USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 29
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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 hoard of health, or its agent, upon receipt of such statement and certificate, shall forth with 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 he 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 hody of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall hury a human hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the hody is to be huried or the funeral is to he 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 hedside 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 hy recognized disease unrelated to any . forin ofrinjury, have died without recent medical attendance or whose phy- sician is ahsent 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 hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut 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 death. As related causes, name earlier morhid 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 heen 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 he 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 hy the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-301 AL Suffolk (County)
E NOTATED
1945
MAY 7 5 parfaital
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permii with Board of Health or its Agent.
Registered No.
84 ...
{ If death occurred in a hospital or institution, give its NAME instead of street and nuniber) St.
2 FULL NAME ama J. Mª Barry
( If deceased is a married, widowld or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode);
Length of stay: In hospital or Institution (Refore death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
( write the word)
yeers
IF STILLBORN. enter that fact here.
8 AGE 77 Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
10 or Business :
Industry
Pause mark
11 Social Security No.
12 BIRTHPLACE (City)
( Siste or conutry)
...
Charlton
Tamil carolina
13 NAME OF
FATHER
hu Watch
14 BIRTHPLACE OF
FATHER
Ireland
(State or country)
15 MAIDEN NAME
OF MOTHER
But while to learn
16 BIRTHPLACE OF " MOTHER'. (City) (State or country)
Mut able to be
17 Informant
arnaud
Relation, Kuny
il ay Pure
I HEREBY CERTIFY that a satisfactory standard certificate of death wes filled with ma BEFORE/the burial or transit permit was Issued :
-
(Signature, of Agent of Board of Health of other) 14/12/45
(Omcial Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
APRIL
1945
( Month )
(Day)
(Year)
I HEREBY CERTIFY,
That & attanded deosasad from
19 ...
Ło.
april 9
19
Last saw his
5. 19 death Is said to
have occurred on the date stated above, at
15302 .
Immediate couse of death .. -
IMPORTANT
Intestinal Freundende
Dua to.
Tariamente quatro
Due to.
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations
Dete of
Of eutopsy.
What test confirmed diagnosis ?
Physician Underline the cause to u hich death should be charged sta- tistically.
20 Was disease or Ajury inany way related to oooupation of deceased ? If so, spaolfy ..
(Signed)
(Address) En Beach Ruben Data 15
9
..
M. D.
19XX
21
Place of Burial, Cremation
DATE OF BURIAL
24/ex 13
(City or Town)
19.4 ..
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and Aled. 19
APR 1 5-1945
( Registrar)
100M-G ·2·42-8855
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a reoltal to that effect. PARENTS
PLACE OF DEATH r
1
Windy !! No.
118 Kinchall and Rescue
"name.)"
(Wes deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
years 2 months days.
In this community
yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
5 SINGLE
MARRIED
WIDOWED
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
ToGive maiden name)
( Husband's name in full)
6 Age of husband or wife if ali
Duration
4-9-45
Malden
(City or To my
PHYSICIAN - IMPORTANT
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital msdloal officer shali forthwith, after the death of a person whoin he has attemuled during his last illness, at the request of an undertaker or other authorized person or of any 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 se re- quired by section one. where ssme was contracted. the dursiion of his last fliness, when Isst seen slive by the physician or omcer and the date of his desth ... Gen. Laws, Chap. 16, Sec. 9.
A physician or officer furnishing a certificate of death aa 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 army. 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, sud shall also certify in such certificate both the primary and the secondary or iinmeiliate cause of death as nearly as he can state the saine. For neglect to comply with sny provision of this section, auch 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, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety.eiglit 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. #Sec. 10.
No undertaker or other parson 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 the clerk of the town where the person died; and no undertaker or otber person shall exhume a buman body and remove it froin 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 sucb permit ahsll be issued until there shall have been delivered to sucb board, agent or clerk, as the case may be, satisfactory written statement containing the facta required by law to be returned sul recorded, which shall be accompanied, in case of an original interneut, by a satisfactory certificate of the attending physician, if any, aa required by Isw. o1 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 selectinen for the purpose, shali upon application niake the certificate re- quired of the attending physician. If death is csused by violence. tbe medi- cal examiner shali make such certificate. If such a permit for the removal of a human body, not previously interred, froin 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 ot tbe undertaker desiring to make such removal sliall constitute a permit for such removal; provided, thst such body shall be returned to the town from which it was removed within thirty-six hours after such removal, uniesa a permit in the usuai 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, sucb recital shall appear upon the permit. The bosrd of health, or its sgent. upon receipt of such statenient 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 ueces sary information which can be obtained as to the deceased, or ss to the manner or cause of the death, which the clerk or registrar way require .- Cbap. 114. Sec. 45, G. L., (Tercentenary Edition).
