USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 88
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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 froni the hoard of health or its sgent appointed to issue such permits, 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 the care of the cemetery or burial ground in which the interment is made. ... Cbsp. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall mske examination upon the view of the dead bodies of ouly such persons ss are supposed to have died hy 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 lles aud take charge of the same; ... - General Laws, Cbap. 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 physlolans 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 pbyaf- cian is absent from home when the certificate of desth is needed.
(3) Medloal Examiners will investigate and certify to all deatha sup- posably due to injury. These include not only desths caused directly or in- directly by traumatism (including resulting septicemia), and by the action of clientical (drugs or poisons), thermal, or electrical agents, ami deaths following abortion, but also deaths from diseasa resulting from Injury or infeotlon related to occupation, the sudden deatha 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 desth. not the moile of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name tbe disease causing death. As relsted causes, name earlier morbid conditions, if any, related to the principal cause and any important compllestion of the principal cause.
Statement of Oooupation .- Precise statement of occupation is very im- portant, so that the relstive 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 bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed msy he returned as at school or at boine. For a woman whose only occupation 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 bousekeeper-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)
Winthrop (City or Town) No. Winthrop Community Hospital
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 ... 255
S ( If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
2 FULL NAME
Eunice Sabin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
26 Wave Way Avenue
St.
Wint?
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
.Hosp ...
yeara
months
4
days.
In this community 7 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife In full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if aliva
years
IF STILLBORN. enter that fact here.
8
AGE
7 Years
X. Months
X ... Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Schoolgirl
Industry
10 or Business :
none
11 Social Security No.
non.e.
12 BIRTHPLACE (City)
(Siate or country)
Malden
Nass.
13 NAME OF
FATHER
Edward Sabin
14 BIRTHPLACE OF
FATHER (Clty)
Everett
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Irene Broidy
16 BIRTHPLACE OF
Chelsea
MOTHER (City)
(State or country)
Mass.
17 Edward .... Sabin
Relation, If any
Informant
( Address )
to Have way Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificata of daath was filed with me BEFORE tha buffal or transit permit was Issued : Wie.S. Children (Sighature of Agent of Board -m Hlesith or other)
Health repeat 11/11/43
(Omcial Designation) ( Date of Issue of Permie),
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Www.20. 19.
4300
20.20.
19
I last saw h
Malive on
Www. 20194 death is aald to
hava occurred on tha data statad abova, a
14.45000
.m.
Duration
Status Lymphatic Lymphatiting
IMPORTANT
Due to. Release
Due to
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT
Physician
Major findIngs :
Of operations
Data of
Of autopsy
What test confirmed diagnosis ?.
20 Was diseasa or injury in any way ralated to occupation of daoeased ?... ...........
If so, specify ..
(Signad)
2
. M. D.
(Address)
estimation Date/ 11/2019V
icirosc
(City or Town)
l'lace of Burial, Cremation or Removal.
DATE OF BURIAL
November 21
19.43.
.......
22 NAME OF
FUNERAL DIRECTOR.
H. J. Tori
ADDRESS
151 Washington Ave, Chelsea
Received and Alad.
19
2. 1943
( Registrar)
100M-6 - 2-42-8855
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effsot. PARENTS
-
-
Registared No.
PHYSICIAN - IMPORTANT
(Was deocaaed a
U. S. War Veteran,
if so spaolfy WAR)
rss
(Usual place of abode)
(Before death)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
20
1947
That 1 attandad deosased from
Underlina the cause to which death should be charged sta- tistically.
21
Milomir Cem .-
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 atandard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one. where same was contracted. the duration of his last illneaa, when last seen alive by the physician or officer aud the date of his death . .. Gen. Lawa, 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 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, 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 hundred sud fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety eiglit and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred aud sixteen and nineteen hundred and seventeen. G. L. Chap. 16, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a humau body in a town, or remove therefrom a human body which has not heeu huried, until he haa received a permit 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 person died; and no undertaker or other person shail exhume a human body and remove it froin a town, from one cemetery to another, or from one grave or tomh 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 body is buried. No such permit ahall be issued until there shall have been delivered to such board, agent or clerk, as the case inay be, a satisfactory written atatement 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. 01 in lieu thereof a certificate aa hereinafter provided. If there ia no attending physician, or if, for sufficient reasoua, 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 la caused by violence. the medl- cal examiner ahall 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 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, unless a permit In the usual form for the removal of such hody haa heen sooner ohtalned hereunder. If the death certificate containa a recital, aa required
hy 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 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 nece+ aary information which can be obtained as to the deceased. or as to the mamuer or callse of the death, which the clerk or registrar way require .- Chap. 114. Sec. 46, C. L., ( Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought luito the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent 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 the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examinera shall make examination upon the view of the dead hodiea of only such persons as are supposed to have died hy 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 hody lies aud take charge of the same; ... - General Lawa, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calls for the observance of the following rulea 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 physioiana will certify to such deatha only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medicai attendance or whose phyaf- cian is ahsent from home when the certificate of death ia needed.
