Town of Winthrop : Record of Deaths 1944, Part 24

Author: Winthrop (Mass.)
Publication date: 1944
Publisher:
Number of Pages: 526


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 24


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75 | Part 76 | Part 77 | Part 78 | Part 79 | Part 80 | Part 81 | Part 82 | Part 83 | Part 84 | Part 85 | Part 86 | Part 87


PARENTS


14 BIRTHPLACE OF


FATHER (City)


cannot be learned


(State or country)


15 MAIDEN NAME


OF MOTHER


cannot be learned


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Cannot be learned


17 M. K. McPhillips


Relation, if any


Informant.


(Address)


DSH


A TRUE COPY.


ATTEST :


(Registrar of city or town where death occurred)


DATE FILED


€ 4/44


19


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Mar. 22, 1944


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY


Mar.


6,,


Mar.


22,


4419


That I attended deceased from


22


.... 19 .... 4.4death Is said to


I last saw h .............. alive on.


Mar.


have occurred on the date stated above, al2 ... 30P.


.m.


Duration


Immediate cause of death


Arteriosclerotic heart disease


20 yrs"


Due to.


Due to


Other conditions


(Include pregnancy within 3 months of death)


Physician


Major findings :


Of operations


Date of


should be charged sta- tistically.


Of autopsy


clinical


What test confirmed diagnosis?


20 Was disease or Injury in any way related to oooupation of deceased ?


If so, specify.


(Signed)Lora M. Remillard


DSH


M. D.


(Address)


21 PLACE OF BURIAL,


CREMATION OR REMOVAL.


Winthrop


Winthrop


(Cemetery)


(City or Town)


DATE OF BURIAL


3/24/44


.19.


22 NAME OF


FUNERAL DIRECTORWard S. Reynolds


ADDRESS


Winthrop


19


Received and filed


APR 11 1944


(Registrar of City or Town where deceased resided)


50m (e)-1-41-4667


of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased


PLACE OF DEATH -


(County)


1


Danvers


(City or Town) Danvers State Hospital No.


St.


Abbey C. Briggs


(If U. S.


War Veteran,


speolfy WAR)


19.44


Underline the cause to


which death


M R-302


PLACE OF DEATH


SUFFOLK BOSTON


(City or Town)


No. N.E. Deaconess Hosp


The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


BOSTON


(City or town making return)


2880


Registered No. (If death occurred in a hospital or institution, St.


give its NAME instead of street and number)


2 FULL NAME.


Winifred Seaton


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residenoe. No.


69 Crystal Cove Ave.


st. Winthrop Mass


(If nonresident, give city or town and State)


Length of stay : In hospital or Institution ......... Hosp


(Before death)


(Specify whether)


years


months 18 days.


In this community


yrs.


mos.18


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX female


4 COLOR OR RACE


white


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


single


5a If married, widowed, or divorced 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


ÅGE 67


Years.


Months.


Days


If less than 1 day Hours .Minutes


Usual


9 Occupation :


at home


Industry


10 or Business :


at home


11 Social Security No ..


none


12 BIRTHPLACE (City)


(State or country)


Brookline, Mass.


13 NAME OF


FATHER


Worthington W. Seaton


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Brooklyn, N. Y.


15 MAIDEN NAME


OF MOTHER


Sarah M. Allyn


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Brooklyn,New York


17 Family records


Relation, if any


Informant


(AddressCrystal Cove Ave. Winthrop


A TRUE COPY.


ATTEST:


is X rays


(Registrar of city or town where death occurred)


DATE FILED


March ... 27 .. ..... 1944


19


18 DATE OF


DEATH


March 22 1944


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY,


March


4


19 ... 44


to


March


22


That I attended deceased from


194


I last saw her


.alive on


March


21


19.44


death Is sald to


7:45 a.


m.


Duration


Immediate cause of death


Coronary occlusion


1 hr


Due to ...


Coronary arteriosclerosis


Due to


Diabetes mellitus


Other conditions ...


(Include pregnancy within 3 months of death)


Generalized arteriosclerosis


Physician


Major findings:


Osteo myilitis leg and


Of operations


root


Date


of


3/6/44


Underline the cause to which death should be charged sta-


Of autopsy


Samo


tistically. What test confirmed diagnosis? Autopsy, blood signs 20 Was disease or injury in any way related to ocoupatlon of deceased ?.... no.


If so, specify


(Signed)


J. Murray


Boston, Lass.


