USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 46
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SPACE FOR ADDITIONAL INFORMATION
RM R-301
PLACE OF DEATH
(CountyY
..... (City of Town)
boze.
....
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return) 138
Registered No ..
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran? If so, specify WAR)
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
years
month&
4 days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
(write the word)
3 SINGLE
MARRIED
WIDOWED
OF DIVORCEDSulle
5a If married, widowed, or divorced HUSBAND of ..
(Give maiden name of wife in full)
(Husband's name in full)
years
7 IF STILLBORN, enter that fact here.
Years Months ........... Dayel
If less than 1 day
Hours ...
Minutes
Industry
10 or Business:
Hetited 10 que
11 Social Security No ....
(Unterme) Awall
14 BIRTHPLACE OF FATHER (City) ..
Donovan
16 BIRTHPLACE OF MOTHER (City). (State or country)
Aulard
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with ms BEFORE the burial ør transit permit was issued:
Childrener. (Signature of Agent of Board of Health or other) lealthe Pack 7/11/44
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
July
8
1944
(Year)
(Month)
(Day)
19 A HEREBY CERTIFY
VAN 12
.. , 19 ....? to.
July 7,
1944
I last saw h ....
. alive on
19
., death is said to
have occurred on the date stated above, at.
6:20 A
m.
Immediato cause of death.
Coronary
Thrombosis
Duration Important 6. Mos.
Important
Other conditions.
(Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
200000
What test confirmed diagnosis? CLINICA/ SIGAS
PHYSICIAN
Underline the cause to which death should be charged ata- tistically.
20 Wes disease or injury in any way related to occupation of deceased ?. 200
If so, specify
(Signed) DoinghRUD, THASS Date Vyfy Ro RER& (Address)
Relation, if any 21 Place of Burial, Cremanun or Removal. DATE OF BURIAL
(City or Towy
19 ..
22 NAME OF FUNERAL DIRECTOR ADDRESS
Received and filed JUL 1-1-1944
19
A TRUE COPY ATTEST:
(Registrar)
1 No .... 3 SEX (or) WIFE of .. 8 AGE ... Usual 9 Ocoupation : 12 BIRTHPLACE (City) (State or country) 13 NAME OF FATHER 18 MAIDEN NAME OF MOTHER PARENTS 17 Informant (Address) See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. mation should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physician to insert a recital to that effect. 7(Official Designation) 100m(h)-1-41-4695 NN. D. WRITE PLAINLE, WITIT ONTAJING DLAVA INES TTTO DO A FUNMIANENT ALVVAV. LYGTY ILGIII Vf 111101- (State or country)
2 FULL NAME Home / Musicall
(If deceased is a married, widowed or divorced woman, give also maiden name.) 16 Ocean Vain
St
(If nonresident, give city or town and State)
That I attended deceased from
Due to.
Due to.
M. D.
6 Age of husband or wife if alive.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shali forthwith, after the death of a person whom he has attended during his last iliness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required hy section one, where same was contracted, the duration of his iast illness, when last seen alive hy the physiclan 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 hy the preceding section or hy section forty-five of chapter one hundred and fourteen, 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, specifying the war, and shall aiso 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 pro- vision of this section, such physician or officer shail forfeit ten dollars. For the purposes of this section 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 expedition and the Philippine Insurrection, which shall, for said purposes, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety-eight and Juiy fourth, nineteen hundred and two, and the Mexican horder service of nineteen hundred and sixteen and nineteen hundred and seventeen .- General Laws, Chap. 46, Sec. 10.
