USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 42
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R-301 AY +
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 helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired hy section one, where same was contracted, the duration of his last illness, when last seen alive 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 section or hy 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 hoth 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 horder 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 hody which has not heen 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 hoard, 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 tomh to another in the sanie cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall he issued until there shall have heen delivered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall he 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 he 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 hy 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 he 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 hody 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 teu 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, 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 aud 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 hodies 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 bury 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 board, from the clerk of the town where the body 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 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 hy recognized disease unrelated to any form of injury, 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 abortion, 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 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 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-301 A
PLACE OF DEATH
2.1
(CountyX Winthrop (City,or Tona) 34 Girdieste Gload
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. 121 ...
[ (If death occurred in a hospital or institution, St. {give its NAME instead of street and number)
Erina Quidi
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. NO 221 (Usual place of abode)
Girdlestone Uld.
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months
days.
In this community 3 / yro.
mon.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female White
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCE
( write/the word)
Single
So If married, widowed, or divoroed HUSBAND of
(Give malden name of wife in full)
( Husband's name in full)
6 Age of husband or wife if aliva years
7 IF STILLBORN, enter that fact here.
8 71 Years
.. Months
12Days
If less than 1 day
Hours
Minutes
.....
House Kuiper
11 Social Security No.
12 BIRTHPLACE (City)
( Siste or country)
Viareggio Italy
13 NAME OF
FATHER
Luigi Surde
14 BIRTHPLACE OF
FATHER (City)
....
(State or country)
15 MAIDEN NAME
OF MOTHER
ME Assunta Malfatti
16 BIRTHPLACE OF
MOTHER (Clty)
( State of country)
.......
17 Informant (Address) 34 Birdlisting Rd Pintura
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal or tenait permit was Issued : Nach. Suldress, (Bigdatere of agent of Board of Realty or other)
Health (fizer 6/25/45 ( Date of Inque of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
23
1945
( Day)
(Year)
19 CHEREBY CERTIFY,
May 1, 1945. 10.
June 23, 1945
I last saw h.
en alive on
here 23. 1945, death Is cald to
have occurred on tha date stated above, at
4:20 pmm.
Immediate cause of deathy Ia
nordic 8, Mitral vegas, 3 g,
Due to
rigitation-
Due to
Myocarditis
Several Anarsaca
4mld
Other conditions.
( Include pregnancy within 3 montbe of death)
Mejor findings :
Of operations
1
Date of
Of eutopsy
What test confirmed dlegnosis?
L
IMPORTANT
Physician Underline the cause to which death should be charged va. tistically
20 Was diseese o?,injury in ony way related to occupation of decaesed ?
If so, spaolfy.
Icardo La Dalton
( Signed)
Date 6/24945
21
1
Place of Bufial, Cremation or Removki. (City of Town)
DATE OF BURIAL Gerne 26,
1945
22 NAME OF
FUNERAL DIRECTOR-
CTOR John Cincotti + dans
ADDRESS
7 Cooper da Torsten
Received and fied
JUIN 20 1945
19
(( Deal Designattonly
( Registrar)
Duration ~
IMPORTANT .......
,
.
M. D.
Relation, If any) Wirthun law)
1 (or) WIFE of AGE Usual 9 Ocoupetion : PARENTS If deosased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physicians to insert a recital to that effeot. extracts from the laws on back of certificate. ferme, so that it may be properly classified. Exact statement of OCCUPATION is very important. Sco instructions and Industry 10 or Business :
2 FULL NAME
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so speckfewWAR)
( If nonresident, give city or town and State)
That I attended deoeesed from
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 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 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 relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenthy. eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and mine- 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 110 undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one'grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit Shall be issued until there shall have been delivered to such board, agent or clerk, as the case may he, 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 he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thercafter 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 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 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 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 forin of injury, 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 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT SERVICE NUMBER
ORM R-301 +
MARGIN RESERVED FOR DINVINY
100m (h)-1-41-4695
PLACE OF DEATH
Suffolk (County)
The Commonwealth of MRamsarhusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
2 FULL NAME Charles Henry Palmer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
27 Bellevue Ave.
St
(If nonresident, give city or town and State)
Hosp.
years
months
6
days.