M. D.


(Address)


Date


3/22/1944


21 PLACE OF BURIAL, Winthrop Com, Winthrop Mass. CREMATION OR REMOVAL .. (Cemetery )


DATE OF BURIAL


March 25, 1944


19


(City or Town)


22 NAME OF


FUNERAL DIRECTORR. A.White


ADDRESS


Winthrop Naso


Received and filed


APR IU 1944


19


(Registrar of City or Town where deceased resided)


50m (e)-1-41-4667


resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)


1


(If U. S.


War Veteran,


speolfy WAR)


(Usual place of abode)


(Give maiden name of wife in full)


have occurred on the date stated above, at


RECEIVED


TOWN


OF


11 1.2 1


#


no


SEURO


WINTHRO


APR1 01944 AM


I R-302


SUFFOLK BOSTON (County)


(City or Town)


Mass. Gen. Hosp


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


BOSTON


(City or town making return)


72


(If death occurred in a hospital or institution, St. give its NAME instead of street and number)


2 FULL NAME


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Resldenoe. No.


(Usual place of abode)


262 Shirley


St.


Winthrop


(If nonresident, give city or town and State)


5


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX M


4 COLOR OR RACE


W


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Married


(Month)


(Day)


(Year)


5a If married, widowed, orchristine Papavesilopolous


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


7 IF STILLBORN, enter that fact here.


8


AGE 82


Years


Months.


Day


If less than 1 day Hours .Minutes


Usual


9 Ocoupation :


Fruit ... dealer.


Industry


10 or Business :


Self


11 Social Security No ...


none


12 BIRTHPLACE (City)


(State or country)


Greece


13 NAME OF


FATHER


Alexander Papouleas


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Greece


15 MAIDEN NAME


OF MOTHER


Portia Unknoen


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Greece


17 Informant (Address)


Relation, if any "Wife


A TRUE COPY.


ATTEST:


4


(Registrar of city or town where death occurred)


DATE FILED


March 31, 1944


19


19 | HEREBY CERTIFY,


3/23/449


to.,


3/28/44


19


That I attended deceased from


I last saw h.


im ..... alive on.


3 2.8/44


19


.,


death Is sald to


have occurred on the date stated above, at.8:05 ...


m.


Immedlate cause of death


Benign prostatic hyperplasia


6 yrs


Due to.


Due to


Other conditions.


Bronchiectasis


unknown


(Include pregnancy within 3 months of death)


Major findings :


Perineal prostatectomy


Of operations.


Date of


3/27/44


Physician Underline the cause to which death should be charged sta- tistically.


Of autopsy ..... no ... autopsy.


What test confirmed diagnosis ?.


Clinical


20 Was disease or Injury in any way related to oooupation of deceased ?


If so, speolfy


C. L. Clay


(Signed)


(Address)


Mass. Gen. Hosp


Dato.


3/28/44


M. D.


21 "PLACE OF BURIAL, Winthrop Cem. Winthrop,


CREMATION OR REMOVAL


(Cemetery )


DATE OF BURIAL


March .. 31, 1944


19


22 NAME OF


FUNERAL DIRECTOR


R. C. Kirby


ADDRESS


Boston Mass


Received and filed


APR 10 1944


19


(Registrar of City or Town where deceased resided)


50m (e)-1-41-4667


resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)


1


PLACE OF DEATH


No.


Angelus Papouleas


(If U. S.


War Veteran,


specify WAR)


no


Length of stay: In hospital or Institution.


(Before death)


(Specify whether)


Ho sp


years


months


5


days.


In this community


yrs.


18 DATE OF


DEATH


March 28, 1944


:


Registered No.


3045


(City or Town)


Duration


72


RECEIVED


TOWI!


WINTHROP


6


MASS.


APR1 01944 AM


01 A


1


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town) 88 Brookfield Rd


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 ite Agent. 73


Registered No.


St.


( If death occurred in a hospital or institution,


give ita NAME instead of street and number)


PHYSICIAN · IMPORTANT


2 FULL NAME


Elizabeth A. Cody


Sheehan


( If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence. No.


88 Brookfield Rd


(Usual place of abode)


St.


(If nonresident, give city"or town and State)


Length of stay: In hospital or Institution


(Before death)


(Sperify whether)


years


months


days.


in this community 5 yrs.


mos.


dayı.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


Female


4 COLOR OR RACE


White


5 SINGLE


( write the word)


MARRIED


WIDOWED


or DIVORHEDd owed


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


DanieGive gidenstre e par


( Husband's name in full)


ein full)


6 Age of husband or wife if alive years


IF STILLBORN. enter that fact here.


