USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 25
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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 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, Seo. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment 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 borue when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. Thesc 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 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 con- ditions, ir 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 discase 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
Suffolk
(County)
Winthrop
(City or Town)
No.
30 Perkins St.
The Commontoralth of Massarinisetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agente !! 1
Registered No.
§ (If death occurred in a hospital or institution, St. { give ita NAME instead of street and number)
2 FULL NAME
Florence Coulam Erwin
( If deceased is a married, widowed or divorced woman, give also maiden name.) 30 Perkins
(a) Residence. No.
(Usual place of abode)
1
years
months
days.
35
In this community
yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
4
4
44
(Month)
(Day)
(Year)
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Willi tie pidemimiff wife in full)
( Husband's name in full)
6 Age of husband or wife if alive 07
years
> IF STILLBORN. enter That fact here.
8
64
Years
1
Months
7
Days
if less than 1 day Hours Minutes
Usual
9 Occupation :
Housewife
Industry
At home
11 Social Security No.
NOme
12 BIRTHPLACE (City)
Lowe11
Mass
13 NAME OF
FATHER
William B. Coulam
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Eng land
15 MAIDEN NAME
OF MOTHER
not known
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
17 William F. Erwin
Informant ( Address) Perking St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burlat or transit permit was Issued : IM.D. Childress 0 (Signature of Agent of Board of Health or other)
Health officer 4/8/44
(Official Designation) (Date of Issue 'of Permit)
19 | HEREBY CERTIFY.
Iam. 51
......
That I attended deosased from
194 4
april 4,
19.
.....
i last saw h.d .......... alive on
ans. 4,
1944, death is said to
have oocurred on the date stated above, at 10:45A .m.
Immediate oause of death Hermestencia Cardine Durare
.LABORTANT 22 upp
Due to.
artsen
Chanel
Due to
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 oooupation of deceased ? If so, specify .... (Signed) Samuel S. Vredtien, W.V. M. D. (Address) 270 samley st Date 4/7/ 19.8.39
21
Edison Cemetery
Lowe11
Place of Burial, Cremation or Remoyal.
April
DATE OF BURIAL
19
22 NAME OF
FUN
147
Winthrop St. Winthrop
Richard 16. White
ADDRESS
Received and APR 17 1944 19 .....
( Registrar)
100M-E · 2·42-8855
4 COLOR OR RACE|
white
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Married
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
1 3 SEX female AGE 10 or Business : 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 on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and (State or country)
PLACE OF DEATH
PHYSICIAN - IMPORTANT
(Was deceased &
U. S. War Veteran,
If so speolfy WAR)
Duration
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or ragistared hospital medical officer shall forthwith, after the death of s person whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of any meniber of the family of the deceased, furnisb for registration a standard certificate of death, stating to the best of his knowledge and belief the uante of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one, wlivre 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 bundred 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 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 iinmediate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, sucb physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-woven of said chapter one hundred and fourteen, the word "war" shall inchile the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes. he deenied to have taken place hetween February fourteenth, eighteen hundred and ninety eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen bundred and seventeen. G. L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman 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 uo such board, from the clerk of the town where the person died; and no undertaker or otber person shall exhume a buman body and remove it froin a town, from one cemetery to another, or from oue grave or tomb other than the receiving tonib to another In the same cemetery, until be 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 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 auy, aa required by law, o1 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 pbysi- cian who is a member of the board of health, or employed by It or by the selectmen for the purpose, shall upon application niake the certificate re- quired of the attending physician. If deatb is caused by violence, tbe medl- 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 commonwealth cannot be obtained early enough for the purpose, tbe certificate of death made as above provided and in the possession ot tbe undertaker desiring to make such renioval shall constitute a permit for such removal; provided, that such body shall be returned to the town from wbich 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 Chilted States In any war In which It has been engaged, sucb recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statenient 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 veces sary infornimiion which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar unay require .- Cbap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the conimonwealth until he has re- ceived a jærniit so to do from the board of healib or its agent 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 apointed to have tbe care of the cemetery or burial ground in which the interment is made. ... Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examinstion upon the view of the dead bodies of only such persons as are supposed to have died by violence. If & 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, 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 wili 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 pbyaf- cian is ahsent from home when the certificate of death is needed.
