USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 43
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MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced
Ida Berman
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband'a name in full)
6 Age of husband or wife If alive 69
years
Due to
Due to. left hemiplegia due to
6 yrs ....
cerebral hemorrhage
Other conditions .... General arteriosclerosis
(Include pregnancy within 3 montha of death)
and prostatic hypertrophy
Physician
13 NAME OF
FATHER
Abraham Annapolsky
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Leah
-
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Informant (Address)
Relation, if any ( ... wife
Of autopsy
What test confirmed diagnosis?
clinical
....
6-3
43
No.
(City or Town)
Jewish Memorial Hospital
BOSTON (City or town making"return)
(If U. S.
War Veteran,
speolfy WAR)
(If nonresident, give city or town and State)
1
1 1 1
1 1
1
3
1 1
1 1 1
1
3 1
M R-301 !|
1 PLACE OF DEATH 3 SEX male HUSBAND of (or) WIFE of PARENTS 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 is very important. See instructions and extracts from the laws on back of certificate. IN. D .- WRITE PLAINLY, WITH ONFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of Industry 10 or Business:
Suffolk (County)
winthrop
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
124
5 (If death occurred in a hospital or institution, No.Winthrop Community Hospital Inc.
St. ( give its NAME instead of street and number)
2 FULL NAME
John F.
Finn
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
379 Lovell St. Last Boston
St.
Lass
(Usual place of abode)
ength of stay: In hospital or institution
(Specify whether)
years
months
days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED single
5a If married, widowed, or divorced
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive. .years
7 IF STILLBORN, onter thal fact here.
8 AGE Years. Monthy .. Days
If less than 1 day
17
... Hours
Minutes
Usucl
9 Occupation:
Tove
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Bernard Finn
14 BIRTHPLACE OF
FATHER (City)
Charlestown
(State or country)
00
C
15 MAIDEN NAME
OF MOTHER
Rite Teouch
16 BIRTHPLACE OF
MOTHER (City)
Ghelgen
(State or country)
-ass.
17 Bernard Jury Relation, it my
Informing
(Address)
379 Lettell & E Botas
I HEREBY CERTIFY that a satisfacigry standard certificate of death was tiled with me BEFORE the burial of Irapsil permit was issued:
Mm. J. Chil dress
(Signature of Agentsof Board of Health & Ater), Health officer 6/11/43
(official Designation)
(Date of Issue of Fofmit) /
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June
9
1943
(Month)
(Day)
(Year)
19 1
HEREBY CERTIFY. That I attended deceased from
June 9
19 .. 98
9
I last saw hamn. .. alive on ..
to have occurred on the date stated above, at.
Duration
Immediate cause of death.
...
17 h
Due to Imauch formatione
que to mothers exames
Due to
pregnancy
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 deccased ?
If so, specify.
(Signod)
Seschaffa
M. D.
Vidros) 19Bankster
Date
De 9 19 40
21
Holy tevoss
mardin
Place of Burial, Cremation or Removal. DATE OF BURIAL ....
Kine
19 43
22 NAME OF FUNER EL DIRECTOR Riderickmanauto
ADDRESS
East Bata
Received and filed.
MIN 1 4
15
A TRUE COPY ATTEST:
(Registrar)
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
200m-10-'39. No. 8427-d
BOSTON NOTIFIED 1/9/43
(write the word)
.....
( U. S. War Veteran. specity WAR)
(City or Town)
to ..... 19.5 .... 5 death is said
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 regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was eontracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the elerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in licu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or hy the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a 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 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 fur- nish for registration any other necessary information which can be
obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall bury a human body or the ashes thereof which have been hrought 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 fulfillinent of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have 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 septice- mia), 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 occupa- tion, the sudden deathis 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 con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
X
-301 A
PLACE OF DEATH
Suffolk (County)
1
Wint rop
...
(City or Town)
No. 33 Bay View Ave
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. 125
Registered No.
( If death occurred in a hospital or institution, St.
give its NAME instead of street and number)
2 FULL NAME
John A. Shea
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
33 Bay View Ave
(Usual place of abode)
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 community.O
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Married
Sa If marrie
HUSBAND of
(Give maiden name of wife in full)
iyiarea Jacobson
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive
years
> IF STILLBORN. enter that fact here.
AGE
52
Years
Months
-
Days
-
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Bookeeper
Industry
10 or Business :
Rapid ..... Transit
11 Social Security No.
023- 10-6759
12 BIRTHPLACE (City)
(Siate or country)
Mass
13 NAME OF
FATHER
Michael Shea
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Hanna Sullivan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Mildred Shea
Walyier, If any
( Address)
33 Bay View Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : VMED. Clubdues
(Signature of Ageht of Board of Ipfaith or other) 6/14/43
( Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month )
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deosasod from
(
to
time 13.
1943
i last saw h. Iam alive on
1 . 19 death Is said to
have occurred on the date stated above, at
11.303
m.
Immediate gause of death.
Conmanifest
Duration
IMPORTANT ....
Due to.
Due to
Other conditions ..
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed diagnosis?
IMPORTANT
Physician
L'uderline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased? 10
If so, specify.
('Signed)
(Address)
Holy
Cross Mld
, M. D.
K
21
Place of Burial, Creniation or Removal.
DATE OF BURIAL ..
June ,I6.
