USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 3
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(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 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 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
01 A
1
PLACE OF DEATH
7 Suffolk {County) Winthrop (City or Towny 34 Wave Way
The Commonforalth of Massacinisetts 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.
( { If death occurred in a hospital or institution, St. ( give its NAME instead of street aud number)
Bobby
PHYSICIAN - IMPORTANT
(Was deceased a
world
U. S. War Veteran, if so specify WARD DANTE
(Usual place of abode)
Length of stay: In hospital or Institution
(Before death)
(Sperify whether)
years
months
days.
In this community 30 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word)
Single
5a if married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name In full)
6 Age of husband or wife if alive years
IF STILLBORN. enter that fact here.
8 AGE 30 Ye Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Dentist
Industry
10 or Business :
tl Social Security No. · pone
2 BIRTHPLACE (City) Winthrop, mais (Siate or country)
13 NAME OF
FATHER
P: Samuel Dobby
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Lena Zuing
16 BIRTHPLACE OF
MDTHER (City)
(State of country)
Russia
17 Jack Burstein Relation, If any incele
Informant
(Address) 48 Coolidge ff, Brooklyn
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued :
(Signature of Agent of Board of Health or other)
1 Match Ortitels 1/9/45
(Omclal Designation) ( Date of Issue of Permie)
18 DATE OF
DEATH
( Month)
(Day)
(Year)
19 I HEREBY CERTIFY, 19 19
That I attended deosased from
to
I last saw h.
alive on.
19 , death is said to
have occurred on the date stated above, at
6.151
.m.
Duration
Immediate cause of death ..
Due to
Due to ...
m.s. com
Other conditions.
( Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
IMPORTANT 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.
(Signed)
(Address)
Jate.
gm 1945
21
Winthrop.Den
Place of Burial, Cremation or Hemoval.
DATE OF BURIAL
raw
(City or Town) .
10, 1945
22 NAME OF
FUNERA
Manquel Stanetslag
ADDRESS
Towashington , Dar.
Received and Ated
19
(Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to insert a reoltal to that effeot. PARENTS
100M-6 - 2-42-8855
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
34 Wave Way
Gove.
-St.
(If nonresident, give city of town aud State)
MEDICAL CERTIFICATE OF DEATH
9
1945
IMPORTANT
.....
...
No. James Joseph Dobley 2.
,
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medioal offioer shall forthwith, after the death of a person whoin he has attetuled 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. deflurd 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. tawa, Chrap. 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 deceaseil, 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, and 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 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 aud forty-seven of said chapter one bundred and fourteen, the word "war" shall incinde the China 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 Jtexi- 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 buman 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 tbe 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 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 boily is buried. No such permit shall be issued until there shall bave been delivered to such 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, o1 in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, hia certificate cannot be obtained early enough for the purpose, or is insufficient. a physi- cian who is a member of the hoard 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 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 obtalued 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 corpa of the United States in any war In which it has heen engaged, such recital shall appear upon the permit. The board of health. or its agent. upon receipt of such stateoient 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 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 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 ajqminted to issue such permits, 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 from a peraun alqminted to have the care of the cemetery or burial gromul in which the internient is made ... . Chap. 114. Sec. 46. C. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as sre supposed to have died by violence. If a meilical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the hody lies 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 phyalcians will certify to such deatba 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 physlolana will certify to such deaths only aa those of persons who, though disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phyaf- cian is ahsent from home when the certificate of death is 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 chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseasa resulting from injury or Infootion 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 moile of dying, e. g., heart failure, asphyxia. asthenia, etc. Aa 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 ia 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 discase 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 aa at school or at hoine. For a woman whose only occupatiou was that of home 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 had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
IR-30N
Suffolk
(County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
11 ...
No. Winthrop Community Hospital
5
(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME.
Elizabeth
H. Fulham
Niland
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ....
212
Lincoln St
St.
(Usual place of abode)
(If nonresident, give city or town and state)
Pength of stay: In hospital or institution
(Specify whether)
years
H
months
4
days.
In this community 25
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, or divorced
HUSBAND of
John Give mide meafrede in full)
(or) WIFE of
(Husband's name in full)
6.9
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
If less than 1 day
Years.
