USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 24
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19
(Registrar of City or Town where deceased resided)
1
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)
Registered No.
2544 63
§ (If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
-
No.
Boston State Hospital
..... Whitney
(If deccased is a married, widowed or divorced woman, give also maiden name.)
76 Sagamore
.St.
Winthrop
(If nonresident, give city or town and state)
years
months
days.
In this community
yrs.
mos.
days.
(write the word)
widowed
.. yeara
li less than 1 day
Hours ..
Minutes
13 NAME OF
FATHER
George N Sprague
15 MAIDEN NAME
OF MOTHER
Lydia B Farence
Minnie Raymond Relation, if any
sister
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred).
DATE FILED
3/21/42
19
.....
(TI U. S.
War Veteran,
specify WAR)
1
-
charged sta- tistically.
(Cemetery)
(City or Town)
Date of.
Duration
1 i 1
i
1
3
، i
1
t
4
I
S
t
I t
с
L P
c I
e
G
€ 1 1
ORM R-305
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
after the close of the month in which the death occurred. (Sce Chap. 46, Sec. 12, G. L.) Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time
PLACE OF DEATH
SUFFOLK! BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No.
2546
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Harry
H
Hills
(If deceased is a married, widowed or divorced woman, give also maiden name.)
228 Main
.....
months
days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
white
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED married
5a If married, widowed, or divorced
HUSBAND of
Marrietta. Crossman
(Give maiden name of wife in ful!)
(Husband's name in full)
6 Age of husband or wife if alive. years
7 IF STILLBORN, enter that fact here.
AGE
Years.
Months
Days
If less than 1 day
Hours ....
Minutes
Usual
9 Occupation:
retired
11 Social Security No.
12 BIRTHPLACE (City)
Boston Mass
13 NAME OF
FATHER
Joseph Hills
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Manchester Mass
15 MAIDEN NAME
OF MOTHER
-
16 BIRTHPLACE OF MOTHER (City) (State or country)
17
Informan!
w.i.f.e.
Relation, if any
(Address)
A TRUE COPY. * Francis
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
3/21/42
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March 19 1942
(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.) Cardiac failure septicemia
20 Accident, suicide, or homicide (specify)
Date of occurrence.
Where did
Injury occur?
(City or town and State)
19
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 ?
no
.Was there an autopsy ?
no
21 Was disease or lujury In any way related to occupation of deceased ?
1: so, specify
(Signed)
C .J. O!LEary
. 1vl. D.
(Address)
Boston
Date
3/1919
42
22. Winthrop lass
Place of Burial. Cremation or Removal.
(City or, Town)
DATE OF BURIAL
March 22 1942
19
23 NAME OF
FUNERAL DIRECTOR
C R Bennison
ADDRESS.
Winthrop
Received and Lled 19
(Registrar of City or Town where deceased resided)
(If U. S.
War Veteran,
specify WAR)
St.
Winthrop
(a) Residence. No.
(Usual place of abode)
Length of stay: in hospital or institution ...
(Specify whether)
years
No .. Peter Bent Brigham Hospital ................ St.
1
3 SEX m.le (or) WIFE of 8 89 Industry 10 or Business: PARENTS 25m-10-'39. No. 8427-g of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible (State or country)
68
ORM R-305
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
- 3 55X 5a lf married, widowed, or divorced HUSBAND of . (or) WIFE of 6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here. 8 16 AGE Years. Months. Days Usual Laborer 9 Occupation: 10 or Business: 11 Social Security No. 12 BIRTHPLACE (City) (State or country) 13 NAME OF FATHER 14 BIRTHPLACE OF FATHER (City) (State or country) 15 MAIDEN NAME OF MOTHER 16 BIRTHPLACE OF PARENTS MOTHER (City) (State or country) of death should be transmitted on Form R-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. (See Chap. 46, Sec. 12, G. L.) 25m-10-'39. No. 8427-g Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time Boston,
Gingel Ord)
MARRIED
WIDOWED
or DIVORCED
(Give maiden name of wife in full)
(Husband's name in full)
Years
lf less than 1 day
Hours
Minutes
Industry C. C.C. upply Dept.
029-12-2171
Hass.
Simeon D. Vincent
Boston,
Mass.
Gladys A. Davis
Richmond
Vä.
