USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 84
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son
(Address) 19 Jefferson St Winthrop
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death Williamt. Chilchess,
(Signature of Agent of Board of Health or other)
agent 12/17/44
(Official(Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
Que
16
1944
(Year)
(Month)
(Day)
19 I HEREBY CERTIFY
Feb 15
19.429
to
That I attended deccased from
Que 16
19.9252
I last saw her alive on
One 16, 1944 death is said to
have occurred on the date stated above, at/ 2.55 A. M.
Immediate cause of de
Pulmonary Order
oedema
Duration IMPORTANT 920
Broken Compensation.
Due to .....
? Plomatic ource
Due to
/
Cardiovascul
Other
Hypartenaire Cardio Vascular
(Include pregnancy within 3 months of death) Senare
Major findings:
Of operations.
Date of.
Of autopsy.
What test confirmed diagnosis ?.
clinical
MEPORTANT
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
(Signed)
(Address) 48 Wirthofedt.
Date 12/16/
M. D.
21
winthrop
map han winthrop
Place of Burial, Cremation or Removal.
(City or Town)
44
19
22 NAME OF
FUNERAL DIRECTOR
John F. Omalen
ADDRESS
Winthrop Massachusetts
Received and filed.
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. PARENTS
from the laws on back of certificate.
50m-(e)-3-43-11574
PLACE OF DEATH
Suffolk (County)
Registrar's No.
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
2 FULL NAME
Catherine F Dailey
MEDICAL CERTIFICATE OF DEATH
stenous
17 George Dailey
DATE OF BURIAL
December 19
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 deccased, furnish for registration a standard certificate of deatlı, stating to the best of his knowledge and belief the name of the deceased, bis supposed age, tbe 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- 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 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.
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 huricd, 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 hoard 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 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 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 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 dicd 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 bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled 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 or indirectly 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 discase, 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 business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of 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
R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 117 Court Rd Winthrop
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.
Registered No.
252
S ( If death occurred in a hospital or Institution, St.3 give Its NAME instead of street aud number)
2 FULL NAME
Elizabeth A. Glassett
( If deceased Is a married, widowed or divorced
woman, give alao maiden name.)
(a) Residence. No.
117 Court Rd. . Winthrop
St.
(If nonresident, give city or town and State)
75
in this community
yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December
16
(Month)
(Day)
,
(Year)
19 | HEREBY CERTIFY, That I attended deosasad from
November 4
1944, to December 16.
19
4€
I last saw h.
... alive on ...
December 16, 1944, death Is said to
have occurred on the date stated above, at.
4:30 P.m.
Immediate cause of death 2)
Chronic Glomerulone phritis
Duration
IM BREADS.
...... 6 days.
Due to.
ArtEmoscholicHeat
Disease with decompensation 1 month
Other conditions.
hone
(Include pregnancy within 3 months of death)
Major findings :
Of operations
none
Date of.
Of autopsy
none
What test confirmed diagnost Clinical+ Faboralar
tistically.
20 Was disease or injury in any way related to occupation of deceased ? no. If so, specify ..
....
(Signed) Maurice Traunstein
(Address) 562 Stilly SDate Declub 0 19 1944
21
Holy Cross Malden
l'lace of Burial, Creniation or Removal.
(City or Town)
DATE OF BURIAL
December19 1944
19
22 NAME OF
FUNERAL DIRECTOR
R.C.Kirby
AODRESS
Boston, 2,2010
Received and fled IL 181911
19
( Registrar)
100M-6 - 2-42-8855
1
No.
-
(Usual place of abode)
Length of stay : In hnsoital or Institution
none
(Before death)
(Specify whether)
PERSONAL ANO STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female
white
Sa If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Thomffie piden cra's 's fill)
( Husband's name in full)
> IF STILLBORN. enter that fact here.
8
AGE
76
Years
3
Months
2.4. Days
At Home
Usual
9 Occuoation :
Industry
10 or Business :
Housewife
11 Social Security No.
none
Parkgate
'2 BIRTHPLACE (City)
( State or country)
England
14 BIRTHPLACE OF
FATHER (City)
(State or country ) Ireland
15 MAIDEN NAME
OF MOTHER
Mary Dorber
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country) England
17
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
extracts from the laws on back of certificate.
terina, au Tuar if may be property classified. Exact statement of decorAtion is very important. See instructions and
13 NAME OF
FATHER
Stephen J. Whelan
5 SINGLE
( write the word)
MARRIED
WIDOWEO
or DIVORCEPi dowed
6 Age of husband or wife if alive years
If less than 1 day Hours .. Minutes
Albert E. Glassett( .s.on
Relation, If any
Informant
( Address)
117 Court Rd .. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was Issued: W.M. D.Chuldreser
(Signature of Agent of Board of Health or other)
Health Office 12/18/44
(Oficial Designation) (Date of Issue of/Permit)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so speolfy WAR)
no
years
months
days.
1944
Due to Uremia
....