No underlaker or other person shall 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 hoard of health or Its agent appointed to issue such perinits, or if there is no such hoard, from the clerk of the town where the boily is to be buried or the funeral is to he held, or fruin s per wun appointed to have tbe care of the cemetery or burial ground in which ibe interment ia made. . . . Chap. 114. Sec. 16. G. L., (Tercentenary Ediliou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within lils county the body of such a person, he shall forthwith go to the place where the body lies aud take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these iawa calls for the observance of the following rules of practice :
(1) Attending physicians wili certify to such deaths only as those of persons to whom they have given bedside care during s last iliness from disease unrelated to any form of injury.
(2) Board of Health physloians will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of Injury. have died without recent medical attendance or whose pbsaf- cian ia absent from home when the certificate of destb Is needed.
(3) Medloal Examiners will Investigate and certify to all dicatha sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism (including resuiting septicemia), and by the action of clientical (drugs or poisons), thermal, or electrical agents, aml deaths following abortion, but also deatha from diseass resulting from Injury or infeotlon ralated to occupation, the sudden deaths of persons not disablad 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., hesrt fallure, asphyxia, asthenia, etc. As principai 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.
Statemant of Oooupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in tbia section for every person aged 10 years or over. If the occupation had been given up or changed or account of the dixcase causing death, report the usual occupation prior to illness. If the decessed had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or st horne. For a woman whose only occupation was that of bone bousework, 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 had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
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.
Registered No. 85
§ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME.
John Thomas Collar
...
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
.......***
(Specify whether)
years
months
days.
In this community ) yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH. apiel 11
(Month)
(Day)
(Year)
Sa If married, widowed, or divorced HUSBAND of .....
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
6 Age of husband or wife if alive ..
.years
7 IF STILLBORN, enter that fact here.
8
AGE
Years
.Months ............ Days!
V
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :.
Industry
10 or Business:
Photographer
11 Social Security No ..
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
I. 13 Let. 1.1.
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF MOTHER (City) .. (State or country)
NU OviLis
17
Relation, if any
Informant. (Address) 1
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
um. Dlechildren
(Signature of Agentle board of Health or other)
160. april 13/45
(Official Designation) (Date of Issue of Permit)
! HEREBY CERTIFY, That I attended deceased from 1943, to af211 194/5-
I last saw halive on Ch.11
, 19 .. 56, death is said to
have occurred on the date stated above, at ........ Immediate cause of death. Myocardial Infact
Duration IMPORTANT 10 da
Due to .....
Due to Ch.Hy pantimme Cardio Ramal
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings: Of operations.
Of autopsy.
What test confirmed diagnosis? Che
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
M. D.
(Sig
(Address) 48 With St Na Dato.
4/12
1945
21 Place of, Burial. Cremation of Removal. Y (City or Town) DATE OF BURIAL .. Winetrop Cometray
22 NAME OF
FUNERAL DIRECTOR.
Charles R Bennison
ADDRESS 174 Winthrop It Withup 20
Received and filed 19
APR ... 1.2 .1945
(Registrar)
X
3 SEX
4 COLOR OR RACE
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
1
100m-2-40-D-729-a
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
No. 48 Winthrop ... Shore .. . D.r.i.v.a.
(If U. S.
War Veteran,
specify WAR)
.St.
(If nonresident, give city or town and state)
1945
0
... m.
Date of.
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 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.
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 froin the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it froin a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required 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 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 inake 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 re- moval 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 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 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 received 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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably 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 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 important, 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, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-301 A
1
PLACE OF DEATH
Suffolk County) Winthrop (City or Town)
NOTIFIES
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.
86
St { {If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME Baby fil Salhanick
( If deceased is a married, widowed or divorced woman, give also maiden name.)
47 Dehon
St.
(If nonresident, give city or town and State)
Length of stay: In mosoltal or institution
( Before death)
( Specify whether)
years
months days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female White
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWEO
6 DIVORCED
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