USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 30
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( write the word)
Single
5a If married, widowed, or divoroed HUSBANO of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive
yaers
7 IF STILLBORN, enter that fact here.
8 AGE Years Months .. Oays
if less than 1 day
Hours .. /.O. Minutos
21
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
none
Winthrop, mars
12 BIRTHPLACE (City)
( Siste or country)
13 NAME OF
FATHER
Samuel Salhanick
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Fall River, man
15 MAIDEN NAME
OF MOTHER
Ruth Werner
16 BIRTHPLACE OF
MOTHER (City)
Boston, mars.
(State or country)
17 alice Malingno ciation if we informenk (Address) 44 Llehon DT Revere
1 HEREBY CERTIFY that a satisfactory standard oartifloate of death was Aled with me BEFORE the burial or transit permit was issued ?
(Signature of Agent of Board of Health or other) 4/13/7:0
lait (Official Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
april
( Month)
( Day)
(Year)
19 | HEREBY CERTIFY,
UnnfH/ 1945
Ło ..
That 1 attended deosased from
April 11.
1945
I last saw h
alive on.
Gmail (,, 1945 death is said to
have occurred on the date stated above, at ..
11:30€
Immediate oouse of death
11:264
Que to
Gremature Burtto
Due to
Prematuur Separation 7
Placenta
Other conditions
( Include pregnancy within 3 months of death)
Mejor findings :
Of operations
Oate of
Of eutopsy
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 oooypation of deceased ?
if so, spaoify
(Signed)
hun Guest. M. O.
(Address) 2 Meses for Onto
8/12
21 Mi. Lebanon- Workmeno Cercle-Who
Place of Burial, Cremation or Removal.
(City or Town )
OATE OF BURIAL.
april
13,
1945
22 NAME OF
AOORESS
washington tv, Don
Reoaived and Aled
APR 1 7 1945
19
( Registrar)
.
chloela .82
PARENTS
100m(i)-1-44-13634
@AtracTS Trum ine laws on pack of certificate. If deceased wes a U. S. War Veteran, Q. L. Chap. 45, Section 10, requires physicians to insert a recital to that effeot. Cher hasp. 4/30/45,
r
MAY 7 Winthrop Community Hospital. No.
Registered No.
(a) Residence. No.
(Usual place of abode)
PHYSICIAN - IMPORTANT (Was deceased 2 U. S. War Veteran, if so specify WAR) Relivene ??
11
1945
Duration
IMPORTANT
Russia
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 samne was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert 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 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 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 ien 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, Chap. 38, Sec. 6.
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).
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 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
.
R-301 A 7
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
St.
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
(If U. S.
War Veteran,
specify WAR)
no
(If deceased is a married, widowed or divorced woman, give also maiden name.)
214 Somerset Que
St.
(If nonresident, give city or town and state)
In this community 33 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) widow
Sa If married, widowed, or divorced HUSBAND of.
(Give maiden name of wife in full)
Walter James Staples
(Husband's name in full)
6 Age of husband or wife if alive .. years
7 IF STILLBORN, enter that fact here.
AGE.
Years.
10 Months.
8 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
house wife
11 Social Security No.
12 BIRTHPLACE (City)
Last Boston
(State or country) mass
13 NAME OF
FATHER
William Henry Hunter
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Eliza Davis
Portsmouth
Relation, if any
17 Richard H Stables.
-1011
Informant .. (Address) 314 Januariet Qui, Manuele
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transit permit was issued:
,
{Signature of Agent of Board of Health or other)
4. /6/43
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
1 18 DATE OF
DEATH
april
15 1945
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY That I attended deceased from
april 14 1945 to april 15 19 45 Vlast saw her alive on que 14, 19 45, death is said to have occurred on the date stated above, at 10.50 a. m.
Immediate cause of death ..
Due to.
Due to.
Other conditions arterios Salerocio.
(Include pregnancy within 3 months of death)
Major findings:
Of operations.
none
Date of
Of autopsy
22
What test confirmed diagnosis ?. Clinical
4 years. 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? 200
If so, specify,
(Signed)
(Address) Hunchof Mass Date 4/15
.19.45
M. D.
21
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
april 17
22 NAME OF
Chas R Benne
271
FUNERAL DIRECTOR ...
...
ADDRESS
174 Winthrop de Winterals
Received and filed 19
APR 17 1945
(Registrar)
214 Jonenet Que No ....
2 FULL NAME
Louise adele (Hunter) Staples>
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
1 (or) WIFE of 8 70 PARENTS 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. mivivi soulu pe careruny supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business :
100m-2-'40-D-729-a
16 BIRTHPLACE OF
MOTHER (City) ...