No undertaker or other person shaii hury or otherwise dispose of a human hody in a town, or remove therefrom a human body which has not heen huried, until he has received a permit from the hoard of heaith, or its agent appointed to issue such permits, or if there is no such hoard, from the cierk of the town where the person died; and no undertaker or other person shali exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiv- ing tomh to another in the same cemetery, untli he has received a permit from the hoard of heaith or its agent aforesaid or from the cierk of the town where the hody is huried. No such permit shall be issued until there shaii have heen delivered to such hoard, agent or cierk, as the case may he, a satlafactory written statement containing the facts required hy law to he returned and recorded. which shall he accompanied, In case of an original interment, hy a satisfactory certificate of the attending physician, If any, as required hy 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 in- sufficient, a physician who is a member of the hoard of health, or em- ployed hy it or hy the selectmen for the purpose, shali upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shali make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot he obtained early enough for the purpose. the certificate of death made as ahove provided and in the possession of the undertaker desiring to make such removai shall constitute a permit for such removai; provided, that such hody shall he 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 re- moval of such hody has heen sooner ohtained hereunder. If the death certificate contains a recltai, as required hy 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 recitatshail. appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and tramlt it to the clerk of the town for registration. The person to whom the Ermit Is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be ohtained 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).
Medical examiners shall make examination upon the view of the dead hodies 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 shail forthwith go to the place where the body lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall hury a human hody or the ashes thereof which have heen brought Into the commonwealth untli he has received a permit so to do from the hoard of heaith or its agent appointed to issue such permits, or if there la no such hoard, from the cierk of the town where the hody ls to he huried 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).
RULES OF PRACTICE
The fulfillment of the purpose of these laws cails for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last iliness 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 unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners wiii investigate and certify to all deathe supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resuiting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from' injury or Infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- 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 morhid conditions, if any, related to the principal cause and any important complication of the principai cause.
Statement of Occupation .- Precise statement of occupation la very important, so that the relative heaithfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had heen given up or changed on account of the disease causing death, report the usual occupation prior to Illness. If the deceased had retired from husiness, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at home. For a woman whose oniy occupation was that of home housework, write housework. 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
R-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City of Town)
No. 19 George St ....
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be tiled for burial permit with Board of Health or its
( If death occurred in a hospital or institution, give ita NAME instead of street and number)
2 FULL NAME Charles ... Herbert ... Bennett (If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so spoolfy WAR)
(a) Residence. No.
19 ... Gerogo ... St .....
(Usual place of abode)
............
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution (Before death)
yearo
months
days.
in this community
16yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDDWED
or DIVORCED
Married
5a If married,
HUSBAND of
Midoradr &adivorced
divans.Bennett
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive 56
years
IF STILLBORN. enter that fact here.
8 65 AGE : Years - Months 15. Days
If less than 1 day Hours. .Minutes
Usual
9 Dccuoation :
Station Statistics
industry
10 or Business :
Insurance
11 Social Security No.
021.05-9129
12 BIRTHPLACE (City)
New Bedford
(Siate or conutry) Mass.
13 NAME OF
FATHER
Samuel Bennett
PARENTS
14 BIRTHPLACE OF
FATHER (City)
New Bedford
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Hannah Ryder
16 BIRTHPLACE DF
MDTHER (City)
Rochester
(State or country)
Mass.
Jocas) 362 Stunden ST, Wanpase July Das 44
21
WO
diawn
Place of Burial, Cremation or Removal.
DATE OF BURIAL
July 14 1944
(City or Town)
19
22 NAME OF
FUNERA
Richard A White
ADDRESS
147 Winthrop St., Winthrop
19
...
(Oficial Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
July 11 1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY, That i attended deceased from January 7, 1943, to July 11 19:44
Plast saw him
July 11
death Is said to
have occurred on the date stated abova, at
6:05P
m.
Immediate oause of death.
Cerebral Hemontaje
Duration 1 hour
2 years
Due to.
angua Pectoris
1 year
Dther conditions.
none
( Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings :
Of operations
none
Date of none
Of autopsy
none
What test confirmed diagnosis ?! clinical x lab
20 Was disease or injury in any way related to occupation of deceased & ..
if so, specify
(Signed) alert
alguno Mit
9 ... . M. D.
Everett
17 Informant Mildred Tvang Bennett Geroge St., Winthrop ( Address )
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 : Hub. Childress
(Signature of Agent of Board pt 'Health or other) Health Deprices 7/13/44
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.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
100M-6 - 2-42-8855
=
Received and fied. JUL-17-1944
( Registrar)
Underline the cause to which death should b. charged sta- tistically.
