USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 52
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(Signature of Agent of Board of fresfth or other) Heatthe Office 8/10/44
(Official Designation) (Date of Issue of Permity
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
IMPORTANT Physician Underline the cause to which death should he charged sta- tistically.
20 Was disease or Injury in any way related to occupation of deceased?
If so, specify.
(Signed) Jennie S. Hartman
M. D.
(Address) 17 Washington by Date 8-9
19.4.4
21 S. Miguel Place of Burial, Cremation of Renovat. Call City of Town) DATE OF BURIAL Aug10
ADDRESS
22 NAME OF
FUNERAL DIRECTOR.
215
Worth Sh Beste
19
1
(Registrar)
50m-(e)-3-43-11574
PLACE OF DEATH
(County) Winthrop (City or Town) Winthrop Communite Hospital St.
I
. If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. su hospital PARENTS
5a Ifmarried, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here
Stillfor.
Due to.
Received and filed.
1110 11 1944
[ (If death occurred in a hospital or institution, { give its NAME instead of strect and number) PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
1944
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he 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 registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last scen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- tecn, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such fphysician 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 fourtcen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the hoard 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 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 hoard of health or its agent aforesaid or from the clerk of the town where the hody is huried. No such permit shall be issued until there shall have heen delivered to such board, agent or clerk, as the casc 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, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the 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 removal shall constitute a permit for such removal; provided, that such body 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 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 heen engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the nanner 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 body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do froin 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. 46, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness front 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 phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly cr indirectly by traumatismn (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths fromn disease resulting from injury or infection related to occupation, the sudden deathis of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can he 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 husiness, 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, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A Suffolk
1
PLACE OF DEATH
County) Denthrop
(City or Town) 79 Cliff avec. No.
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. 15062
Registered No.
St. $ { If death occurred in a hospital or institution, ( give its NAME instead of street and number) PHYSICIAN - IMPORTANT
Jesinie Cohen
{If deceased is a married, widowed or diyorced woman, give also maiden name.
. (a) Residence. No. 79 cliff que St.
(Usual place of foode)
Length of stay: In hospital or Institution (Before death) (Specify whether)
years
months days.
(If nonresident, give city or town and State)
In this community 23 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female Muli.
4 COLOR OR RACE| 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word) married
5a If married, widowed, or divorced HUSBAND of (or) WIFE of
( Husband's name in fuli)
56 years
6 Age of husband or wife if alive
IF STILLBORN. enter that fact here.
8 AGEL
5. Years Months Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
Sauxerife
Industry 10 or Business :
athome
11 Social Security No. mone
'2 BIRTHPLACE ( City)
(Siate or country)
Russia
13 NAME OF
FATHER
Louis abrams
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME OF MOTHER annie (unknown
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Jacob Cohen ( Relation, if any
Informant .. (Address)
I HEREBY CERTIFY that a Satisfactory standard oortmodt Arith was
filed with me BEFORE the burial or transit permit was Issued
"(Signature of Agent of Board of Health or other) Health Officer 8/10/44
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
august
10
1944
( Month )
(Day)
(Year)
19 | HEREBY CERTIFY,
June
3
1944
That I attended deosased from
Ło.
August 10
44
19
Plast saw her
.allve on ...
august 10, 19 44 de
death Is sald to
have occurred on the date stated above,
at 12:20 P.m
Immedlate oause of death.
Carcinoma of uterus
IMPORTANT 2 years
Due t
Several Cancunmatosis
Due to.
Other conditions.
none
( Include pregnancy within 3 months of death)
IMPORTANT
Physician
Underline
Of autopsy.
none
which death should be
What test
nfirmed dlagn
Clinical + labua
Itistically.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify .....
(Signed) Jacob
Chiamo Mia
Hurley JT Date Cinq 10 1974
21 andra Valin
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
aug //-
44 19.
22 NAME OF
FUNERAL DIRECTOR,
Jacob Hoferrice
ADDRESS
39 Math. Secondo
Received and fled AUG 11 1944
19
( Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physicians to Insert a recital to that offoot. PARENTS
100M-6 -2-42-8855
2 FULL NAME.
(Was deceased a
U. S. War Veteran,
if so spoolfy WAR)
MEDICAL CERTIFICATE OF DEATH
Duration
5
1year
Major findIngs:
Of operations
Cancunna o eterno
Date
o
October 1942
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physiolan or registered hospital medical officer shali forthwith. after the death of a person whoin he has attended during his last illnesa, at the request of an undertaker or other authorized person or of ans meniber of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one, wlivre same was contracteil. the duration of his last illness, when last seen alive by the physician or officer and the date of hia death ... Cen. Laws, Chap. 46, Sec. 9.
A' physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served In the army, navy or marine corpa 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 imnmeiliate cause of death as nearly as he can state the ssine. 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 purposes. 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 aud 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 hody which has not been buried, until he has received a permit from the board of health, 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 undertaker or other person shall exhume a human body and 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, until he has received a permit from the board of health or ita agent aforesaid or from the clerk of the town where the boily is buried. No such permit shall be issued until there sball bave been delivered to sucb board, agent or clerk, as the case inay be, a satisfactory written statement containing the facts required by law to be returued 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. of 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 meniber 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 death is caused by violence, the medi- cal examiner shall make such certificate. If auch a permit for the removal of a human body, 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 above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that auch 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
hy section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the I'nited States In any war in which it has heen 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 transmiit 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 of 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 hody or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the hoard 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 grouml in which ibe interment is made. ... Chap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners ahall make examination upon the view of the dead hodies of ouly such persons as are supposed to have died by violence. If a medical examiner has notice that there is within lils county the hody of such a person, he shall forthwith go to the place where the hody llea 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 deatha only as those of persons to whom they have given hedside care during a fast 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 pbyaf- cian is ahsent from home when the certificate of death is needed.
(8) Medloal Examinera will Investigate and certify to all dcatba sup- posably due to Injury. These include not only deaths caused directly or in- directiy hy traumatism (including resulting septicemla), and hy the actlon of chemical (drugs or poisons). therius], or electrical agents, aml deatbs following abortion, hut also deaths from disease resulting from injury or Infeotlon 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 meana the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name tbe 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 ia very im- portant, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every person aged 10 yeara or over. If the occupation had been given up or changed on account of the discase causing death, report the usual occupation prior to illness. If the deceased had retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may he returned aa at school or at home. For a woman whose only occupation waa that of honie bousework. write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private faniily, cook- hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
01 A
Jackson heights Suffolk /6/ 8 (County)
n. y. Wefeedthe Commonwealth 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.
Registared No.
{ {If death occurred in a hospital or institution, give its NAME instead of street and number)
Baby Girl Benoit
2 FULL NAME.
( If deceased is a married, widowed or divorced woman, give also maiden namei)
(a) Residenca. No.
2212- 78Th Street (Usual place of abode)
Length of stay: In mesoltal or Institution
( Before death)
( Specify whether)
years
months
days.
in this community
yra.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE| 5 SINGLE
( write the word)
Female
White
MARRISO
WIDOWED
or DIVORCEO
Single
Sa 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 aliva
years
7 IF STILLBORN, enter that fact here.
8 AGE Years Months Days
day
Usual
9 Occuoetlon :
If less than 1 Hours F. Minutes 28
Industry 10 or Business :
11 Social Security No.
Winthrop
12 BIRTHPLACE (City)
( Siste or country)
MASS.
13 NAME OF.
FATHER
BENJAMIN L. Benoit Ji
14 BIRTHPLACE OF
FATHER (City)
Lowell
(State or country)
Mass.
15 MAIOEN NAME
OF MOTHER
Natalie ANN BLANCHARD
16 BIRTHPLACE OF
MOTHER (City)
CONCORD
( State or country )
MASS
17 Informant (Address )2124) 787 St. Jackson Heights new york
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE the burlai or transit permit was Issued : William D. Childress -
(Signature of Agent of Board of Health or, other) agent aug. 12/44
(Official Designation) ( Date of Irque ot Permit)
18 DATE OF
DEATH
(Month)
( Day)
(Year)
19 | HEREBY CERTIFY,
That 1 attended deosased from
nap 11. 19 44.
to
1)
19 44
1 last saw h.
ET allve on.
Shand 1. 19 44 death is said to
have occurred on tha date stated above, at.
Immediate oause of death
7:15
Premature 7 /2 months
Que to.
Placenta Previa
Due to
Other conditions.
( Include pregnancy within 3 months of death)
PraCENTA
Major findIngs :
Ofoperations
١٨×٣٣٤
Date of Au q 17-1944
Of autopsy
What test confirmed diagnosis ?
IMPORTANT
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? NO
if so, spaolfy ...........
('Signed)
( Address) 200 WartenG
Ostedet 1/
21
Benjamin Benoit & Father
any
DATE OF BURIAL
August
(City or Town)
14
1944
22 NAME OF
FUNERAL DIRECTOR
Rothwell MACRAe
ADORESS
CONCORD MASS
Recaived and Aled
AUG 15 1944
.. 19
(Registrar)
100m(i)-1-44-13634
ital If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a reoltai to that effeot. PARENTS
PLACE OF DEATH
1 WINTHROP (City or Town) Wirthrop Community Hospital No.
Jackson Heig
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
New York
(If nonresident, kive elty or town and State)
MEDICAL CERTIFICATE OF DEATH
1944
Duration
IMPORTANT
,
. M. D. 19 .
st. Patricks Cenciary - howell, MASS- Piace of Burial, Oremetion or Nen del.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he 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 registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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