signature of Agents of Board of Health of her ) Qualthe officer "Official Designation) (Date of Issue of Permit)
11/27/4/
MEDICAL CERTIFICATE OF DEATH
DEATH
(Month)
(Day)
(Year)
19/ I HEREBY CERTIFY, That i attended deceased from July 29 1938 to nov. 26 194/
I last saw her alive on ...
nov. 26
194, death is said
to have occurred on the date stated above, at. 4:15 p.M. The principal cause of death and related causes of importance in order of onset were as follows: acute Coronary
Date of Onset IMPORTANT
11/26/41
Contributory causes of importance not related to principal cause: angina Pectoris
June 10/41
Name of operation
none
.Date of.
What test confirmed diagnosis @livenl
Was there an autopsy co
20 Was disease or injury in any way related to occupation of deceased? If so, specify ....
(Signed)
.y., M. D. (Address) 562 Secley IT Date: 1/26/1946
21 PLACE OF BURIAL,
Winthrop Com. Everest
CREMATION OR REMOVAL
(City or town)
(Cemetery/
DATE OF BURIAL
november 29, 1941
22 NAME OF
Manuel Staneteby
UNDERTAKER
ADDRESS
10 Washington IL CD OU
Received and filed 19
(Registrar)
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
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.
No. 9321-a
100m-9-'33.
1
PLACE OF DEATH
No ..
St., ............... Ward
(If U. S.
War Veteran,
specify WAR)
(a) Residence.
No.
(Usual place of abode)
18 DATE OF
november 26 1941
-
14 BIRTHPLACE OF FATHER (City) (State or country)
Russia
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 perso:1 ager1 10 years or over. If the occupation had been given up or change 1 on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed inay be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. 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 what- ever write none.
To be complete, an occupation return must state:
8 .~ The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative," etc. Find out the parti- cular kind of work done and return that, as spinner. weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store, " "'factory. " 'mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, collon mill, etc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborcr" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
Statement of cause of death .- Cause of death means the disease. or complication which causes death, not the mode of dying, e. g., hcart 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. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis
Date of onset
1015
Chronic interstitial nephritis
1021
Cerebral hemorrhage
:
July 5. 1927
Contributory causes of importance not related to principal cause:
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. "The principal cause in the above example happens to be the second cause given.
COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased. furnish for 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 dicd, defined as required by section oue. where saine was contracted, the duration of his last illness, when last secn 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 wliere 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 delivered to such board, agent or clerk, as the case may be, a satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early cnough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the common- wealth 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 re- moval; 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 re- quired by section ten of chapter forty-six, that the deccased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appcar 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 i of the town for registration. The person to whom the perinit 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 deccased, 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.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Scc. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made ... . Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attend- ance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or clectrical 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.
·
A R-301 Al!
PLACE OF DEATH
Suffolk (County> Northrop (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.
236
Registered No (If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
Winthrop Mars
(If nonresident, give city or towh and state)
(a) Residence. No. (Usual place of abode) Length of stay : In hospital or institution
n. hosportal
(Specify /whether)
- years
- months
9
days.
In this community /0 yrs.
- mos. - days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
13 DATE OF
DEATH
(Month)
(Day)
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
M Emmin
(Husband's name in full)
67
years
7 IF STILLBORN, enter that fact here.
If less than 1 day
AGE 66 Years - Months. - Days
Hours
Minutes
Usual
9 Occupation:
at home
10 or Business:
Housework
II Social Security No ..
12 BIRTHPLACE (City)
Werk Sparingfuetil
(State or country)
mais
13 NAME OF
FATHER
William Henry Cawthorne
14 BIRTHPLACE OF
FATHER (City)
Manchester, England
(State or country)
15 MAIDEN NAME
OF MOTHER
Many & Kelliker
16 BIRTHPLACE OF MOTHER (City) (State or country)
Galway Dieland
17 . Informant (Address)
Relation, if any
204 Lincoln St Paulhus
I HEREBY CERTIFY that a satisfactory standard certificate of death (was filed with me BEFORE the burial or transit permit was issued: Www. D. Children. (Signature, of Agent of Board ofhealth or other) Le able Officer 11/27/41
(Date of Issue of Pe:Yi6)
19 THEREBY CERTIFY That I attended deceased from
to .. 41 I last saw h ...... h.Dalive on .. un-26, 19. death is said
to have occurred on the date stated above, at & 30Pm. Immediate cause of deathe.
