USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 35
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(City or Town)
17 Annie Brady Daugh ghter DATE OF BURIAL. May 10 1943 19
22 NAME OF
FUNERAL DIRECTOR.
Tolun A. 1 maley
ADDRESS
Winthrop Massachusetts
Received and Aled.
19
MAY 3 1943
(Registrar)
1
If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physicians to insert a recital to that effect. PARENTS
100M-6 - 2-42-8855
Relation li gny
St.
PHYSICIAN - IMPORTANT
(Was deocasad 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 physician or registered hospital medical officer shall forthwith. after the death of a person whoin he has attendled during his last illnesa, at the request of an undertsker or other authorized person or of any meniber of the family of the deceased, furnisb 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 wss contracted. the duration of his last illneaa, when last seen alive by the physician or officer and the date of hia death ... Gen. Laws, Chiap. 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 decessed, to the best of his knowledge and helief, aerved 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, sud shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the ssine. For neglect to comply with any provision of this section, auch physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bumlred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deenicd to have taken place hetween February fourteenth, eigliteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Clap. 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 haa 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 froin 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 its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there sball bave been delivered to sucb board, agent or clerk, as the case inay be, a satisfactory written atatenient containing the facta required by law to be returned and recorded, which shall be accompanied, in case of an original internient, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate aa hereinafter provided. If there is no attending physician, or if, for sufficient reasona, hia certificate cannot be obtained early enough for the purpose, or is 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 ntake 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, froin 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, unlesa a permit in the usual form for the removal of such body haa been sooner obtained hereunder. If the death certificate containa a recital, aa required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corpu of the United States in any war In which It has heen engaged. sucb recital shall appear upon the permit. The board of healtb, 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 uece+ 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- ceived a permit so to do front the hoard of health or its agem appointed to issue such permita, 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 he held, or from a person appointed to have tbe care of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examinera shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died ly violence. If a medical examiner has notice that there is within his county the liody of such a person, he shall forthwith go to the place where the body lies aud 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 physicians will certify to such deatha only aa 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 phyalolans will certify to such deatha only as those of persons who, though disshled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose pbyaf- cian ia absent from home when the certificate of death ia needed.
(3) Medloal Examiners will investigate and certify to all dcatbe 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 abortion, but also deatha from diseasa 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 meana the disease, or complication which causea death, not the mode of dying, e. g., heart failure, asphyxia, astbenia, etc. Aa principal cause name tbe disease cauaing 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 ia very im- portant, so tbat 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 busineaa, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at hoine. For a woman whose only occupation was that of honie bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, as housekeeper-private fantily, cook- hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
SAULI SIVICINCIIL VI VELUTATIVNN IS very important. See instructions and
extracts from the laws on back of certificate. should be carefully supplico. Aus should go statta tanult .. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a reoital to that effeot.
BOSTON NOTIFIED 6/9/43
Suffolk (County)Manche at Boston (City or Town) Winthrop Community Drops
The Commonforalth 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. 101
Registered No. ( (If death occurred in a hospital or institution, {give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
93 Trenton At
St.
East Boston
mars
(If nonresident, give city or town and State)
months
days.
In this community 4 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE[
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
(Month)
(Day)
(Year)
19/1 HEREBY CERTIFY,
Way 1.
43
mag. 7.
19.
to ..
That I attended deceased from
19
43
I last saw h ... M.
.. alive on
Tway 7, 1995
death is said to
have occurred on the date stated above, at
40.
m.
6 Age of husband or wife if alive 60 years
7 IF STILLBORN, enter that fact here.
8
AGE
64
Years
........... Months ...
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
County Officer
10 or Business :
Industry
Charles St. Jail
L1 Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
andrew Queer
PARENTS
14 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
mass
15 MAIDEN NAME
OF MOTHER
Catherine (unknown)
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
maso
Bastan
17 Mas alice H. Green Relation, If any
( Address)
93 Tuetan Lt. EB
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burlar or transit permit was Issued: Man. D. Children
(Signature of Agent of Board ( Health or other) Health Much 5/8/43
( Official Designation)
(Date of Issue of Permie)
...