(8) Madioal Examiners will investigate and certify to all desthe sup- posably due to Injury. These include not only desths caused directly or in- directly by traumatism (including recuiting septicemia), and by the actlon of chemical (drugs or poisons), thermal, or electrical agents, all deaths following abortion, but also deaths from disease resulting from injury or infsotion related to occupation, the auddan deaths of parsons not disablad by reoognizad 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 Oooupatlon .- Precise statement of occupation la very im- portant, so that the relative bealthfulness 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 illness. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at boine. For a woman whose only occupatiou was that of bonie housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper -- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
1 R-303-A
The Commonwealth of Massachusetts SalleCk (County) OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH (City or Town) Registered No. Winthrop. Community Arspital St. § ( If death occurred in a hospital or institution, { give its NAME instead of street and number) - PLACE OF DEATH Winther BOSTON NOTIFIED POSTON NOTIFIED : 5/10/4.4
To be filed for burial permit with Board of Health or its Agent.
76
No. Philomena
2 FULL NAME
(If deceased is a married, widowed or divorced) woman, give also maiden name.)
(a) Residence. No. 56 telcon St. Last Besten (Usual place of abode)
Length of stay: In hospital or Institution Serata (Before death)
hospital
years
months 5
days.
St.
(If nonresident, give city or town and State)
In this community 50 FTS.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACEJ
White
5 SINGLE
(write the word)
MARRIED
WIDOWEO
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
neo The raven gaine of file in full)
( Husband's name in full)
6 Age of husband or wife If allve .
54
years
7 IF STILLBORN, enter that faot here.
8 AGE 55 %. Years
Months Days
If less than 1 day
Hours ...
.Minutes
Housewife
at Name
11 Social Security No ..............
Dane
12 BIRTHPLACE (City)
(State or country)
Soaton
13 NAME OF
FATHER
Serafine Del Porto
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF M
Marianna homenicelle
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Haly
17 Les Virginia
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 Beard of Health or other> Health Price (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
abril- 4-1944
(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.) acule Cardiac Failure
Probably Corman Sclerosez Diabetes mellitus
20 Acoldent, suloide, or homlolde (specify)
Date of occurrenoo.
19
Where did
Injury ocour ?
(City or town and State)
Did Injury ocour In or about home, on farm, In Industrial place, or In publlo
pláoe ?
(Specify type of place)
Manner of
Injury
Collapsed odvet queeckly in
Nature of
hospital bed
Injury
While at work? .Was there an autopsy ?.
21 Was disease or Injury In any way related to ocoupation of deceased ?......
If so, specify
M. D.
(Signed)
Boston
Ilpate-4-1944
(Address)
22 Holy Cross
Inalden
Place of Burial, Cremation or Removal.
(City or Town)
1
19×4
DATE OF BURIAL
23 NAME OF
Albert Scaramella
FUNERAL DIRECTOR
ADDRESS
39 Orleans St, Couldreten
Received and filed
APR 10 1944
19
(Registrar)
=
1 3 SEX Soquale (or) WIFE Usual 9 Occupation : PARENTS Informant 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 If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a récital to that effect Should be carefully supplied. MEDICAL LAAMINERS Should state CAUSE AND MANNEN OF DEATH In plain terms, Industry 10 or Business :
50m (g)-1-41-4667
Virginia. (del Vasto)
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(Specify whether)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medloal officer shall forthwith, after the death of a person whom be has attended during his last illness, at the request of an undertaker or other authorized person or of any meinher 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 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 hy 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 canse 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" shiall include the China relief ex- pedition and the l'hilippine insurrection, which shall, for said purposes, be deemed to have taken place between Fehruary 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. 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 hody which has not been buried, until he has received a permit froin the board 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 person died; and no undertaker or other person shall exhume a human body and remove it from a town, froin one cemetery to another, or from one grave or tomh 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 hody is buried. No such perinit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, 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 be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoaril 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 meilical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as ahove provided and in the pos- session of the undertaker desiring to make such 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 body 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 been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certifleste, shall forthwith countersign it and transinit 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 be obtained as to the deceased, or se 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 hody or the ashes thereof which have hren brought into the cominonwealth until he has re- ceived a perinit »o 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 ia to he held, or from a per- sou appointed to have the care of the cemetery or burial ground in which the interment is inade. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tioni).
Medical examiners 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 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.
. Ile 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 be, with the cause and manner of death .- General Laws, Chap. 33, Sec. 7.
... The medical examiner certifles 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 ohscrvance of the following rules of practice :
(1) Attending physioians will certify to such deaths only ss those of persons to whom they have given hedside care during a last illness from disease uurelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to sny form of injury, have died without recent medical attendance or whose physi- cian is absent from hoine when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from Injury or Infection related to occupation, the sudden deaths of persons not disabled hy 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 aud 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 bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- cia ed hemorrhage, homicidal." "Asphyxiation hy suspension, 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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