Duration
IMPORTANT 3 days
mutfacio
Due to
6 ms
Due to ...
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Date of 1/21/41
Of autopsy
11/21/4
What test confirmed diagnosis ?.
20 Was disease or injury In any way related to occupation of deceased?
If so, specify.
(Signed)
(Address)
somplan on Date
„Date ..
11/2/1941
21
Holy Cross
Malden
(City or Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL
nov 29
1941
22 NAME OF
FUNERAL DIRECTOR
-Les m. Norton (Dooley Funeral Sauce)
ADDRESS
Main It Malden.
Received and fled
19 ....
(Registrar)
information should be carefully supplied. is very important. See instructions and extracts from the laws on back of certificate. (Kelliher" PARENTS
PHYSICIANS should state
AGE should be stated EXACTLY.
I The boston" 8 si 20 name changed to CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION Industry
100m-10-'39. No. 8427-e
(Official Designation)
5 SINGLE
(write the word)
3 SEX Female
4 COLOR OR RACE
White
MARRIED
WIDOWED
or DIVORCED
manuel
Mancheopp Community Die for 50. No. Mary Elizabeth Growin
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
204 Lincoln
.St.
19 .... nrv. 26 19
6 Age of husband or wife if alive
26 1941 (Year)
Underline the cause to which death should be charged sta- tistically.
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 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 deccased, 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 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 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 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- 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 cnough 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 imarine 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 eertifying 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, Seo. 45, G. L., (Torcentenary 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 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 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 dicd 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 cr 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, c. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier inorbid 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 discasc 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 kousekosper-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
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.
237
Registered No § (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR).
St
(If nonresident, give city or town and state)
Hospital
years
» months
21 days.
In this community 23
yrs.
a. nos.
· days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
May Benjamin MG Kenzie
(Give maiden name of wife in full)
69
.years
If lose than 1 day
Hours.
Minutes
17 Relation, if any
Wife
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Williams, Childress
(Signature of Agent of Board of Health or other)
agent Nov. 28/41
(Official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Nov.
26
1941
(Month)
(Day)
(Year)
19 01 HEREBY CERTIFY,
Sept. 20, 1941, to
Nov. 26, 1941
That I attended deceased from
I last saw him alive on Nov. 26, 194/, death is said to have occurred on the date stated above, at 8:55 Am. Immediate cause of death. Duration IMPORTANT 1 Bronchopneumonia
Due to inathetowing begge 2001 Ocarinaof. trauer
Other conditions .....
(Include pregnancy within 3 months of death)
Major findings:
Of operations Carcinoma ol bladder
Of autopsy
What test confirmed diagnosis? Simay
20 Was disease or injury in any way related to occupation of deceased ?. no
If so, specify.
Artan Avarias M. D.
(Signed),.
(Address) Winery the Date 11/20 19/1
21. Winthrop Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
Nov. 28 1941
19
22 NAME OF
FUNERAL DIRECTOR
Richard - White
(BP)
ADDRESS
147 Winthrop St., Winthrop
Received and filed 19
DEC : 1041
(Registrar)
3 davis
........
IMPORTANT
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
100m-2-'40-D-729-a
Winthrop Community Hospital No.
.....
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(County)
Winthrop
1
(City or Town)
2 FULL NAME
Louis C. Mc Kenzie
(a) Residence. No.
51 Birch Rd.
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
3 SEX
4 COLOR OR RACE
White
Male
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(or) WIFE of.
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
AGE
72
Years
5
Months .....
11 Dayal
Usual
9 Occupation:
Excutive
10 or Business:
o10 -18-3332
11 Social Security No.
12 BIRTHPLACE (City).
Portland
(State or country)
Me
13 NAME OF
FATHER
Alexander MeKenzie
14 BIRTHPLACE OF
FATHER (City) ....
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Jane Wilkie
16 BIRTHPLACE OF
PARENTS
MOTHER (City) ..
(State or country)
Scotland
Informant.
Mrs. May I. Mckenzie (
(Address)51 Birch Rd. ,Winthrop
information should be carefully supplied. AGE should be stated DAAvill. FITTDiviAND should state
Industry
Wholesale Druggist
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
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