Received and filed
MAY .10.1043
19
( Registrar)
6 horas ....
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 ?
specify
(Signed)
Jungle. H. Schwartz
M. D.
(Address)
19 Junela SVE.10 Date.
5/8
1943
21
malden
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
May 10
1943
22 NAME OF
FUNERAL DIRECTOR
A. C. Kirby
ADDRESS
Boatos
Date of
5/4/43
What test confirmed diagnosis?
Duration
Immediate cause of
Ceuta tulum dena
Due to.
Chirur hijocarditis
Due to ..
Cancer | Prostate and
Other conditions.
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
Cancer of Prostata
Of autopsy
Line
100m (d)-1-41-4667
R-301 A
1
PLACE OF DEATH No. Frank B. Gueer
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or Institution2 weeks
( Before death)
(Specify whether)
18 DATE OF
DEATH
tway.
3.
1943
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physlolan or registered hospital medical officer shall forthwith. after the death of a person whom he has attended during his last illucss, at the request of an undertaker or other authorized person or of any inember 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 deecased, his supposed age, the disease of which he died, defined aa 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 lia deatlı .. . Gen. Laws, Chiap. 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 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, 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 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, 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 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 licu thereof a certificate as hercinafter 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 selectmen for the purpose, shall upon application make the certificate re- quired of the attendling 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 conunonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased 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 necea- 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 .- Cbap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the aahes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do 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 body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. .. . Chap. 114. Sec. 46, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodiea 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 calla for tbe 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 physi- cian is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deathis 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 .- l'recise statement of occupation is very Im- portant, so that the relative licalthfulness 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 hiome. For a woman whose only occupation was that of honie 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
PLACE OF DEATH -
Suffolk (County) Winthrop (City or Towy) Fort Banks
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
102
St. { { If death oceurred In a hospital or institution, ( give its NAME instead of street and number)
2 FULL NAME
Walter A Kanitsnay
(If deceased is a married, widowed or divorced womfian, give also maiden name.)
21st ambudget. Penna
(a) Residenoe. No.
821
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution.
(Before death)
years
months
days.
In this community
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Mole
4 COLOR OR RACEJ
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 AGE 37 Years .Months ...... - Days
If less than 1 day Hours ....... .Minutes
Usual
9 Occupation :
U.S. ARMY
Industry
10 or Business :
11 Soolal Security No ..
12 BIRTHPLACE (City)
(State or country)
Mt Pleasant Pa.
13 NAME OF
FATHER
Stanley Konitsney
14 BIRTHPLACE OF
FATHER (City)
- Poland
(State or country)
15 MAIDEN NAME
OF MOTHER
Harriet Kourtney
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
- Poland
17 Stanley Konitsnegr Relation, if any
hather ..... Informant. (Address) : 21 2525 Cambridge e
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 Thealm or other) Health Officer 5/13/43 (Official Designation) (Date of Issue of P'ermit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
may
11
(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.) Asphyxiation by Hanging
Acula Psychoso
20 Accident, sulolde, or homiojde (specify)
Date of ooourrence.
May 11
1943
Where did
Injury ooour ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publio
place?
(Specify type of place)
Manner of
Injury
Nature of
Injury
While at work?
Was there an autopsy ?.
21 Was disease or Injury In any way related to occupation of deceased ?.
If so, specify.
Zil H Waltera
M. D.
(Signed)
(Address)
Boston Date May 19 1943
22
ambridge
Penna
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
May 15
19 43
23 NAME OF
FUNERAL DIRECTOR Minas
ADDRESS
254 Beast Revele
Received and filed MAY 1 8 1973
.19
(Registrar)
V
extracts from the laws relative to the return of certificates of death. if deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect
PARENTS
50m (g)-1-41-4667
1
No.
(Specify whether)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, If so specify WAR)
# 2
1943
(Give maiden name of wife in full)
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 best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, deHued 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.
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, he deemed to have taken place between February fourteenth, eighteen hnalred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen aud nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human hody 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 ol 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 mmay 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 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 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 medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such reinoval 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 re- moval, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which
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