880


AGE


Years


Months


... Days


If less then 1 day


Hours


Minutes


Usual


9 OccupationHousewife


Industry


10 or Business :


Own Home


11 Social Security No.


-


St. John


12 BIRTHPLACE (City)


(State or country)


N.B.


13 NAME OF


FATHER


Walter Cody


14 BIRTHPLACE OF


FATHER (City)


St. John


(State or country)


N.B.


15 MAIDEN NAME


OF MOTHER Elizabeth Scott


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


England


17


Informant .


( Address)


Mary.gghfrbarrera


Relation, if any


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 Health or other) Health officer 4/3/44


(Official Designation) (Date of Issue of Permit)


18 DATE OF


DEATH


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY.


That & attended deosased from


Junte 26 1944


1.


i last saw ha


.. allve on


have occurred on the date stated above, at


in


m.


Immediate cause; of death ..


Duration


IMPORTANT


....


1


Other conditions.


( Include pregnancy within 3 months of death)


IMPORTANT


Physician


Major findings:


Of operations


Date of


Of autopsy


What test confirmed dlegnosis?


Underline the cause to which death should be charged sta- tistically.


20 Was disease or injury in any way related to oooupation of deceased ?.


ff so, spsoify ..


. M. D.


(Signed)


Kinhman Date 4-2-1944


(Address)


21Holy Cross Malden


Place of Burial, Cremation or Removal.


April


4


1944own)


DATE OF BURIAL


22 NAME OF


FUNERAL DIRECTOR.


ADDRESS


Lotm.J@maten Winthrop


Received and Aled


AFh 3 1941


19 ...


( Registrar)


100M-G - 2-42-8855


. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS


No.


(Was deceased a


U. S. Wer Veteran,


if so specify WAR)


1944


2


44


19


s said to


Due to


Due to


arterio Milano


Daughter .....


19


........


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physiolan or registered hospital medical officer shall forthwith, after the death of a person whoin he has atteried during his iast liiness, at the request of an undertaker or other authorized person or of ans meniber of tbe 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, bis supposed age, the disease of which he died. defined as re- quired by section one, where same was contracted. the duration of his last Iliness, when laat seen alive by the physician or omcer and the date of his deatb ... Gen. Laws, Chap. 46, Sec. 9.


A' physician or officer furnishing a certificate of death aa required by tbe preceding section or by section forty-five of chapter one bundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, served in the army. usvy 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 aiso certify in such certificate both the primary and the secondary or immediate cause of death as nearly as be can state the saine. For negiect to comply with any provision of this section, auch 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 bundred and fourteen, the word "war" shall Incinde the China relief ex- pedition and the Philippine insurrection, which shali, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and Juiz fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen bundred and seventeen. C. L. Cilap. 46, Sec. 10.


No undartakar or other parson shaii bury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been buried, untii he has received a permit from the board of heaith, or ita agent appointed to issue sucb permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or otber person ahaii exhume a buman body aud remove it froin a town. from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, untii be has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the boriy is buried. No such permit ahaii be Issued untii there shall have been delivered to sucb board, agent or cierk, as the case inay be, a satisfactory written atatenient containing the facta required by law to be returned ami 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 certificste as hiereinafter 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, shali upon application make the certificate re- quired of the attending physician. If death is caused by violence. tbe medi- cai examiner ahail make such certificate. If such a permit for the removal of a iluman body, not previously interred, froin one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of desth made as above provided and in the possession ot the undertaker desiring to make such removai shaii constitute a permit for such removal; provided, that such body shail be returned to the town from which It was removed within thirty-six hours after such removai, uniess a permit in the usuai form for the removal of such body has been sooner obtained hereunder. If the death certificate containa 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 shali 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 shali 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 .- Cbap. 114. Sec. 46. 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 permita, or if there is no such board, from the clerk of the town where the body is to be buried or the fuuerai is to he heid, or from a peraun apiminted to have the care of the cemetery or buriai grouml in which ibe interment is made .... Cbap. 114. Sec. 46. C. L., (Tercentenary Editiou).


Medical examiners shaii make examination upon the view of the dead bodies of only such persons as are supposed to have died ly 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 aud take charge of the same; ... - General Laws, Cbap. 38, Sec. 6.


