USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 22
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SPACE FOR ADDITIONAL INFORMATION
M R-301 A
1
Winthrop (City or Town)
No. 181 ... Pleasant
The Commonforalth ot 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. 52
f ( If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
PHYSICIAN ~ IMPORTANT
2 FULL NAME.
Alice H. Healy ned Hall
)
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
181 .... Pleasant
(Usual place of abode)
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
months
days.
in this communityPO
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Married
5a If married, widowed, or divorced
HUSBAND of
§Give maiden name of wife in full)
(or) WIFE of
Fred .... A. Healy
( Ilushand's name in full)
6 Age of husband or wife if alive 78
years
7 IF STILLBORN. enter that fact here.
8
AGE
77
Years
5
Months
7 ... Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
At .... home
11 Social Security No.
none
12 BIRTHPLACE (City)
( State of country)
Maine
13 NAME OF
FATHER
Andrew J . Hall
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Louise Keene
16 BIRTHPLACE OF
MOTHER (City)
Unknown
(State or country)
Maině
17 Fred .... A.Healy (HayBand'
Informant ( Address) 181 Pleasant St. Winthrop
I HEREBY CERTIFY that a sallsfactory standard certificate of death was filed with me BEFORE the bojiaf or transft permit was Issued : Childress
(Signature of Agent of Board of Health of other) Health Officer 3/25/43
(Official Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
march
22
1943
( Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
That I attended deceased from
19
may 1
35
to
march 22
19 43
I last saw h M
alive on.
march 22
1943, death Is sald to
have occurred on the date stated above, at.
Immediate cause of death
Cerebral Hemorrhage
Due to.
Itexpertensin
Due to.
Other conditions.
Chimie myacanditi
5 400
(Include pregnancy within 3 months of death)
IMPORTANT
Physician
Major findings :
Of operations
Date of
Of autopsy
What test confirmed dlagnosis ?
l'uderline the cause to which death -lwould be charged sta- 1istically.
20 Was disease or onjury in any way related to oooupation of deceased ?........
If so, specify
(Signed) Loni 7 Saler
M. D.
(Address)
175 Pleasant St.
Date men 24
1943
21
........... o.o.d.lawn
Everett
l'lace of Burial, Cremation or Removal.
(City or Town)
19 43
DATE OF BURIAL
March 25,
P. E. Parku
ADDRESS
22 NAME OF
FUNERAL DIRECTOR.
300
Meridian St. , E. Boston
Received and filed.
.19
(Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physlolans to Insert a recital to that effeot.
extracts from the laws on back of certificate.
snouia De carefully supplied. AGt 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
100m (d) . 1-41-4667
- PLACE OF DEATH
Suffolk (County)
PARENTS
st.George
Duration IMPORTANT 5 deux
10 yrs
1000
Female
White
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Registered No.
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 attesaled during his last illness, at the request of an undertaker or other authorized person or of any macher 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 decreased, bis 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 army, 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. sprei- 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 shail forfeit ten dollars. For the purposes of this are. tion and of sections forty-five, forty-six and forty seven of said chapter one hundred and fourtren, 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 humired 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. Chiap. 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 hoard, 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 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. 01 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 hy violence. the medi- cal examiner shall make such certificate. If such a permit for the removal of a Imman body, not previously interred, from one town to another within the commonwealth cannot be obtained carly enough for the purpose, the certificate of death made as 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 way In which it has been engaged. snch recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement ail certificate, shall forthwith cutmiter-ign it atal transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the canse of death shall thereafter furnish for registration any other ucces- sary inforumion which can be obtained as to the deceased, or as to the mamier or cause of the death, which the clerk or registrar may require .- Chape 114. See. 45. G. I ... (Tercentenary Edition).
No malentaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- crived a permit so to do from the board of health or its agent appointed to issne such primies, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a personl appointed to have the care of the cemetery or burial ground in which the interment is urade. . . . Chap. 114. Sec. 46, G. L., (Tercentenary 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 disabled 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 oudy deaths caused directly or in- directly by trammatism (including resulting septicemia), and by the action of chemical ( drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to 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 discase 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 sonde 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
R-301 A
1
Suffolk /County) Winthrop (City or Town)
The Commontoralth 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.i
58
Unna Bumetin ( If deceased is a married, widowed or divorced woman, give also maiden name.) Chefe
(a) Residence.
No.
100 Washington Que
(Usual place of abode)
Length of stay: In nowoltal or Institution
years
months
3
days.
in this community
yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX Female White
4 COLOR OR RACEI
5 SINGLE
( write the word)
DoWE married
V DIVORCED
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
You Give meid Recycler
( Husband's name in full)
6 Age of husband or wife if alive 70 years
IF STILLBORN. enter that fact here.
AGE 5.6 Years - Months Days
if less than 1 day Hours Minutes
Usual 9 Occupation :
Housewife
Industry
10 or Business :
athome
11 Social Security No. none
'2 BIRTHPLACE (City)
( Siate or country)
Russia
13 NAME OF
FATHER
Haskel Weisbard
14 BIRTHPLACE OF
FATHER (Clty)
Russia
(State or country)
15 MAIDEN NAME
OF MOTHER
cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
Galata Ruastein davanti
17 Informant (Address) /100 localunation ave Chers.
I HEREBY CERTIFY that a satisfactory Standard certificate of death was filed with me BEFORE the burial of transit permit was issued : Um. D. Childress f
(Signature of of Board of Health of other) Health Officer 3/23/43
(Official Designation) ( Date of Issue of/Permit)
18 DATE OF
DEATH
march.
23
(Month)
(Day)
1943
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
21
1993, to mar 230
1943.
I last saw h1 alive on
mus 22 -1, 19 44, death is said to
have occurred on the date stated above, at.
25 A.m.
Immediate cause of death
Ulating Colitis
Duration IMPORTANT ...
....
8mo.
Due to
myocarditis
Due to
Other conditions.
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed diagnosis?
Clinical
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ? if so, specify ...
('Signed).
. M. D.
(Address)
5353 Cung Carne Date.
May 23, 1943
21 montifière Cem, Woburn
l'lace of Burial Cremation or Removal.
(City or Town)
DATE OF BURIAL
march
23
1943
22 NAME OF
manuel Stanetela
FUNERAL DIRECTOR Manuel
ADDRESS
10 Washington
et. Dar
Received and filled
.19
( Registrar)
x
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a reoltal to that offact. PARENTS extracts from the laws on back of certificate.
100M-4 - 2-42-8855
2 FULL NAME
(Before death)
(Specify whether)
4.8.43
... Registered No. Winthrop Community Hospital [ death occurred in a hospital or ¿ give its NAME Instead of street and nuniber) C PLACE OF DEATH
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(If nonresident, give clty or town and State)
1 yr
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medloal offioer shall forthwith, after the death of a person whoin he has attended during his last illness, at the request of an undertaker or other authorizeil person or of any member of the family of the deceased, furnish for registration a standard certifcate of death, stating to the best of his knowledge and behef the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one. where same was contracteil. the duration of his last IlIneaa, when laat seen alive by the physician or officer and the date of bio death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa 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 I'nited States in any war in which it has been engaged, insert in the certificate a recital to that elect, 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 saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sections forty-Ave, forty-six and forty-seven of said chapter one bumlred and fourteen, the word "war" shall incinde the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deented to have taken place hetwcen February fourteenth, eighteen 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 heen huried, until he has received a permit from the board of health, or ita agent appointed to issue such permita, 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 cenietery to another, or from one grave or tomb other thau the receiving tomb to another In the same cemetery, until he haa received a permit from the board of health or ita agent aforesaid or from the clerk of the town where the boily is buried. No such permit shall be Isaued until there aball have been delivered to such board, agent or clerk, as the case may be, & satisfactory written atatentent containing the facta 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, aa required by law, o1 in lieu thereof a certificate aa liereinafter provided. If there is no attending physician, or if, for suthicient reasons, hia certificate cannot be obtained early enough for the purpose, or ia insufficient, a physi- cian who ia 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 ia caused by violence. the medl- cal examiner ahall make such certificate. If such a permit for the removal of a liuman 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 ot the undertaker desiring to make such renroval 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 containa a recital, aa required
