USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 42
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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 fromn 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 perniit shall be issued until there shall have been delivered to such board, agent or clerk. as the case inay 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 interment, by a satisfactory certificate of the attending physician, if any, as 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 he 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 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 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 renroval 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 l'uited 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 canse of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human hody 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 agem 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. ... 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 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 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 persona to whom they have given bedside 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 disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose physi- cian is ahsent from home when the certificate of death is needed.
(3) Medioal 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, 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 Oocupation .- l'recise 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 honie housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa housekeeper-private family. cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
PLACE OF DEATH
Suffolk Lynn notified
7/10
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. 137
Inale Chile of Hyman Vera Somers
2 FULL NAME
( If deceased is a married, widowedxor divorced
woman, give also maiden name.)
(a) Rasidence. No.
12 Blossom
(Usual place of abode)
nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months days.
in this community
yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Mule
4 COLOR OR RACE
While
5 SINGLE
( write the word)
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)
6 Age of husband or wife if alive
> IF STILLBORN. enter that fact hera.
8 AGE Years Months . Days
If less than 1 day
Hours 20 Minutes
Usual
9 Occupation :
Industry 10 or Business:
11 Social Security No.
Winthrop
PARENT8
14 BIRTHPLACE OF
FATHER (City
(State or country)
Boston
15 MAIDEN NAME
OF MOTHER
Vera
Pollack.
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston
17 Hyran Jones,
Informant ( Address) 72 Bloom At- Dyhn
I HEREBY CERTIFY that a satisfactory standard certificate of daath was fied with me BEFORE the burial or fragilt permit was Issued? Www. S. Chil dress
(Signature of Agent of Board of Health of other) Realthe Officer 6/21/44
"(Oficial Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June
20,1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
That I altendad decsasad from
June 20
19 44
June 20,
19 XX
......
I last saw himy alive on
June 20, 1944, death is said to
have occurred on tha date stated above, at.
3:00 Am.
Immedlate cause of death
.
Prematurity
1.
punto
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? Course Andwego
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceasad ?.
If so, specify ...
20- Julian
(Signed)
.. M. D.
(Address ) Oll Seherne wealthME. fr
Date 6)
20 1944
21
Beth Israel
1
DATE OF BURIAL ....
19.
22 NAME OF
FUNERAL DIRECTOR.
Philip Hymanson
ADDRESS
Received and Aled ..
JUN-2-3-1944
19
( Registrar) X
- If deceased was a U. S. War Veteran, G. L. Chap. 46, Section, 10, requires physicians to insert a recital to that effect. caivented depa 10/30/4x
extracts from the laws on back of certificate.
100M-G - 2-42-8855
1
(County) Winthrop
(City of Town) { Winthrop Community Hoop No.
St.
" ( If death occurred in a hospital or institution, ¿ give its NAME instead of street aud number)
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
If so spaolfy WAR)
muss.
St.
atorie
years
Duration IMPORTANT
IMPORTANT
12 BIRTHPLACE (City)
( State or country)
13 NAME OF
FATHER
Hyman Somers
Place of Burial, Cremation or Removal.
(City or Town)
44
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 attetuled during his last illness, at the request of sn undertaker or other authorized person or of ans meniber of the fanily of the deceased, furnish for registration a standard certificate of desth, 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 illness, when last seen alive by the physician or omcer aud the date of bia death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing s certificate of death as required by the preceiling section or by section forty.Ave 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 I'nited States in any war in which it has been engaged, insert in the certifcste a recitsl to that effect. speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immeiliate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bumired and 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 hetwcen 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. Clisp. 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 bully which has not been buried, until he has received a permit from the board of hesith, or ita 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 undertsker or other person shall exhume a human body and remove it froin a town. from one cenietery 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 aball bave been delivered to such board, agent or clerk, as the case inay 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 physl- 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 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 connnouwealth cannot be obtained early enough for the purpose. the certificate of desth made as above provided and in the possession of the undertaker desiring to make such renovsl shall constitute a permit for such removal; provided, thst 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 nmarine corps of the United States in any war In which it has hren engaged. such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statenient and certificate, shall forthwith counter-ign 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 of canse of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45. C. 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 permit so to do frun the board of health or its agent appminted 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 tbe care of the cemetery or burial gromml in which the interneut is made. ... Chap. 114. Sec. 46. C. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons ss are supposed to have died hy violence. If a meilical examiner has notice that there is within hils county the body of such a person, he shall forthwith go to the place where the lonily llea 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 deatha only aa 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 physiolans will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attemlance or whose phyaf- cian is ahsent from home when the certificate of desth is needed.
