USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 59
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DATE FILED
Aug 25/44
19
Received and filed
SEP 12 1944
19
(Registrar of City or Town where deceased resided)
=
V
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Aug 21, 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.) Acute cardiac failure
Probably coronary sclerosis
20 Aooldent, suicide, or homicide (specify)
Date of ocourrenoe
19
Where did Injury oocur ? (City or town and State)
Did Injury occur în or about the home, on farm, In Industrial place, or În publio place ? (Specify type of place)
Manner of
Injury
Collapsed and died quickly
Nature of
Injury
While at work?
Was there an autopsy ?.
no
21 Was disease or Injury in any way related to occupation of deceased?
If so, specify
(Signed)
W ... J .... Brick ley
M. D.
(Address)
Boston Mass
Date 8/21/41
22
Lowell Cem
Lowell ... Ma.s.s ...
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Aug .24 /44
19
23 NAME OF
FUNERAL DIRECTOR
H S Reynolds
ADDRESS
Winthrop .... Mass.
25m (h)-1-41-4667
occurred. (See Chap. 46, Sec. 12, G. L.) of the city or town in which the deceased resided as soon as possible after the close of the month in which the death resided in another city or town at the time of death should be made forthwith and transmitted on Form R-305 to the clerk
PLACE OF DEATH
(County)
1
(City or Town)
No. en route to E B Relief Station
(If U. S.
War Veteran,
speolfy WAR)
Winthrop
R-302
1
PLACE OF DEATH
norfolk (County) Wrentham (City or Town) Wrentham State School
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
Wrentham (City or town making return) 443 63- 69
Registered No.
(If death occurred in a hospital or institution,
No.
2 FULL NAME
Saul Cohen
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 5 Wave way Que. (Usual place of abode)
et Winthrop, mass
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ....
11 years
3 months 25 days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
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
years
7 IF STILLBORN, enter that fact here.
AGE ..
20 Years
9
Months 26 Days
If less than 1 day Hours. Minutes
Usual
9 Occupation :
none
Industry
Patient at
Wrentham State School
11 Social Security No ..
none
12 BIRTHPLACE (City)
(State or country)
massachusetts
بقلمدسن حيا
13 NAME OF
FATHER
William Solen
PARENTS
14 BIRTHPLACE OF
Unknown
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Ida Lefkowitz
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
Unknown
17 Recordo % Informant Wrentham State School Relation, if any (Address) Wrentham, massachusetts
A TRUE COPY.
ATTEST:
Bertha D. Startz
(Registrar of city or town where death occurred)
DATE FILED
august 28, 19
44
22 NAME OF
FUNERAL DIRECTOR
Manuel Stanetchy
ADDRESS
10 wade. St. Dorchester, mass.
Received and filed SEP 1 5 1944 .19
(Registrar of City or Town where deceased resided)
n
Duration
Immediate cause of death
Pulmonary Tuberculosis
Due to
Due to
Other conditions.
Imbecility
Life Physician
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
nove performed
Date of.
Underline the cause to which death should be charged sta- tistically.
Of autopsy
zione performed
What test confirmed diagnosis ?.
Clin, Diay
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify
Charles L. Trickey
M. D.
(Signed)
(Address)
Wrentham
Date 8-25 19 44
21 PLACE OF BURIAL,
CREMATION OR REMOVAL Winthrop Cemetery Everett Mass
DATE OF BURIAL
(City or Town)
(Cemetery)
august 25,
1944
50m (e)-1-41-4667
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
-
St.
give its NAME instead of street and number)
(If U. S. speolfy WAR)
no
1944
18 DATE OF
DEATH
august
24
(Month)
(Day) (Year) That I attended deceased from
19 | HEREBY CERTIFY,
march
1942
to
august 24, 1944
I last saw h une alive on
august 24, 1944, death is said to
.
have occurred on the date stated above, at
5.50P.
.m.
2 700 9 mos.
8
10 or Business :
zu State
(Before death)
(Specify whether)
-303-A
1
PLACE OF DEATH
(County) Winthrop. Registered No. (City or Town) Hintting Comments Hostartal St. { { If death occurred in a hospital or Institution, ( give its NAME instead of street and number)
No.
James A. Wallace
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, If so specify WAR) No
(a) Residence. No.
36 Banks St. Winthrop
(Usual place of abode)
Length of stay: In hospital or Institutlon
.hospital -years
*months
7
days.
In this community
25 yra.
mos.
-
days.
( Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACEJ
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED married
male
white
5a If married, widowed, or divorced
HUSBAND of
...