17 Simion D. VincentRelation, if any
Informant. 472 Winthrop St. , (Winthrop) (Address)
A TRUE COPY.
the wally
ATTEST:
(Registrar of city or towy where, death occurred) 3/21/42
DATE FILED 19 ..
MEDICAL CERAFICATE OF DEBT#2
13 DATE OF
DEATH
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 followsi &if an injury yas involved, stem fully. Collapsed fungs.
Accident
ar.20,1942
20 Accident, suicide, or homicide (specify)
Date of occurronce ....
Lawrence
19
£1
Where did Injury occur?
C . C . C . Paci (City pr town and State)
Did injury occur in or about the home, on farm, in industrial place, or in public place:aught in between eletator
Manner of
Injury
Nature of
yes
Injury
While at work ?
Was there an autopsy?
no
21 Was disease or Injury In any way related to occupation of deceased ?
If so, specify
John J. Jeacy
(Signed)
32 Lawrence
3/21M. D42
(Address)Iy
ross Com. Halden
19
22 Place of Burial, Cremation or Remarch My, of Dois DATE OF BURIAL. .. 19
23 NAME OF
FUNERAL DIRECTOR
Boston, Mass.
ADDRESS
Received and filod.
15
1
25,1942
(Registrar of City or Town where deceased resided)
X
1
Lawrence
(City or 'Town)
No. General Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Lawrence (City or town making return)
Registered No
24. 65
(If death occurred in a hospital or institution,
St. 1 give its NAME instead of street and number)
2 FULL NAME
Josoph .......
Vin
(If deceased is a married, widowed or divorced
472 winthrop St.
woman, give also maiden name.)
(If U. S. War Veteran. specify WAR)
Winthrop, Mass.
(a) Residence. No .....
(Usual place of abode)
Length of stay: In hospital or institution ..
Hospt.
(Specify whether)
years
months days.
4 hrs.
(If nonresident, givecity or town and state)
In this community"
yrs.
Inos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE 5 SINGLE
White
PLACE OF DEATH
Essex. (County)
...
St.
Frederick . Magrach
no
false elspethfff @of. place)
RM R-301 A
...
1
PLACE OF DEATH
Suffolk (County) Soffo Winthrop (City or Town) 24 Sargent No.
The Commonturalth 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.
66
§ ( If death occurred in a hospital or institution, St. 1 give ita NAME instead of street and nuniber)
2 FULL NAME
Florence G. Marnix
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe.
No.
26 Sargent
St.
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution .........
( Before death)
(Specify whether)
years
months
days.
In this community30
yrs. - mos. -
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEJ
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
Single
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8
AGI
40
.. Years
7
Months.
1
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Secretary (Retired)
Industry
U.S. Dept. of Agriculture
11 Social Security No.
None
12 BIRTHPLACE (City)
(State or country )
Boston, Mass.
13 NAME OF
FATHER
William H. Mannix
14 BIRTHPLACE OF
FATHER (City)
Newburyport,
(State or country)
Mass
15 MAIDEN NAME
OF MOTHER
Sarah L. Mclaughlin
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
N.S.
17 Informant Albert B. Mannix (Address) 26 Sargent St. Winthrop.
Relation, if any Brother
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transli permit was Issued: William D. Childress
(Signature of Agent of Board of ITealth or other) agent afrix 4/42
(Official Designation) (Date of Issue of (Pormit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
That I attended deceased from
abril
-
1937.
to
april
19 42
1 last saw her
allve on
3 17
1942
death Is sald to
have oocurred on the date stated above, at
2:45 P.
m.
Immediate cause of death
Duration IMPORTANT
5 yrs
Due to. Il have cared for this
patient only during occasional
absence of Dr. H. A. Kelly of
Mittopp
118
(Include pregnancy within 3 months of death)
IMPORTANT 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 ? ma
If so, specify
Lothar Cochran, M. D.
(Signed).
(Address)
Months
" Brookline
Date 4/3 1942
21
Holyrood
Place of Budal, Cremation or Removal.
DATE OF BURIAL
»(City or Town)
2
19 42
22 NAME OF
FUNERAL DIRECTOR
Edward
ADDRESS
Medford Mass.
....
-
Received and filed
19
( Registrar)
100m (d)-1-41-4667
N. D.
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain
WNIIG r
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. extracts from the laws on back of certificate.