(State or country)
New Hampshire
Duration IMPORTANT 24 hours.
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 death, stating to the best of his knowledge and belief tbe name of the deceased, his supposed age, the disease of which he died, definded 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 bis 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 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 cnough for the purpose. the certificate of deatb 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 froin 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, 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 tbe 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 deatb, 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 tbe care of the cemetery or hurial ground in which the interinent 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 bave 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 deatbs supposably due to injury. These include not only deatbs 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 deatb, not tbe mode of dying, e. g., beart 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 bad been given up or cbanged on account of the disease causing deatb, 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 woinan whose only occupation was that of home bousework, write housework. For a person engaged in domestic service for wages, bowever, designate tbe occupation by tbe appropriate terins, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301
If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physician to insert a recital to that effect. See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. mation should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF
PLACE OF DEATH
Suffolk County
(City or Town) ....
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No ..
88 ....
Winthrop Community Hospitals {If death occurred in a hospital or institution. No.
2 FULL NAME
(If deceAsed is a married. widowed or divorced woman, give also maiden name.) 226 Cottage Park Roadst
(a) Residence. No ..
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
temale
4 COLOR OR RACE
white
B SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
Sa If married, widowed, or divorced HUSBAND of ...
(or) WIFE of.
(Give maiden name of wife in full)
Orlando Fuller Belcher
(Husband's name in full)
6 Age of husband or wife if alive.
.years
7 IF STILLBORN, enter that fact here.
B AGE 86 Years 6 Months 11 Days
Ifless than 1 day
Hours
Minutes
Usual
º Occupation :.
at home
Industry
10 or Business :
11 Social Security No ....... none
12 BIRTHPLACE (City)
(State or country)
arono Grono
maine
PARENTS
13 NAME OF
FATHER
Nathaniel Lent
14 BIRTHPLACE OF
FATHER (City) ....
unable To obtain
(State or country)
18 MAIDEN NAME
OF MOTHER
Lois Whittier
16 BIRTHPLACE OF
MOTHER (City) ....
(State or country)
unable to Obtain
17 Mis C. R. Buffum
(fuice
Informant. (Address) 226 Collage Park Rd by Marraige
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wm-D- Cheil dreux
(Signature of Agent of Board of Health or other) Health Spicer (Official Designation) (Date of lesue of Permit)
4/21/40
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april
20
(Month)
(Day)
1945 (Year)
19 I HEREBY CERTIFY That I attended deceased from EptEmber 15, 1944, to april 20, P. 19 45 I last saw her alive on april 20 1945, death is said to have occurred on the date stated above, at 1245 Immediate cause of death. Angina Pectoris
Duration Important 6 month
3 years
Due to.
Other conditions Kone (Include pregnancy within 3 months of death)
Important
PHYSICIAN Underline the cause to which death should be
charged sta- What test confirmed diagnosis? Clinical+ Laborator Mistically.
20 Was disease or injury in any way related to occupation of deceased ?. 200
If so, ępacify
(Signed) Maurice Traumateine
(Address) 567 Shribey Str
.Date ..
M. D.
abril 201845
21 ..
Winthrop temet
(City or Town)
DATE OF BURIAL.
april 23
19.95
22 NAME OF
FUNERAL DIRECTOR
Charles R Bennison
ADDRESS 174 Whathing St Winthrop
Received and filed 19
MA 70 1915
A TRUE COPY ATTEST:
APR 2 6 1945
(Registrar)
1
100m (h)-1-41-4695
1
Lisail Durham (Lunt) Belcher
¿ give its NAME instead of street and number) PHYSICIAN-IMPORTANT
(Was deceased a U. S. War Veteran? If so. (specify WÄR)
years
2 months
days.
In this community 70 yrs.
no mos.
-
days.
Due to arterioscleratic Heart Disease
Major findings:
Of operations
have
Date of.
Of autopsy
none
Burkum
Relation. If any
Place of Burial. Craauktion or Removal.
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 famlly of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, his supposed age. the dlsease of which he died, defined as required hy section one, where same was contracted, the duration of his last illness, when last seen allve hy 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 hy the preceding sectlon or by section forty-five of chapter one hundred and fourteen, shall, if the deceased, to the best of his knowledge and helief, 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, specifylng 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 pro- vision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this section 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 nineteen hundred and seventeen .- General Laws, Chap. 46, Sec. 10.
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