USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 29
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SPACE FOR ADDITIONAL INFORMATION
Y
IM R-301 A
1
inthrop
(City or Town) 3 Elmwood Court No.
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or Its Agent.
82
{ { If death occurred In a hospital or Institution, St. {give its NAME instead of street and uuuiber)
2 FULL NAME
Pauline Emily (Hackett) Bacon
(If deccased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
3 Elmwood Court
St.
(If nonresident, give city or towu and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
married
MARRIED
WIDOWED
or DIVORCED
18 DATE OF
DEATH
Mar
6
1942
(Year)
(Month)
(Day)
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
j 7 7 (Give-maiden name of wife in full)
i chael Bacon
(TTusband's name in full)
8%
6 Age of husband or wife if alive years
7 IF STILLBORN. enter that fact here.
8
AGE
80 Years 1.
Months.
.1.9. Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
it home
Industry
10 or Business :
11 Social Security No.
newmarket
12 BIRTHPLACE (City)
(State or country)
Canada
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed diagnosis?
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deoeased ?.
If so, specify.
M. D.
('Signed) .
(Address) Winthrop Board & Date
Galth ,1942
21 .
ininron
Relation, if any Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
ay 8
19
42
22 NAME OF
FUNERAL DIRECTOR.
Charlas R. Bennison
ADDRESS
inthron Kass
Received and filed.
19
(Registrar)
100m (d)-1-41-4667
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial oc transit permit was Issued : Www. D. Childrenfx.
(Signature of Agent of Board of Health or other)
5/4/42
(Official Designation) (Date of Issue of Permit)
19 ... 19 | HEREBY CERTIFY, That I attended deceased from Christian i "Aquential.
I last saw h ..... ) alive on ...
10
media
have occurred on the date stated above, at ......
death Is said to
54
m.
Duration IMPORTANT
Natural camer
Due to ...
10
Due to.
tio -vascular- ven
renal disease
Jeans
13 NAME OF
FATHER
James Hackett
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
15 MAIDEN NAME
OF MOTHER
Unable to obtain
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Unable to obtain
17 lillard IBacon
Informant ( Address) 3 Linwood Court inthron
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 If deceased was a U. S. War Veteran, G. L. Chap. 46. Seotion 10, requires physicians to Insert a recital to that effect. extracts from the laws on back of certificate.
PLACE OF DEATH
Suffolk (County)
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
years
months
days.
In this community 58 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
Immediate cause of death.
alternance
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 ans meniher of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and behef the name of the deceased, his supposed age. the discase of which he died. defined as re- quired hy section one. where same was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Cen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa required by the preceding section or by scetion 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, aml shall also certify in such certificate both the primary and the secondary or immediate canse of death as nearly as he can state the saine. 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 humired and fourteen, the word "war" shall inclinle the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen bundred 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 ita agent appointed to issue such permits, or if there is no such board, fromn the clerk of the town where the person died; and no undertaker or other person shall exhunie a human body and remove it fromn 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 froin the clerk of the town where the boily is huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case inay 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 internrent, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasous, his certificate cannot he 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 aelectmen for the purpose, shall upon application make the certificate re- quired of the altending physician. If death is caused hy 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 tower 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 hercunder. If the death certificate contains a recital, as required
by section ten of chapter forty-aix, that the deceased served In the army, navy or marine corps of the I'nited States in any war in which it has heen 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 case 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 canse of the death, which the clerk or registrar unay 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 hoard 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 he 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 bodies of only sneh 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. G.
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 deatha 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 aa those. of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbysi- 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 of in- directly by traumatism (including resulting aepticemla), and by the actlon of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 .- Canse of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- 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 discase- 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 occupatiou was that of honie housework, write- bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
IM R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No. 45 Floyd
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.
St.
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME
Louis Clifton Smith
(If deceased is a married, widowed or divorced woman, give also maiden name.)
45 Floyd
St
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
(Specify whether)
35 years
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowedtor divor HUSBAND of
ivorceddlyn Holden
(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.
AGE
85xe
5
Months.
21
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :.
owner
Industry
Laundry Machinery
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
massachusetts
13 NAME OF
FATHER
Villiam Smith
14 BIRTHPLACE OF
FATHER (City)
Granby
(State or country)
massachusetts
15 MAIDEN NAME
OF MOTHER
helen Barton
16 BIRTHPLACE OF
MOTHER (City).
Granby
(State or country) Massachusetts
17
Relation, if any
Bertha smith wife
Informant.
(Address)
45 Floyd St.,
Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Children8 (Signature of Agent of Board of Health or other)
Health Officer 5/15/45
(Official Designation) (Date of Issue of Permit) /
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
may
13
1942
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY,
That I attended deceased from
19 40 to May 13
.. ,
19 42
I last saw h hr alive on may 13
....... , 19.5. 2, death is said to
have occurred on the date stated above, at.