RULES OF PRACTICE


The fulfillment of the purpose of these laws caila for the observance of the following rules of practice :


(1) Attending physicians wiil certify to sucb deatha only as those of persons to whom they have given bedside care during a last illness from disease unreiated to any form of injury.


(2) Board of Haalth physlolans wiii certify to such deatha oniy aa those of persons who, though disshled by recognized disease unrelated to any form of injury. have died witilout recent medicai attenulance or whose pbyaf- cian ia ahsent from home when the certificate of death is needed.


(3) Medloai Examiners will investigate and certify to ali dicatba sup- posably due to Injury. These include not only deaths caused directly or In- directiy by traumatism (Including resulting septicemia), and by the action of chienricai (drugs or poisons), thermal, or electrical agents, aml deaths following abortion, but aiso deatha from diseaaa resulting from Injury or Infeotlon ralated to occupation, the audden deaths of persons not disablad by recognized disease, and those of persons found dead.


Statement of Cause of Death .- Cause of deatil meana the disease, or complication which causes death. not the movie of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As reiated causes, name earlier morbid conditions, if any, related to the principal cause and any Important compiication of the principai cause.


Statemant of Oooupation .- Precise statement of occupation is very im- portant, so that the reiative beaithfuinews 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 ou account of the disease causing death, report the usual occupation prior to ilness. if the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfuliy employed may be returned an at school or at boine. For a woman wbose oniy occupatiou was that of honre bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa bousekerper-private family, cook-hotei, etc. For a person wbo bad no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


M R-301 !|


1


PLACE OF DEATH


2 FULL NAME


(a) Residence.


No 652 Saratoga


(Usual place of abode)


.ength of stay: In hospital or institution


(Specify whether)


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


male


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


Stillborn


7 IF STILLBORN, enter that fact here.


8


AGE


Years


Months.


Days


If less than I day


Usual


9 Occupation:


Industry


10 or Business:


11 Social Security No.


12 BIRTHPLACE (City)


Winthrop Mass


(State or country)


13 NAME OF


14 BIRTHPLACE OF


FATHER (City)


Cast Boston


(State or country)


15 MAIDEN NAME


OF MOTHER


PARENTS


16 BIRTHPLACE OF


Cambridge.


MOTHER (City)


(State or country)


(Address)


652 Paraboas


G.B


......


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION


is very important. See instructions and extracts from the laws on back of certificate.


information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


N. B .- WRITE PLAINLY, WITH ONFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of


FATHER


George Dwellen


5/10/44


fulfolk (Country) Withroy (City or Town) Winthrop Community Hospital No ....


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


(City or town making return)


Registered No.


1 (If death occurred in a hospital or institution, St. give its NAME instead of street and number)


Baby Boy Dwellers


(If dCeased is a married, widowed or divorced/woman, give also maiden name.)


years


months


days.


yrs.


mos.


days.


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


afinal


(Month)


3


1944


( Day )


( Year)


19 I HEREBY CERTIFY, That I attended deceased from


19.


.. , to.


19


el last saw h.kwww ..... alive on.


19.


death is said


to have occurred on the date stated above, at


2:13P


Duration


Immediate cause of death.


Still Com


9/10


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 ?.


PHYSICIAN


Underline the cause to which death should be charged sta- tistically.


20 Was disease or Injury In any way related to occupation of deceased ?


If so, specify ..


(Signed) Fred D" DeJan


M. D.


(Addre


670 Saratoga 1 ato 4/7/4


21


Place of Buril, Cremation of Removal.


DATE OF BURIAL


april 4


1944


22 NAME OF


Charles It- Treanor


FUNERAL DIRECTOR


ADDRESS


Each Boston


·


Received and fled


19


..... A TRUE COPY ATTEST: (Registrar)


200m-10-'39. No. 8427-d


17 Donatella Dwelly Relation Lif any


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


News. Children (Signature of Agent of Board of Health of other) ( Malthe Offices 4141446 "(Official Designation) (Date of Issue of Permit)


(write the word) fingle


6 Age of husband or wile if alive. .yours


Hours Minutes


Donatella Marzone


mass


...


(If U. S.


War Veteran.


specify WAR)


no


St.


Eud Boston


(If nonresident, give city or town and state)


In this community


(City


Town)


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS


GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physielan 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 onc, 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.


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 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 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 physician who is a member of the board of health, or employed by it or by 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




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