by section ten of chapter forty-six, that the deceased aerved in the army, navy or nrarine corpa 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 veces aary information which can be obtained as to the deceased. or as to the manner of canse of the death, which the clerk or registrar may require .- Cbap. 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- cerved a perunit so to do from the board of health or its agent appointed to issue such permita, 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 he held, or from a person appointed to have the care of the cemetery or burial ground in which the internient ia made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examinera 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 hody of such a person, he shall forthwith go to the place where the body liea and take charge of the same; ...- General Lawa, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rulea of practice :
(1) Attending phyalcians will certify to such deatha only aa those of persona to whom they have given bedside care during a fast illness from disease unrelated to any form of injury,
(2) Board of Health physiolana will certify to such deatha 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 phyal- cian ia absent from home when the certificate of death ia needed.
(3) Medloal Examiners will investigate and certify to all deatha sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism ( including resulting septicemla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, aml deaths following abortion, but also deatha from dlacasa resulting from injury or Infection related to occupation, the sudden deatha of persona not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death. Cantse of death meana the dlaease, or complication which causea death. not the mode of ilying. e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng death. As related causes, name earlier morbid conditiona, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .-- Precise statement of occupation la very 1m- portant, so that the relative healthfulnesa of various pursuits can be known. Make some entry in this section for every persou aged 10 yeara 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 bad retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at horne. For a woman whose only occupatiou was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa bousekerper-private family, cook- hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
Suffolk
(County)
Winthrop Community Hospital
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. 59
Registered No.
[ { If death occurred in a hospital or Institution,
St. (give its NAME instead of street and uutuber)
2 FULL NAME
Bessie Helen Dutre
(Wright)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
191 Court Rd.
St.
(If nonresident, give city or towu and State)
Hospital
years
50
days.
In this community 12 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
marche
23
( Month )
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
to
March 92,
19.953
March 23
83
I last saw h
.alive on.
March 2310kg
death Is said to
have occurred on the date stated above, at
2.35
m.
Immediate cause, of death ...........
Lympho blastoma-
Due to.
Due to.
Other conditions
(Include pregnancy within 3 months of dceth)
Major findings :
Of operations
StrangulatadherNig
Date of qua. 29.19-12
t'inlerline Tile cause to which death
Of autopsy ..
What test confirmed diagnosis ?.
Pathological
charged sta- 1istically.
20 was disease or injury in any way related to occupation of deceased? NO If so, speoily
(Signed)
Edward . tranzy
.M. D.
( Aodress)
LAS LA Date Mais 2 19 K3
21
Oak Grove
Medford
3
l'lace of Burial, Cremation or Removal.
DATE OF BURIAL
March
2.43
.......
22 NAME OF
FUNERAL DIRECTOR Marvard
ADDRESS
Received and filed
19
(Registrar) L
100m (d)-1-41-4667
1
Winthrop ~
(City or Town)
No.
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or Institution.
( Before death)
3 SEX
4 COLOR OR RACEI
Female
White
5a If married, widowed, or divorced
HUSBAND of
7 IF STILLBORN. enter that fact here.
AGE
Years
Usual
9 Occupation :
Housewife
Industry
10 or Business :
Own Home
11 Social Security No.
None
12 BIRTHPLACE (City)
( State or country)
Mass.
FATHER (City)
(State or country)
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
Informant
( A·bilros%)
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.
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
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