10 ps
m.
Immediate cause of death.
......
Duration IMPORTANT
2.6
Due to.
Due to
Other conditions.
Sesli
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings: Of operations.
Date of.
Of autopsy.
What test confirmed diagnosis?
Underline the cause to which death should be charged sta- Istically.
20 Was disease or injury in any way related to occupation of deceased? 200 If so, specify Tous & Sales (Signed (Address) 175 1 leas and ST
M. D.
Date May 14/1942
21. South Hadley Cemetery Jonth odley Place of Burial, Cremation or Removal. DATE OF BURIAL LO7 16
(City or Town)
Falls
19+
22 NAME OF
FUNERAL DIRECTOR.
Ches.
E. emnison
ADDRESS
inthron, 12SS.
Received and filed. MAY 1 5 1942 19
(Registrar)
8 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 PLAINLI, WIIN UNFADING DLACA INA-SUN ALINANINA. PARENTS 100m-2-'40-D-729-a
1
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.
57
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 whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, 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 receiv- ing tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded. which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed 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 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 re- moval of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty- six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can 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 burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia). and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from 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 .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
IM 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. § (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Abbie Agnes (Gammell) Dixon
(If deceased is a married, widowed or divorced woman, give also maiden name.)
45 Winthrop Street
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
Hospi.t.a l __ years -months 5
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
OF DIVORCED Married
(Give maiden name of wife in full)
(or) WIFE of
Howard A S Dixon
(Husband's name in full)
P6 Age of husband or wife if alive
64
.years
7 IF STILLBORN, enter that fact here.
AGE
Years
Months.
Days
If less than 1 day Hours Minutes
9 Occupation :
Housewife
11 Social Security No.
None
12 BIRTHPLACE (City)
Charles town
(State or country) Mas's.
13 NAME OF
FATHER
Warren Gammel1
Boston
FATHER (City) ....
(State or country)
Mass.
?
North
16 BIRTHPLACE OF :.
.
MOTHER (City)
(State or country)
Mass .
Shirley
17 Howard A Dixon
Relation, if any
Husband
Informant.
(Address)
45 Winthrop St. Winthrop Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
H.O may 15/42.
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
(Month)
(Day)
That I attended deceased from
19
I HEREBY CERTIFY.
.....
1944 to
.... ,
19 Ye
I last saw him alive on
hey 13, 19/2, death is said to
have occurred on the date stated above, at.
4.201
m.
Immediate cause of death.
Duration IMPORTANT
Due
Due to.
.....
Other conditions.
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
-
20 Was disease or injury in any way related to occupation of deceased ?.. .....
If so, specify.
(Signed)
(Address) Y Washingtonich Date 5-15/
M. D.
18 4/
21
Winthrop
Winthrop.
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL.
May
17
1942
....
22 NAME OF
Howard SUIngsaldo
FUNERAL DIRECTOR
ADDRESS
uminos mais.
MAY 1 8 182
Received and filed
Donald Smc Lead
(Registrar)
IMPORTANT PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
1
Winthrop
(City or Town)
J
(a) Residence. No.
(Usual place of abode)
3 SEX
Female |White
Sa If married, widowed, or divorced
HUSBAND of ..
per voting list
8
72
4
2
Usual
10 or Business:
14 BIRTHPLACE OF
15 MAIDEN NAME
OF MOTHER
PARENTS
·
100m-2-'40-D-729-a
N. B .- WRITE PLAINLI, WIIN UNFADING DUMCA INITAAU AU
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
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
Industry
Own Home
No Community Hospital
(If U. S.
War Veteran,
specify WAR!
In this community7
yrs. - mos. - days.
MEDICAL CERTIFICATE OF DEATH
14
1942
(Year)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the host of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required hy section one, where same was contracted, the duration of his last iliness, when last seen alive hy 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 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 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 receiv- Ing tomh to another in the same cemetery, until he has received a permit from the board of health or its agent aforesald or from the clerk of the town where the hody is buried. No such permit shall be Issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required 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 herelnafter provided. If there is no attending physician, or if, for sufficlent reasons, his certificate cannot be obtained early enough for the purpose, or Is in- sufficient, a physician who Is a member of the board of health, or em- ployed hy It or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human 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 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 re- moval of such body has been sooner ohtalned hereunder. If the death certificate contains a recital, as required hy section ten of chapter forty- slx, 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 recltal 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 certifylng the cause of death shall thereafter furnish for registration any other necessary information which can he 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., (Tercentenary Edition).
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