(3) Medioal Examiners will investigate and certify to all ilcaths 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 sgents, aml deaths following abortion, but also deaths from discasa 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 .- Curse of death meana the disease, or complication which causes desth, not the mode of ilying. e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng death. Aa related causes, name earlier niorbid conditions, if any. related to the principal cause and any Important complication of the principal cause.
Statement of Ocoupatlon .- Precise statement of occupation la 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 ou account of the discase causing desth, report the usual occupation prior to illness. If the deceased bad retired from business, report the ususi occupation prior to retirement. Children not gainfully employed may be returned an at school or at huine. For a woman whose only occupstiou was that of hone housework, write bousework. For a person engaged in domestic service for wages. however, designate the occupation by the appropriate terma, aa housekeeper-private faniily, cook-hotel, etc. For a person wbo bad no occupation whatever write none. 2
SPACE FOR ADDITIONAL INFORMATION
RM R-301 |
1
PLACE OF DEATH
Female
2 FULL NAME
(Usual place of abode)
Length of stay : In hospital or institution
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female 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)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
Stillbom
8
AGE
Years
Months.
Days
If less than 1 day
Usual
9 Occupation:
Industry
10 or Business:
1I Social Socurity No ..
12 BIRTHPLACE (City)
tinteiro
(State or country)
13 NAME OF
FATHER
Francis Carney
14 BIRTHPLACE OF
FATHER (City)
Boston
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
East Boston
(State or country)
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
(Signature of Acent of Board of Health of other)
200m-10-'39. No. 8427-d
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
(State or country)
mars
BOSTON NOTIFIED /10/4/4
Suffolke County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return) ...
Registered No
128
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Sarney.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No ..
73 Summer
profitul
years
months
1
days.
In This community
yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June 24, 1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY. That I attended deceased from
19
.. ,
10
19
I last saw h ............ alive on
19.
...... , death is said
to have occurred on the date stated above, at 1:21 am. Immediate cause of death ..
Duration
Due to
Prematuril
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Of autopsy .
What test confirmed diagnosis? Thrive Verdens
PHYSICIAN Underline the cause to which death should be charged sta- tigtically .
20 Was disease or injury lo any way related to occupation af deceased ?
If so, specify ...
.. , M. D.
(Signed)
(Addres
21
St. michael
Baton
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
fine
19 44
22 NAME OF
FUNERAL DIRECTOR
Frederick + magrath
ADDRESS
East Botox Vilaas
Received and filed
JUN-2-8-1944
19
A TRUE COPY ATTEST: (Registrar)
-
2019VY
17 Francis Carney Relation, if any
Informant (Address) 73 Summer St Kyde Parte
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Was. Children.
Health Officer. 6/26/44 (Official Designation) (Date of Issue of Permit)
(write the word) Single
Years
Hours ...... Minutos
Juges.
15 MAIDEN NAME
OF MOTHER
NE Augie Spalino
father
Cinthia (City or Town) No Winabad Community Hospital
(If U. S. War Veteran. specify WAR)) ....
Hyde Park mars
St.
(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 physleian or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during hls last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was 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 hody which has not been buried, until he has received a permit from the hoard 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 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 body is buried. No such permit shall be issucd 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 he obtained early enough for the purpose, or is insufficient, a physician who is a member of the hoard of health, or employed hy it or hy the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal ; provided, that such body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooncr 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 appcar 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 he
ohtalned as to the deceased. or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Seo. 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, Sec. 16, 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 hedside 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 hy recognized disease un- related to any forin of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
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