USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 95
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A physician or officer furnishing a certifleate 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 srmy, 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, 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 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 snd 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 snd July fourth, nineteen hundred and two, and the Jfexi- 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 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 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 snd 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 lien 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 board of health, or employed by it or hy the selectmen for the purpose, shall upon application make 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, 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. ff the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration, The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- 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 .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such perntits, 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 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 physiclans 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 ahortion, but also deaths from disease resulting from Injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the 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
-301 A
extracts trom the laws on back ot 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
100M-6 - 2-42-8855
PLACE OF DEATH
Suffolk (County)
BOSTON NOTIFIED 1.04+4
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
Registered No. S ( If death occurred in a hospital or institution, give its NAME instead of street and nuniber) PHYSICIAN . IMPORTANT
2 FULL NAME.
Stillborn ... Baby .... Akel]
(BOY)
(If deceased is a married, widowed or divorced woman, give also msiden name.)
(a) Residence. No.
181 Paris
St.
East ... Boston
(If nonresident, give city or town and State)
Length of stay: In hosoltal or institution
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACEI
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
male white
singla
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 alive .. years
9 IF STILLBORN. enter that fact here. stillborn
8 AGE Years Months Days
If less than 1 day Hours Minutes
Usual
9 Dccupation :
Industry
10 or Business :
11 Social Security No.
'2 BIRTHPLACE (City)
(State or country)
Winthrop
13 NAME OF
FATHER
Harold Akell
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Boston
15 MAIDEN NAME
OF MOTHER
Emma Macchione
Anna
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Harold Akell Informant (Address) 181 Paris St. East Boston
Relation, If any .... father ..
I HEREBY CERTIFY thst A solisfactory standard certifiosts of death was fled with ms BEFORE they baratos traffsit permit was Issued ?
22 NAME OF
FUNERAL DIRECTOR.
ADDRESS
9 Chelsea St. Fest Boston
19
(Omclal Designation)
( Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
December
23
194 3
DEATH
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deosased from
19 ..
to
I last saw h.
.. allve on
19
...... , death is sald to
have occurred on the date stated above,
at 6:53 p
.m.
Duration
Immedlate oause of death
IMPORTANT
Due to. Spina Cufila
Other conditions
( Include pregnancy within 3 months of death)
IMPORTANT
Physician
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
Underline the cause to which death should bs charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ? If so, spoolfy.
('Signed)
(Address)
M. D.
Comec.
24943.
21
St. Michael
.Boston Place of Burial, Cremation or Remorak (City or L'own)
DATE OF BURIAL -Red .- 27 19.43
( Signature of ARest of Boarden) Health of other) / Healthe Office 12/29/43
Reosived and Aled
JAN 4 1944
( Registrar)
1
Winthrop (City or Town)
No. Winthrop Community Hospital
.... St.
(Was deosased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
1
19 ......
Due to
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 attemuled during his last illness, at the request of an undertsker or other authorized person or of sny meniber of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one, where same wss contracted. the duration of his last Illneas, 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 s certificate of death aa required by the preceding section or by section forty-five of chapter one hundred and fur- teen, shall, if the deceased. to the best of his knowledge and belief, served in the army, navy or marine enrps of the l'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 saine. For neglect to comply with any provisinn of this section, auch physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sectinns 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 seid purposea, he deemed to have taken place between February fourteenth, eighteen hundred and ninety. eiglit 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. 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 haa received & permit from the board of health, or its agent appointed to laque 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 fromn a town. from one cemetery 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 body is buried. No such permit shall be issued until there aball have been delivered to such boerd, agent or clerk, es the case inay be, a aatisfactory written statement 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, as required by law. 01 in lieu thereof a certificate aa hereinafter provided. If there is no attending physician, or if, for sufficient reasons. hia certificate cannot be obtained early enough for the purpose, or ia insufficient, a physi- cian who ia e 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 is caused by violence, the medl- cal examiner ahali 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 cennot 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 containa a recital. aa required
by section ten of chapter forty-aix, 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+ 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 .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a hunisn body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, 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 Editiou).
Medical examinera shall make examination upon the view of the dead bodies 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 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 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 illueas from disease unrelated to any form of injury.
(2) Board of Health physiolans 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 medical attendance or whose phyaf- cian ia ahsent from home when the certificate of death ia needed.
(3) Medloal Exeminera 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 deatbs following abortion, but also deatha from diseaaa resulting from injury or Infeotlon related to occupetion, the audden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of deathi meana the disease, or complication which causes death. not the mode of dying, e. g., heart failure, asphyxia. asthenia, etc. Aa principal cause name the diaease 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 Occupation .- Precise statement of occupation la very im- portant. so that the relative healthfulness of various pursuits can be known. Make aome 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 businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at horne. For a woman whose only occupatiou was that of honie housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family. cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
:
R-303-A
PLACE OF DEATH
Sullak (County)
No. Eliza
The Commonlocalth 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.
225
St. [ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 11 Pauline St. Writtich St.
Length of stay: In hospital or Institution.
( Before death )
(Specify whether)
years
months
4 days.
In this community
9
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE|
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widow
(or) WIFE of
Freue midep une o& wife in full)
(Ilusband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that faot here.
8
AGE 86
Years
Months
25 Days
If less than 1 day
Hours.
........
Minutes
Usual
9 Occupation:
Housework
12 BIRTHPLACE (City)
Phildelpha
(State or country)
Penn.
13 NAME OF
FATHER
William Cooper
FATHER (City)
Unable To Obtain
(State or country)
Penn.
15 MAIDEN NAME
OF MOTHER
Ann. Fergerson
16 BIRTHPLACE OF
MOTHER (City)
Unable To Obtain
(State or country)
Penn.
17 Fred W.Burns, Son
Informant ( Aldre=) 11 Pauline St Winthrop Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was Issued : Mm'S Children (Signature of Agent) of Board Of Healthno other) Health Officer 12/27/43 (Official Designation) (Date of Issue of Permity
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Dec-
24
-1943
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that i have investigated the death
of the person above-named and that the CAUSE AND MANNER thereof
centeno vilerinin
are as follows: (It, an injury was involved, state fully.).
Fracture Lt Humerus
....
fractura Pelvis
20 Accident, sulolde, or homicide (specify) accelertal
Date of ooourrenoo
Dec - 20-
1943
Where did
Injury ocour ?
(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
tell accidentally at have home
Nature of
un Dec -20-1943
Injury
While at work?
)
Was there an autopsy?
21 Was disease or Injury In any way related to ocoupation of deceased?
If so, specify
(Signed)
M. D.
(Address)
Lake, 25-1947
22
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
23 NAME OF
FUNERAL DIRECTOR
Howard Scrignoles
ADDRESS
Winthrop man.
Received and filed.
DE6-27 1948
... 19.
(Registrar)
X
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(If nonresident, give city or town and State)
Hospital
Winthrop (City or Town) Mintheo Communit Hospital (Cooper)) Duruy
1
2 FULL NAME
(Usual place of abode)
3 SEX
Female
White
5a If married, widowed, or divorced
HUSBAND of
10 or Business :
11 Social Security No .. ..
None
14 BIRTHPLACE OF
PARENTS
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 relative to the return of certificates of death.
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for
Industry
At Home
50m (g)-1-41-4667
Relation, if any
DATE OF BURIAL
December 29
19 43
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 bas attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
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, 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 internient, 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 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 by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, 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 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 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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