IMPORTANT Physician L'uderline the cause to which death should be
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 ans meniber of the family of the deceased, furnisb 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 illnesa, when last seen alive by the pbyaician or officer and the date of bia 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 ariny, 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 effect, 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, such physician or officer shall forfeit ten dollars. For the purposes of thia aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deeincd to have taken place hetwcen February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen 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 body which has not been buried, until he haa 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 otber person ahall exhume a buman body and remove it from a towti. from one cenietery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there aball bave been delivered to sucb board, agent or clerk, as the case inay be, a satisfactory written statement containing the facts required by law to be returned ail 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. o1 in lieu thereof a certificate as liereinafter 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 aelectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, tbe medi- cal examiner shali make such certificate. If aucb a permit for the removal of a human body, not previously interred, from one town to another within tbe comnonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of tbe 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 aerved in the army, navy or marine corps of the United 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 coulter-ign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other nece+ sary information which can be obtained as to the deceased, or as to the matter of 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 ashea thereof which have been brought into the commonwealth until he has re- Celved a permit so to do from the hoard of health or its agent appminted to Issue such perinits, or if there is no such hosrd, 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 tbe care of the cemetery or burial ground in which ibe internient is made .... Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as sre supposed to have died by violence. If a medical examiner has notice that there is within his county the hody of such à person, he shall forthwith go to the place where the boxdly liea aud 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 deatha only aa those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deatha only aa those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical atteinlance or whose pbyal- clan is ahsent from home when the certificate of death is needed.
(3) Medloal 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 Infeotion 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 modie of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name tbe disease caualug death. As related causes, name earlier niorbid conditions, if any, related to the principal cause and any important complication of the principai cause.
Statement of Occupation .- Precise statement of occupation ia very im- portant, so that the relative bealthfulness of various pursuits can be known. Make some entry in this section for every persou aged 10 years or over. If the occupation had been given up or changed ou account of the discase. causing desth, report the usual occupation prior to illness. If the deceased bsd retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at huine. For a woman whose only occupatiou waa that of home bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, aa bousekeeper-private faniily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
·
RM R-302
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
PLACE OF DEATH
BOSTON (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
1
(City or Town)
No.
Melville Nursing Home
St .
S (If death occurred in a hospital or institution,
3 give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
war Veteran,
specify WAR)
(a) Residenoe. No.
237 .... Shirley ..... St.
St.
Winthrop
(Usual place of ahode)
Nursing Home
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
7
montha
days.
In this community
yrs.
7
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX F
4 COLOR OR RACE|
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEWidowed
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
( Give waisen per fowife in full)
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8
AGE .. 7.0.
... Years
Months.
.. Days
If less than 1 day .Hours ... Minutes
Usual
9 Occupation :
None
industry
10 or Business :
--
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
Rus sia
13 NAME OF
FATHER
Joseph Josephson
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Freda - --
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17
Informant.
(Address)
A TRUE COPY.
ATTEST :
22 NAME OF
FUNERAL DIRECTOR
B.F. Solomon
ADDRESS
·Brookline
Received and filed.
19
DATE FILED
(Registrar of city or town where death occurred) Dec. 20, 1944
19
( Registrar of City or Tow
Town where deceased resided)
T
Due to
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of
Underline the cause to which death should be charged sta- tistically.
Of autopsy.
What test confirmed diagnosis@lin ..... findings
20 Was disease or injury in any way related to occupation of deceased ?. no .. If so, speolfy
(Signed)
R. J. Sherman
M. D.
(Address)
Boston
Data12 18/44
21 PLACE OF BURIAL, Har Morish, W. Roxbury
CREMATION OR REMOVAL ..
(Cemetery)
DATE OF BURIAL
Dec ...... 19., .... 1.9.4.4
19
(City or Town)
Freda Tabachnik
Relation, if any
Daughter
18 DATE OF
DEATH
De.c ..... 18 .. .... 1944.
(Month)
(Day)
(Ycar)
19 |HEREBY CERTIFY,
12/13/44
19
That I attended deoeased from
to ...
12/18/44
19
i last saw h .............. alive on
12/17 /44
19
death is said to
have occurred on the date stated above, at. m.
Duration
Immediate cause of death.
Coronary occlusion with cardiac
decompensation
Due to.
Generalized advanced
arteriosclerosis
50m (e)-1-41-4667
1 0
W
Rose Berlow
Registered No.
10917253
RECEIVED
TOV
OF
OFFICE O
11 1.2. 1
2
GLERA
1111
ASS
WIN
6
IROP M
JAN-91945 AM
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 If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effeot. PARENTS
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
125 Cliff Ave.,
Winthrop
The Commonforalth 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, 255
( ( If death occurred in a hospital or institution, give ita NAME instead of street aud number)
2 FULL NAME.
Nathaniel Edwin Lewis
( If deceased is a married, widowed or divorced womsn, give also maiden name.)
(a) Residence. No.
125
Cliff Ave ..
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