Due to.
arteriosclerosis
MEDICAL CERTIFICATE DF DEATH
(Specify whether)
St.
Registered No.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whoin he has attended during his last Illness, at the request of an undertaker or other authorized person or of any meniber of the family of the deceased, furnish for registration a standard certifcate of death, stating to the best of his knowledge and belief the name of the deceased. his supposed age, the disease of which he died. defined as re- quired by section one. where same was contracted. the duration of his last illness, when laat seen alive hy the physician or officer and the date of his death ... Cen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa required by the preceding section or by section forty-five of chapter one hundred and four- teen, shish, if the deceased. to the best of his knowledge and helief, 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 elect, 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, auch physician or officer shall forfeit ten dollars. For the purposes of thia 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. he deemed to have taken place between February fourteenth, eigliteen hundred and ninety- eight 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 budy which has not heen buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it froin a town, from one cenietery to another, or from one grave or tomb other thau the receiving tomb to another In the same cemetery, until he has received a permit from the board of health or its agent aforexaid 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 hoard, agent or clerk, as the case inay 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, 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 be obtained early enough for the purpose, or is insufficient, a physi- cian who ia a member of the board of health. or employed by It or hy the selectinen 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 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 comunonwealth cannot be obtained early enough for the purpose, the certificate of desth made as ahove 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 hody 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. sucb 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 transmilt 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 furulsh for registration any other urce+ 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 hury a hunian 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 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 appointed to have tbe care of the cemetery or burial ground in which the interment ia made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
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 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 phyalcians 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 physlolans will certify to such deaths only aa those of persons who, though disahled hy recogulzed disease unrelated to any form of injury, have died without recent medical attendance or whose phyaf- cian is ahsent from home when the certificate of death ia needed.
(3) Medioai Examinera will investigate and certify to all deatha aup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatiam (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, all deaths following abortion, but also deaths from diseass resulting from Injury or Infection related to occupation, the sudden deaths of persons not disablad hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death meana the disease, or complication which causes death. not the mode of dylug, e. g., heart fallure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng death. As related causes, name earlier morbid conditions, If any, related to the principal cause and any important compliestion of the principal cause.
Statement of Oooupation .- Precise statement of occupation ia very im- portant, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every persoit aged 10 years or over. If the occupation had been given up or changed on account of the dixcase 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 he returned aa at school or at hoine. For a woman whose only occupatiou waa that of honie housework. write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
1 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
125 Cliff Ave.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filled for bartal permit with Board of Health or its Agent
Registrar's No.
§ (If death occurred in a hospital or institution, St.
¿ give its NAME instead of strect and number)
2 FULL NAME
Rebecca (Hasselbrack) Fisher
(If deceased is a married, widowed or divorced woman, give also maiden namc.)
(a) Residence. No.
263 Winthrop Street
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
Inst.
2
years
months
days.
In this community
16yrs.
Mos.
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDWidow
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
William Fisher
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
AGE
8
81
6
Months.
5
Days
If less than 1 day
Hours ..
Minutes
Usual
9 Occupation:
Housewife
Industry
10 or Business :
At Home
11 Social Security No.
None
12 BIRTHPLACE (City)
Egg Harbor
(State or country)
New Jersey
13 NAME OF
FATHER
Conrad Hasselbrack
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Germany
15 MAIDEN NAME
OF MOTHER
Adelade Bolton
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
17 Florence Edwards Daughter Informant. (Address) 263 Winthrop St. Winthrop
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that)a satisfactory standard certificate of death They =D. Children .
(Signature of Agent of Board of Health or othery
Health Officer 7/17/44
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
July
15 1944 (Year)
(Month)
(Day)
19 I HEREBY CERTIFY, That I attended deceased from
May 15, 1944,
to.
July 14
1944
I last saw her alive on
Vulyry, 1944 death is said to
have occurred on the date stated above, at.
3:40 a.M.
Immediate cause of death
Mayocarditis
Duration IMPORTANT 6 mos
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?
Clinical Siins
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed).
(Address)
1 Winthrop
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