USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 15
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MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE|
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
,
ED Married
Sa If married, Midoved, 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 65 years
IF STILLBORN. enter that fact here.
8 AGE 75 Years Months Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
Barber
fr
Industry
himself
11 Social Security No.
·2 BIRTHPLACE (City)
(Siate or ennutry)
Hungary
13 NAME OF
FATHER
Harry Greenfield
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Hungary
15 MAIDEN NAME
OF MOTHER
mollie- unknown
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Hungary
17 Informant ( Address) 15
Or HaroldB. Greenfield Religion in any DATE OF BURIAL. Mer. 18,
22 NAME OF
manuel Stanitipy
FUNERAL DIRECTOR
ADDRESS
10 Washington
IT, Ppt
Received and Aled FED"1 9-1945 19
(Registrar)
1
PLACE OF DEATH
...
Suffolk ........... ( County) Winthrop (City or Towny .... 14 coral ave No. graph Greenfield
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. 4
4.2
S ( If death occurred in a hospital or institution, St. (glve ite NAME Instead of street and nuniber)
PHYSICIAN · IMPORTANT
2 FULL NAME.
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 14 coral
(Usual place of ahode)
St.
Worth
(If nonresident, give elty or town and State)
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
yeara
months
days.
In this community
mos.
days.
18 DATE OF
DEATH
February
16
(Month)
(Day)
(Year)
191938 to.
1945
19 | HEREBY CERTIFY,
That 1 attended daosased from
Sept 20
Feb
16
I last saw h ..........
... alive on
Feb
15
19.45, death Is said to
have occurred on the date stated abova, at
9:45
.A.m.
Immediate oause of death. 1 Coronary thrombosis
(2) Congestive heart failure
3 year ....
Dua to.
Due to
Other conditions ..
chronic myoconditio
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy.
What test confirmed diagnosis ?
IMPORTANT
Physician
L'uderline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased ?. If so, spaolfy.
(Signed ) .....
H.B. greenfield
..... . M. D.
(Address) 447 Shidey St, Whithoop Date Telis 1945
21 Winthroto com Cover - mais l'lace of Burial, Cremation or Removal. (City or Town) 45 19
Registered No.
(Was deceased a
U. S. War Veteran,
if sp speolfy WAR)
no
22
yrs.
1945
nol
runthold
Duration IMPORTANT
10 or Business:
PERSONAL AND STATISTICAL PARTICULARS
Winth
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 sny meniber of the family of the deceased, furnisb 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 ss re- quired by section one. where same wss contrscied. the duration of his last illness, when last seen slive 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 decessed, to the best of his knowledge and belief, served in the army, navy or marine corps of the l'urited States In any war in which it has been engaged, inserl in the certificate a recital to that effect, speci- fying the war, and shall slso certify in such certificate both the primary and the secondary or inmediate 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 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 Chins 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- csn 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 buman body in s 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 permita, or if there is no such board, from tbe 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 thau 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 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 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, 01 in lieu thereof a certificate aa 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 aelectinen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence. tbe medl- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within tbe commonwealth cannot be obtained early enough for the purpose; tbe certificate of desth made as above provided and in the possession ot 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, unlesa a permit in the usual form for the removal of such body has been sooner obtalned 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. 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 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 mater or cause of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 45, C. L., (Tercentenary Edition).
No undertsker or other person shall bury s 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 hoard of health or its agent appointed to issue such perinita, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have tbe care of the cemetery or burial ground in which the interment is made .... Cbap. 114. Sec. 46. C. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons ss are supposed to have died by violence. If s 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 body 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 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 physlolans will certify to such desths 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 pbyaf- cian is ahsent from home when the certificate of death ia needed.
(3) Medioal 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 clienical (drugs or poisons), thermal, or electrical agents, and deatbs following ahortion, but also deaths from diseass 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 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 on account of the dixcase causing death, report tbe 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 an at school or at hoine. For a woman wbose 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 terms, as housekeeper-private family, cook-hotel, etc. For a person wbo had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
ORM R-305
3 SEX
F
(or) WIFE of
Usual
9 Occupation :
PARENTS
17
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Industry
10 or Business :
4 COLOR OR RACE
5 SINGLE
(write the word)
W
MARRIED
WIDOWED
or DIVORCEDWidowed
5a If married, widowed, or divorced HUSBAND of
(Husband's name in full)
6 Age of husband or wife If alive years
7 IF STILLBORN, enter that faot here.
8
AGE
62
Years
Months
10 Days
if less than 1 day
Hours.
Minutes
At .... home
none
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Boston, Mass.
13 NAME OF
FATHER
unknown
14 BIRTHPLACE OF
FATHER (City)
(State or country)
unknown"
15 MAIDEN NAME
OF MOTHER
Margaret Flynn
16 BIRTHPLACE OF
MOTHER (City)
New .... York., ..... N ... Y ...
