USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 69
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Janie Mackenzie
years
if less than 1 dey Hours Minutes
WEften, if any
( Address )
107 Winthrop St Winthrop
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registerad hospital medical officer shall forthwith, after the death of a person whom he has attenled during his last illness, at the request of an undertaker or other authorized person or of any ineinher of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the naine of the deceased, his supposed sge, 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 hia 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-tive 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, sprci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate call-e of death as nearly as he can atate 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 ex- pedition and the Philippine insurrection, which shall, for said purposes. be deemed to have taken place between February fourteenthi, eighteen hundred and ninety-eiglit and July fourth, nineteen Inindred 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 town, or remove therefrom a human body which has not been buried, until he has received a perinit from the board of health, or its sgent 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 oue 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 aelectmen 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 he obtained early enough for the purpose, the certificate of death made as above provided and in the poa- 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-aix hours after such re- moval, 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, aball forthwith countersign it and transmit it to the clerk of the town for regls- tration. The person to whom the perinit ia 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 lo 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 to do front the board of health or its agent appointed to issue such perinits, 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 interment 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 ia within his county the body of such a person, he shall forthwith go to the place wbere 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 auch 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 phystolans will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any forni 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 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
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 node of its productiou together with the circunstances when these arc knowu. For example : "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with aaao- ciated hemorrhage, homicidal." "Asphyxiation by suspension, auicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circunstances 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- stancea leading to medico-legal inquiry. For example : "Ilemorrhage 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
R-301 A
1
No.
2 FULL NAME
(a) Residence No.
(Usual place of abode)
Length of stay: In hospital or Institution
yeara
(Before death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE| 5 SINGLE
male White
MARRIED
( write the word)
WIDOWED
HUSBAND of
idont raices Sampson
(Give maiden name of wife in full )
centr 11/ 10/44
(or) WIFE ot
( Husband's name in full)
IF STILLBORN. enter that fact here.
AGE 69.
Years
Months
Days
Usual
Chauffeur
9 Occupation :
per mes
10 or Business :
11 Social Security No.
more
12 BIRTHPLACE (City)
( State or country)
Boston Muss
13 NAME OF
FATHER
James Magel
14 BIRTHPLACE OF
England
FATHER (Chty)
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Powers
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
P. E.L.
Frances magee (wife)
17
Informant ...
( Address )
Relation, If any
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that offoot.
PARENTS
extracts from the laws on back of certificate.
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
Industry
pohon Undertaken
PLACE OF DEATH Suffolle (County Winthrop (City or Toyn) 6 Court Rd James E. Magel
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.
St.
S ( If death occurred in a hospital or institution, ¿ give ita NAME instead of street aud nuniber) PHYSICIAN - IMPORTANT
( If deceased 'Is a marrige), widowed of divorged wohan, give also maiden name.)
6 Court Rd
St.
(If nonresident, give city or town and State)
months
days.
In this community
17 yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
october.
20.
()fonth)
(Day)
(Year)
19 | HEREBY CERTIFY,
Sehr1.
944
to .
02.20
That I attended daosased trom
un
I last saw h
alive on
act 19.
19 44
hava occurred on tha date statad above, at
9A. m.
n.
Immediate cause ofn
acute Pulmonary Educa
Duration IMPORTANT 1 Day
1 Day ....
Due to.
Choux Hyperkusin
Other conditions.
( Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to oooupation of deceased ?
If so, spacify .........
JEoss. H. SCHWARTZ
(Signed) .....
, M. D.
(Address) O Brucete JF S. B Date
10/22/1944
21
Winthrop
Winthrop
Place of Burial, Creniation or Removal. (City or Town)
DATE OF BURIAL
Och 23
19.
44
22 NAME OF
FUNERAL DIRECTOR:
Charles 1. Treanor
ADDRESS
East Boston
Received and fled
.....
19
( Registrar)
VV
Married
6 Age nf husband or wife if alive 65 yaars
If less than 1 day
Hours
Minutes
100M-6 - 2-42-8855
I HEREBY CERTIFY that a satisfactory standard oartifioate of daath was filed with me BEFORE the burial or transit permit was Issued : William D. Childrens
(Signature of Agent of Board of Health or other)
agent oct- 23/44
(Official Designation) (Date of Issue of Permit)
Registered No.