In this community
24
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June
23
1945
(Month)
(Daf)
(Year)
45 19 I HEREBY CERTIFY. That I attended deceased from September 2, 1944 to June 22 19 I last saw h cin alive on June 22, 1945, death is said to have occurred on the date stated above, at .. 7 05 A.m.
Immediate cause of death, Cerebral Hemorrhage
Duration Important 5 days
2 years
5 years
Important
PHYSICIAN
Major findings:
Of operations.
none
Underline the cause to which death Date of. Of autopsy none should be charged sta- What test confirmed diagnosis ? unical+ Laboral totically.
20 W'ss disease or injury in any way relaled lo occupation of decessed?
M. M. D.
If so, specify
(Signed) Maurice Traunstein
(Address) 562 Shirley
sx
Date More 231945
Winthrop
21.
Winthrop
Place of Burial, Cremation or Removal.
DATE OF BURIAL
June
(City_or Town)
25,
1945
FUNERAL DIRECTOR
22 NAME OF
Howard S Brymolto
ADDRESS
Wanthuy mais
Received and filed
JUN 20 1945
19
A TRUE COPY ATTEST: (Registrar)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Neue S- Childrens (Signature of Agent of Board of Healthyor omner) Health Officer
6/25/45 (Date of Issue of Permit)
(write the word)
Married
HUSBAND of.
(Give maiden name of wife In full)
(or) WIFE of.
(Husband's name in full)
74
years
If less than 1 day
Hours
.Minutes
Usual
Gate Tender (Retired)
Industry
N.Y .&n N.H. Railroad
11 Social Security No.
706-03-0341
M 88 .
15 MAIDEN NAME
OF MOTHER
Georgeanna Stedman
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Novia Scotia
Relation, if any Wife
)
Informant!
(Address)
27 Bellevue Ave. Winthrop
Due to.
Hypertension
Due to. interiorclerosis
Other conditions
none
(Include pregnancy within 3 months of death)
Registered No.
1.22 R ...
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number) PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran? If so, (specify WAR)
1 Winthrop (City or Town) No .. .... (Usual place of abode) Length of stay: In hospital or institution .. (Before death) 3 SEX Male 4 COLOR OR RACE White Sa If married, widowed, or divorced Auch 6 Age of husband or wife if alive 7 IF STILLBORN, enter that fact here. 8 AGE 72 Years 10 Months 1 Days 9 Occupation : 10 or Business ;. 12 BIRTHPLACE (Ctty) (State or country) 13 NAME OF FATHER Ezra Palmer 14 BIRTHPLACE OF FATHER (City) ...... (State or country) Canada PARENTS 17 Emma E Palmer If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires phys cian 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 (Official Designation) N. B .- WRITE PLAINLY. WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of infor- Boston
Noward 6/29/45
Winthrop Community Hosp.
(Specify whether)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Emma Vosburghe
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 hest of his knowledge and belief the name of the deceased, his supposed age, the disease 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 physiclan 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 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, specifying the war, and shall also certify in such certificate hoth 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, he 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. .
No undertaker or other person shall bury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not heen huried, until he has received a permit from the hoard of health, or its agent appointed to issue such permits, or if there is no such hoard, from the cierk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing tomh to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the hody Is huried. No such permit shall he Issued until there shall have heen dellvered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required hy law to he returned and recorded, which shall he accompanied, in case of an original interment, hy 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 he obtained early enough for the purpose. or is in- sufficient, a physician who is a member of the hoard of health, or em- ployed hy It or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy 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 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 re- moval of such hody has heen sooner obtained hereunder. If the death certificate contains a recital, as required hy section ten of chapter forty-
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