Christine .... A ...... Ryan
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife If alive
65 years
years
7 IF STILLBORN, enter that fact here.
8 AGE ... 68 .. Years. 1 Months. 9 Days
If less than 1 day
Hours.
.Minutes
Usual
9 Occupation :
Police watchman
Industry
10 or Business :
B & A Railroad
11 Social Security Nonone.
12 BIRTHPLACE (City)
(State or country)
Mass
Fast .... Bo.s.t.on
13 NAME OF
FATHER
James A. Wallace
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Margaret Russell
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Christine.A. Nallage. Relation et any Informant ( Address) 36 Banks St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burian or transit permit was Issued : . ADDRESS Boston
(Signature of Agent of Board of Health or other)
(Official Designation) (Date of Issue of Permit)
C
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jebt - 6
(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, etate fully.) Left Corman occlusion. Bilateral Cormary Vcleveres Old Candiac Infarct
n
20 Accident. sulcide, or homiolde (specify).
Date of ocourrenoe.
19
Where did
Injury occur ?
(City or town and State)
Did Injury goour In or about home, on farm, In Industrial place, or In publlo
place ?
(Specify type of place)
Manner of
Injury
Collapsed suddenly & fell to
Nature of
Injury
ground
While at work ?
Was there an autopsy?
21 Was disease or Injury in any way related to ocoupatlon of deceased?
If so, specify
(Signed)
( Address)
Boten
Jour-7-1944
22
Winthrop Ce ... Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
September 9 1944
19
23 NAME OF
FUNERAL DIRECTOR
R.C.Kirby
Received and filed SEP 1 3 1944
19
(Registrar)
extracts from the laws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a recital to that effect
PARENTS
50m (g)-1-41-4667
2 FULL NAME
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
174
St.
(If nonresident, give city or town and State)
-
1944
-M. D.
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 bis 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 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 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 bundred and fourteen, the word "war" sball include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen bundred and ninety-cight 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. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a towu, or renlove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he bas 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 facts required by law to be returued 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 pbysi- cian who is a member of the board of health, or employed by it or by the selectinen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medical 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 above provided and in the pos- session 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 re- inoval, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army. navy or marine corps of the United States in any war in wbich
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, ahall forihwith countersign it and transinit it to the clerk of the town for regla- 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 as 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 bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so 10 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 per- son appointed to have the care of the cemetery or burial ground in which the internient is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
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.
... He 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. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physi- cian 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 deatbs caused directly or In- directly by traumatism (including resulting septicemia), and by the actlon of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths fromn 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
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 and 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 steanı railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by 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."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basal ganglia ) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
01
1
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
The 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.
Registrar's No.
[ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
ManuelVeira Corinha
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
36
Plummer Ave
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
2days.
In this community
60 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEMarried
5a If married, widowed, or diyorced
HUSBAND of
Mary E. Gillis
(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.
AGE
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Brush Maker
Industry
10 or Business:
Brush
11 Social Security No. 928 -01-5758
12 BIRTHPLACE (City)
Boston
(State or country)
Magg
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Azores
15 MAIDEN NAME
OF MOTHER
Rosa Rebello
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Azores
17 Mary Es farinha Pristine if any Informant
(Address)
38 Lummer Ave
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death Williams, Children
(Signature of Agent of Board of Health or other)
agent
Sept. 9/44
(Official Designation) (Date of Issue of Kermit)
18 DATE OF
DEATH
(Month)
(Day)
8
1944
(Year)
19 I HEREBY CERTIFY,
44
19
to
That I attended deceased from
I last saw h
Msnlive on
Ja, 044 death is said to
have occurred on the date stated above, at ...
_M.
Immediate cause of death EMPYENA
Duration IMPORTANT 3 days
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations
Date of.
Of autopsy.
What test confirmed diagnosis?
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
@ Fachowy, M. D.
(Signed).
Iwantumption Date 91-8 19 44
(Address)
21 Winthrop Winthrop
Place of Burial, Cremation of Removal. DATE OF BURIAL
(City pr Town)
Sept
II
1944
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
John Fi Maley
Received and filed
SEP 11 1944
19
(Registrar)
If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect.
avur uID AuwD "Vi vuCK VI Ceriulcule.
50m-(e)-3-43-11574
.
No.Winthrop Community Hospital
(Usual place of abode)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
19
8
65
Years.
Months.
Days
13 NAME OF
FATHER
Antone
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 bundred and four- teen, sball, if the deccased, 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 relief 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 bundred 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 board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may 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, 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 carly 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 be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- 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 bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such 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 lield, or from a person appointed to have tbe 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 witbin 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; . . . - Gencral Laws, Chap. 38, Sec. 6.
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