(City or Town) 1.9.4.3 19/
22 NAME OF
FUNERAL DIRECTOR SIme LO Maten
ADDRESS
Winthrop
Received and Ated. JUN 1-4 -1943
19
( Registrar)
-
V
100M-G -2-42.8855
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS
Heatthe office " (Omclal Designation)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
1943
45
9 mm
Charlestown
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 illuesa, at the request of an undertaker or other authorizeil person or of any member of the family of the deceased, furnisb for registration a standard certifcate of death, stating to the best of his knowledge and beher the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one. where ssme was enutracied. the duration of his last illness, when last meen alive by the physician or officer and the date of hia death ... Ceu. Laws, Cliap. 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. wavy 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 saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of thia sec- tion and of sectinus forty-five, forty-six and forty seven of said chapter one huitred and fourteen, the word "war" shall incinde the China relief ex- pedition aud the Philippine insurrection, which shall, for said purposes. he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can harder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury 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 lasue 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 huinan body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tonth 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 hoard, agent or clerk, as the case inay he, 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 auy, as required by law, o1 in lieu thereof a certificate as liereinafter 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 aelectmen for the purpose, shall upon application niske the certificate re- quired of the attending physician. If death is csused by violence, the medl- cal examiner shall make such certificate. If such a permit for the removal of a human body, uot 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 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 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 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 transnrit 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 nece+ sary information which can be obtained as to the deceased. or as to the mauter or canse 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 ashea thereof which have been brought luto the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such perinits, or if there is no such hoard, from the clerk nf 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 ibe 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 such persons as are supposed to have died by vinlence. 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 liea aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calla for the ohaervance of the following rules of practice :
(1) Attending phyalcians will certify to such deatha only aa those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deaths only as those of persons who, though disahled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose physi- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatism (including resulting septicemla), and by the action of chemical (drugs or poisons), therinal, or electrical agents, and deaths following abortion, but also deaths from dlacasa resulting from injury or Infection related to occupation, the sudden deaths of persons not disabled by recognized dlasaae, 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 ilying. e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng 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 Oocupatlon .- Precise statement of occupation Is very Im- portaut, so that the relative healthfulness of various pursuita 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 he returned as at school or at home. For a woman whose only occupatiou was that of home housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A
1
PLACE OF DEATH
Suffolk ( County) Tutterole (City or Town 102 May View Ave No.
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 126
Registered No.
§ ( If death occurred in a hospital or institution,
St. ( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a #-S. War Veteran,
( If deceased is a married, widowed OR divorced woman, give also maiden name.)
(a) Residence. No.
102 May View Sove
(Usual place of abode)
(If nonresident, /give cfty or town and State)
Length of stay: In hospital or Institution
( Refnre death)
(Specify whether)
yeara
8 months + days.
in this community
yrs.
3
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
S
4 COLOR OR RACE|
( write the word)
5 SINGLE
MARRIED"
WIDOWED
Married
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Policie Mac Donald
( Husband's name in fuli)
6 Age of husbandtor wife if alive 64
yaers
IF STILLBORN. enter that fact hera.
8
AGE 62
Years
2
Months
11
Days
if less than 1 day
Hours.
Minutes
Usual
9 Occupation :
At Home
Industry
10 or Business :
Own Home
11 Social Security No. hove
12 BIRTHPLACE (City
( State or country)
New Brunswick
13 NAME OF
FATHER
Foran Funny
14 BIRTHPLACE OF
FATHER (City)
St Stephens
(State or country)
15 MAIDEN NAME
OF MOTHER
Freuch
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Trew Brunswiche
17 Informant unfred Jearney ( Address )
I HEREBY CERTIFY that a satisfactory standard oartifioate of death wasy filed with me BEFORE the bodai of transit parmit was Issued:
(Signature of Agent of Board of Health or other) Health Check / 6/14/43
...... (Omcial Designation) ( Date of Issue of Permie)/
18 DATE OF
DEATH
Sime
14
( Mfonth)
(Day)
1943 (Year)
19 HEREBY CERTIFY,
That i attandad daosasad from
June 1, 1943
Ło ...
June 14
1943
I last saw her
alive on.
June 14, 19 43 death is said to
have occurred on the date stetad abova, at ..
t 11:50 Am
Immediate cause of death. Carcinoma of left
breast")
........... 6mos ....
Due to. General Carcinomatoris"
amos .......
Other conditions.
none
.... ( Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings:
Of operations.
carcinoma of
left breast
Date of
Of autopsy.
none
Underiino the cause to u hich death should be
What test confirmed diagnosis?
clinical x par charged st.
Zistically.
20 Was disease or injury in any way related to occupation of deceased?
if so, spaolfy ... / ...
Jacob abrange M.W
M. D.
(Signad).
(Address) 562 HuskeyJ
Jul1419443.
Data .ln
21
DATE OF BURIAL
l'ia Y Creniation of Removal. 1 (City or Town) 43 19 .......
22 NAME OF FUNERAL DIRECTOR ADDRESS
34 Maple St Malden mass
Raoelved and Aled.
19.
JUN 1 1 1913
( Registrar)
.
-----
100M-6 - 2-42-8855
X
2 FULL NAME
Ada Gimma Trac Donald
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effeot. PARENTS
Duration IMPORTANT
Due to
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 s person whoin he has attemuled during his last illness, at the request of an undertaker or other authorizeil person or of ans 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 was contracted, the duration of his last illnesa, when last seen alive by the physician or officer and the date of bis death ... Gen. Lawa, Chap. 46, Sec. 9.
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