Months.
.Days
Hours .........
Minutes
Usual
9 Occupation:
Housewife
Own
Home
11 Social Security No.
12 BIRTHPLACE (City)
Boston
(State or country)
Mass
13 NAME OF
FATHER
John Fulham
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Ellen Leonard
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 John Niland
Hus Bản
any
212 Lincoln St
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued
Millian D. Childress
Signature of best of Board of Health or other
Health 1 ... tefficer /19/45
(Official Designation (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
....
(Month)
(Day)
Marrien19 | HEREBY CERTIFY. That I attended deceased from
19.
4%
16
1945
I last saw h.M alive o AmPIC, 19/1 death is said Duration to have occurred on the date stated above, at 9.15Am. Immediate cause of death ........................................................
vitto diverticulitis
Due to
Due to .....
5
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
PHYSICIAN Underline the cause to with Mewhenhe Date of 12/11/4 which death Of autopsy should be charged sta- tistically.
What test confirmed diagnosis ?.
20 Was diseaso or Injury lo any way related to occupation of decoased ?
If so, specify.
(Signod)
Y Washinton en Date 1-16
(Address)
21
...
Place of Burial, Cremation or Removal DATE OF BURIAL Jan. //19 the Town)
22 NAME OF
FUNERAL DIRECTOR
Tally
ADDRESS
Winthrop
Received and filed.
.. 19
.....
A TRUE COPY ATTEST:
(Registrar)
M. D.
1945
Winthrop Winthrop
200m-10-'39. No. 8427-d
1 PLACE OF DEATH 3 SEX Female tid 4/2 1/45 day 8 64 AGE Informant (Address) 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. PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business:
Registered No ..
(H U. S.
war Veteran.
specify WAR).
16
1945
(Year)
....
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 regis- tration 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 from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to sueh board, agent or clerk, as the case may be, a satisfac- tory written statement containing the faets 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 licu 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 physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 a 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-slx, 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 fur- nish 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 issuc 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 observ- ance of the following rules of practice:
(1) Attending physicians will eertify to such deaths only as those of persons to whom they have given bedside care during a last ill- ness 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 un- related to any form of injury, have died without recent medical attendanec 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 septice- mia), 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 occupa- tion, 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 con- ditions, 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 oceupation 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 busi- ness, report the usual oceupation 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
Suffolk (County) Winthrop (City or Town) PLACE OF DEATH No. 88 .... Woodside ... Aze .....
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.
[ { If death occurred in a hospital or Institution, { give its NAME instead of street and number)
2 FULL NAME.
James Henry Smith
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 58 Woodside Ave .... .............
(Usual place of abode)
Length of stay : In hospital or Institution (Before death)
years
months days.
in this community
16yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE;
5 SINGLE
(write the word)
Male
White
MARRIED
WIDOWED
or DIVORCED
Married
Sa If married, widowed, or divorced
HUSBAND of
Flossie Thomson Sith
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if ative years
> IF STILLBORN. enter that fact here.
8 AGE .. 7.4 Years .2 ... Months .13 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Retired
Industry
10 or Business :
Bridge Construction
11 Social Security No. ....
.none
Sommerville
12 BIRTHPLACE (City)
(State or country)
Nova Scotia
13 NAME OF
FATHER
James Henry Swith
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Mary Orchard
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nova Scotia
17
Informant .. Flossie ... T ....... Smith
Relation, If any ....... V11.0.
(Address) ES Woodside Ave., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with ma BEFORE the burial or transit permit was Issued :
.1 (Signature of Agent of Board of Health or other) Healthe Officer 1/22/45
(Official Designation) ( Date of Issue of Permity
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan. 19, 1945
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That 1 attended deceased from
October 28
19 44.
to ...
January
19, 1945
1 last saw h ....... l.1 .... alive on ......
January 18, 1945 death is said to
have occurred on tha date stated above, at ~ 4.557 m.
Immediate cause of death
IMPORTANT
Chronic Miocarditis
2 1/1.5.
Due to
arterio Sacrosis
yr ..
Due to
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings : Of operations
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