PARENTS
Major findings :
Of operations
Tumor of Brain
Date
of: 1937
Of autopsy more
11942
What test confirmed diagnosis ?.
Biopsy
und
1942
......
Tumor of Brain
10 or Business :
(Usual place of abode)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physiolan 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 ululertaker or other authorized person or of any member of the family of the deceased, furnish for registration a atandard 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 re- quired 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.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the ariny, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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 wlicre the person dicd; 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 he 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 be 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 aelectmen 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 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 & pernit 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 aerved 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 neces- sary 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 re- ceived 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., (Terccutenary Edition).
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 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 absent from honte 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 action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths froin 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. 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 .- l'recise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be kuown. 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 retirentent. 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
RRM R-301 A
The Commonmoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burlat permit with Board of Health or its Agent.
2 FULL NAME
Clara Edith (Strout) Fierce
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Chester Avenue
St.
(If nonresident, give city or town and State)
In this community 12 yrs. -
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACEĮ
/hite
5 SINGLE
(write the word)
Widowed
18 DATE OF
DEATH
Hipis
(Month)
(Day)
-
(Year)
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Dora (Give maiden name of wife in full)
wAnton ..
Tierce
( Ilusband's name in full)
6 Age of husband or wife If alive years
7 IF STILLBORN, enter that faot here.
8
67 Years
9 Months.
26 Days
If less than 1 day
Hours
Minutes
it home
11 Social Security No .. ........
Collinsville
12 BIRTHPLACE (City)
(State or country)
Connecticut
FATHER
LaForest Bertrom Strout
Major findings :
Of operations
Physician
14 BIRTHPLACE OF
FATHER (City)
North Jayne
(State or country)
Haine
15 MAIDEN NAME
OF MOTHER
Tary Elmina Stimyson
16 BIRTHPLACE OF
MOTHER (City)
Tinsted
(State or country)
Connecticut
21 Canton South west
JullInsville
l'lace of Burial, Cremation or Ketroval.
(City or Town)
"Conn."
DATE OF BURIAL
Abril 7,
1942
19
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued :
22 NAME OF
FUNERAL DIRECTOR ..
Charles . Bennison
ADDRESS
inthron Mass
(Signature of Agent of Board of Health of other)
Health Officer 4/6/42
(Official Designation) (Date of Issue of Permit)
20 Was disease or injury in any way related to oocupation of deceased ?.
If so, specify.
.....
('Signed).
-
M. D.
(Address)
* ? : Date.
19 .. 2.6
Of autopsy.
What test confirmed diagnosis?
....
٢٠٠٠٠٠١٠
Due to.
Due to
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Underline the cause to which death should be charged sta- tistically.
100m (d)-1-41-4667
1 - 3 SEX Female AGE Usual 9 Occupation : 13 NAME PARENTS Informant. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain extracts from the laws on back of certificate. N. B .- WRITE PLAINLY, WITH UNPAVING BLACK INK-THIS IS A PERMANENT RECORD. Every irem or information Industry 10 or Business :
suffolk (County) Jinthron (City or Town) Registered No. inthron Community Hospital No. S ( If death occurred in a hospital or Institution, St. (give its NAMIE instead of street aud number) r PLACE OF DEATH
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
(a) Residence. No.
(Usual place of abode)
years
/
months
// days.
Length of stay: In hospital or Institution
( Before death )
(Specify whether)
MARRIED
WIDOWED
or DIVORCED
19 | HEREBY CERTIFY,
That I attended deceased from
to
1942
I last saw h ...
allve on.
19.
's.J., death Is sald to
have occurred on the date stated above, at
m.
Immediate cause of death.
Duration IMPORTANT
Date of.
17
Mrs. Edna Hall
(Address) 20 Chester Ave
( Relation, if any
Received and filed F C 1'4'
19
(Registrar)
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 atteluled during his last illness, at the request of an undertaker or other authorized person or of any member of tbe 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. defined as re- quired 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 bis death ... Geu. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased. to the best of his knowledge and belief, served in the army, navy or marine corps of the I'nited States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tiou and of sections forty-five, forty-six and forty-seven of said chapter one bundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetwcen February fourteenth, eigliteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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, froin 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 sanie cemetery, until he has received a perniit 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 bave been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he 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 hiereinafter 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 physi- cian who is a member of the hoard 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 luiman 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
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