202
(Wes deocesed a U. S. War Veteran, if so spacify WAR)
1944
19.X
Due to
Coronary Thorarin
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically,
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or 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 suthorized person or of any member of tbe family of the deceased, furnish for registration a standard certifcate of desth, stoting 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 oue. whu're same was contracted. the duration of his last illness, when iast 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 preceiling section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased. to the best of his knowledge and helief, served In the ariny, usvy or merine corps of the I'nited States In any war in which it has been engaged. insert in the certificate . recital to that effect, speci- fying the war. and shall also certify in such certificate both the primary and the secondary or iinmeiliate cause of death as nearis 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 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 body 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 buman body and remove it fromn 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 shali 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 ia 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 boily, not previously interred, from one town to another within the commonwealth 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 removal shali constitute a permit for such removal; provided, thet 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 recitai, 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 chali thereafter furnish for registration any uther veces sary information which can be obtained as to the deceased, ur as to the maner or canse of the desth, which the clerk or registrar may require .- Chap. 114. Sec. 46, G. L., ( Tercentenary Edition).
No undertaker or other person shali bury a hunian 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 hoard, front 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 core of the cemetery or burial ground in which the interment is made .... Chap. 114. Sec. 16. 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 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 lawa 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 iast illness from disease unrelated to any form of injury.
(2) Board of Health physiolans wili 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 medicai attendance or whose phyaf- cian is ahsent from home when the certificate of death is needed.
(3) Medioal Examiners wili investigate and certify to sil (catbs sup- posably due to Injury. These Include not only desths caused directly ur in- directly by traumatism (Including resuiting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, all deaths following abortion, but also deaths from disease resulting from Injury or Infeotion related to occupation, the sudden deatha 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 causea death. not the mode of liying, e. g., heart fellure, asphyxia, astbenia, 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 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 be 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 diacase causing death. report the usual occupation prior to illness, if the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at hoine. For a woman whose only occupation was that of hone housework, write housework. 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 bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
B-301
PLACE OF DEATH.
Suffolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop
(City or town making return)
Registrar's No.
203
St. § (If death occurred in a hospital or institution, [ give its NAME instead of street and number)
1
May Louise (Show) Road
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR).
(If deceased is a married, widowed or divorced woman, give also maiden name.)
161 Quincy 6 St.
(a)
Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
700
years
months
days.
In this community
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Widow
MARRIED
WIDOWED
or DIVORCED
18 DATE OF
DEATH
October
22
1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY
October 19, 1944
to
October 22
197%
That Lattended deceased from
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
William
Burton
(Husband's name in full)
I last saw her
Lalive on
October 22044
death is said to
have occurred on the date stated above, at 1. 450
Immediate cause of death.
Cerebral Hemorrhage
Duration IMPORTANT 3 days
6 meses
Due
Vemility
3 mos
Other conditions
none
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Date of
Of autopsy
What test confirmed diagnosis ?.
Cliqueal #
IMPORTANT Physician Underline the cause to which death should be charged sta- tiatically.
20 Was disease or injury in any way related to occupation of deceasedn
If so, specify.
(Signed) Jacob abrams 6. 80
(Address) 562 Stanley J., Writtengo
M. D.
Date 10/22644
21
(City/or Toway
springfield crematory, Springfield
Plate of Burjal, Cremation or Removal.
DATE OF BURIAL _..
Oct. 24
1944
22 NAME OF
FUNERA
Bacharel 16 White
ADDRESS
Winthis Mass
Received and filed OCT 20 1944
19
A TRUE COPY ATTIST:
(Registrar)
from the laws on back of certificate.
50m-(c)-6-43-12056
17 dou Hazel M. Road Relation, if any
Informant
(Address)
16 quincy ate Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death wss filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board ofHealth or other) Healthe Prices 10/23/14
KOfacial Designation) (Date of Issue of Permit)
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
at home
Industry
10 or Business:
11 Social Security No.
Palmer
12 BIRTHPLACE (City)
(State or country)
mais
13 NAME OF
FATHER
Charles Show
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Mars
Palmer
15 MAIDEN NAME
OF MOTHER
abigail Halt
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
abbinaton
that it may be properly classified. Exact statement of OCCUPATION Is very important. See instructions and extracts
Lf deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to Insert a recital to that effect PARENTS 32 years. par. sas. was hita 10130/4 x
1
"(County) Winthrop
(City or Town) 161 Funcy ave No.
1 FULL NAME
(Give maiden name of wife in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE 7BYears
4
Montha.
27 Days
Due to.
arterinaturais
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 iu 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 hundred and seventeen. G. L. Chap. 46, Sec. 10.
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