(3) Medloal Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths csused directly or in- directly by traumatism (including recuiting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agenta, and deaths following abortion, but alsc deatha from disease resulting from injury or Infeotlon related to occupation, the audden deatha of persons not disabled hy 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 fallure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng death. As related causea, name earlier morbid conditiona, if any, related to the principal cause and any important complication of the principal cause.
Statement of Oooupatlon .- Precise statement of occupation ia very im- portant, so that the relative healthfulnesa of various pursuits can he known, Make some entry in this section for every person aged 10 yeara or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illuese. if the deceased had retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may he returned aa at school or at huine. For a woman whose only occupatiou waa that of honie housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terma, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-303-A
1
PLACE OF DEATH
Sullakk (County) Hruthron. (City or Town) Mutterit Comment tuspital No.
The Conmanfocalth of Massachusetts 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.
256
St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME
Helma C. andersen
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
Length of stay : In hospital or institution.
(Before death)
(Specify whether)
years
months
14days.
In this community 30 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEI
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
.Oscar .... Anderson
(Husband's name in full)
6 Age of husband or wife If allve
years
7 IF STILLBORN, enter that faot here.
8
AGE
77
4
Months.
29 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 or country)
Sweden
13 NAME OF
FATHER
Olof Berstrou
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Sweden
15 MAIDEN NAME
OF MOTHER
not known
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Sweden
17 Estelle A. Taylor Informant (Address) 249 Pleasant St., Winthrop
Relation, I! Any
.I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was Issued: Childress
Signature fofyAgent of Board of dlealth or other) Health Office 12/1/40
(Official Designation) (Date of Issue of Permit)
20 Aocident, sulolde,
or homlolds (specify)
accidental
Date of ooourrenoe.
nov-12-
19 4 ]
Where did
Injury occur ?
(City of 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
Fall in her home now-12-(26]
Nature of Injury
While at work ?.
Was there an autopsy ?.
21 Was disease or Injury In any way related to oooupation of deceased ?..... 1.
If so, specify.
Hm .. Sucklen Well. D.
(Signed)
(Address)
Bertin
Four-29-1943
22 Winthrop Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Dec. 1.
1943.
19
23 NAME OF
FUNERAL DIRECTOR
Richard 16 White
ADDRESS
147 Winthrop St., Winthrop
Received and filed
DEC 2 1943
19
(Registrar)
extracts from the laws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to Insert a reoltal to that effeot
50m (g)-1-43-4667
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
November - 28-1943
DEATH
(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.) Spon Taneous Cerebral Hemorrhage Fractured Left temor
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, If so specify WAR)
249 Pleasant St. Wethink
(If nonresident, give city or town and State)
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 wbom 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 hest of his knowledge and helief 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 hy 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 helief, 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 hoth 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 tbe China relief ex- pedition and 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 horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Cbap. 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 hody which has not heen 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 tomh 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 huried. No such permit shall he issued until tbere shall have heen delivered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall he 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 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 hy it or hy the selectmen for the purpose, shall upon application make the certificate re- quired 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 an- other within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as ahove provided and in the pos- session of the undertaker desiring to make sucb removal shall constitute a permit for such removal; provided, that such hody shall he 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 hody has heen 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 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 regis- tration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall hury 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 perinits, 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 per- son appointed to have the care of the cemetery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
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 hody 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.
. . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may he, with the cause and manner of death .---- General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and helief.
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 hedside 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 aused 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, 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example : "Com- pound fracture of the femur with ensuing septicemia (gas hacillus) caused hy a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation hy euspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
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