(State or country)
D.Macdonald (Daughter)
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
deago
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Feb. 18, 1945
(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.) Pulmonary embolus: thrombosis of It popliteal vein: Recent imcom- plete fracture It patella
20 Aooident, sulolde, or homloide (specify) ..... Accidental Date of oocurrenceabout .... Dec25 1949
Where did
injury ooour ?
? Winthrop
(City or town and State)
Did Injury occur in or about the home, on farm, in Industrial piace, or in publio place ?
Manner of
Said to have fallen accident-
Injury
ally at .... Winthrop about
Nature of
Dec 25/44
Injury
While at work?
Was there an autopsy ?..... y.eg
21 Was disease or injury In any way related to oooupatlon of deceased?
If so, specify.
(Signed)
W J Brickley
M. D.
(Address)
.Boston
Dat2/ 19/1155.
22
Holy Cross, Malden
Place of Burial, Cremation or Removal.
(City or Town)
Relation, if any
DATE OF BURIAL
Feb .21 , .... 1945
19
23 NAME OF
FUNERAL DIRECTOR
R Ç Kirby
ADDRESS
Boston
Received and filed 19
MAR 2
1945
(Registrar of City or Town where deceased resided)
25m (b)-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 Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
1
PLACE OF DEATH
(County)
BOSTON
(City or Town)
No. Mass General Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
43
Registered No.
1643
St. (If death occurred in a hospital or institution, give its NAME instead of atreet and number)
2 FULL NAME
Margaret Macdonald
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
58 .Bellevue ..... Ave.
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
monthourda
In this community
yrs.
mos.
days.
(if U. S.
War Veteran,
specify WAR)
no
PERSONAL AND STATISTICAL PARTICULARS
1
Informant
(Address)
DATE FILED
Feb. 23, 1945
19
(Specify type of place)
-301 A
PLACE OF DEATH
Suffolk (County)
SENSE PETTO
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
To be filed for burial permit with Board of Health or its Agent. 44
Winthrop Community Hosp .. st. $ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME Dagid F Ingersoll
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
34 Enfield hd
(Usual plece of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
months
days.
In this community 2 3 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE!
5 SINGLE
( write the word)
18 DATE OF February
22
1945
DEATH
(Month)
(Day)
(Year)
Male White
5a If married, widowed, or divorced HUSBAND of
Marie I Mclaughlin June 15, 1944
to
Felmay 22
195
(or) WIFE of
( Husband's name in full)
62
yaars
7 IF STILLBORN, enter that fact here.
8
AGES 9 Years
Months ...... Days
if less then 1 dey
Hours
Minutes
Usual'
9 Occupation :
10 or Business :
Industry
silver ware
11 Social Security No.
12 BIRTHPLACE (City)
( Sinte or country)
Brocton
13 NAME OF
FATHER
Benjamin f.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Maria Jaddett
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Novia fatia
17 Informent ( Address)
rig 54 Enfiela na.
Ingersoll Relation, If any ( Nite Place of Burial, Cremation or Removal. (City or Town) DATE OF BURIAL ... February 25, 1945. 19
I HEREBY CERTIFY that a satisfactory standard pertifioate of death was filled with me BEFORE the burlap or transit po mit was issued: Com. Ilchildren
-
(Signature of Agght lot Board of Health for other)
att Feb. 25/45
....... (Omelal Designation) ( Date of Treue of Permith
20 Was disease or injury in any way related to occupation of deceased ? O if so, specify ..... M. D. (Signed) Jaest abrams .
(Address) 5.62 Hurley OT,
to 2/24 1945
21
Winthrop-Benitez Hteo
22 NAME OF
FUNERAL DIRECTOR
Airby Bros.
ADDRESS
210 Winthrop St ....
Recalved and Alad
F.E.B. 2 .6 .... 1945
19
( Registrar)
.... 8 mos
Due to
Other conditions
( Include pregnancy within 3 months of death)
Mejor findIngs:
Of operations
none
Date of
Of eutopsy
What test confirmed diegnosis ?.
climone x lab
IMPORTANT
Physician Underline the cause to which death should be charged «a. tistically.
100m(i)-1-44-13634
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a rooitai to that effect. PARENTS
Duration 15 minutes
Immediate, cause of death acute Coronary Thrombosis
Due to
augura Pectoris
19 | HEREBY CERTIFY,
That I attended deosased from
Mast saw h.
allve on
February 2 207, death is said to
have occurred on tha date stated above, at
9 A.
m.
6 Age of husband or wife if alive
(Give maiden name of wife in full)
MARRIED
WIDOWED
or DIVORCED
Married
PHYSICIAN . IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
No.
winthrop (City or Town)
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 ariny, 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.
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 sball 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 witbin 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).
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, Cbap. 38, See. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he bas 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).
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 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 deatb. 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 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. -
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