USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 81
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20 Wes disease or injury ih ony way ralatad)to occupation of deceesed ?
if so, spaolfy.
(Signed)
. M. D.
(Address)
Being Throp
Dato Che-19 1945
Place of Burial, Ofemation of Removal.
(City or Town,
DATE OF BURIAL
Acc 21
19.65
22 NAME OF
FUNERAL DIREOTOR
Tperly Broe
ADDRESS
Winthrop, Mais
Received and Aled.
DEC 21 1945
19
( Registrar)
100m.(R)-1-45-15510
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a reoltal to that effeot. extracts from the laws on back of certificate. Know that may be property stanie. Last tour of Vocations portant. det instructions and PARENTS
No.
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name. )
620 Mlabley Stx
St.
a
Duration
IMPORTANT
...................... 447151945
ACE OF
5a If married.
HUSBAND
(Give maiden name of wife in full)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert iu 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 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 certifylng 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 wben 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
R-301 A
1 ـتـ
PLACE OF DEATH
Suffolk. (County)
Winthrop/ (City or Town)
No. 147 Cottage Park Road.
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.
244
.... { {If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME
SewellVerney
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenca. No. 147 Cottage Park Road. ................. St.
(Usual place of abode)
( If nonresident, give elty or town and State)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months
days.
In this communityO. yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male.
4 COLOR OR RACEL
White.
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEWidowed,
Saglf married, widowed, or divoroed
HUSBAND of
Flora Chase Felton
( Give maiden name of wite in fill)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if aliva years
7 IF STILLBORN, enter that fact here.
8 AGE 76 Years 4.
Months 18 .... Days
If less than 1 day Hours Minutes
Usual
9 Ocoupellon :
retired
Industry 10 or Business :
11 Social Security No.029-16-2358
12 BIRTHPLACE ( City)
Portsmouth
( Siste or country) NOU.
13 NAME OF
FATHER
James Verney.
14 BIRTHPLACE OF
FATHER (Clty)
Unableto obtain.
TT
(State or country)
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
=
11
Informant ( Address)
147 Cottage Park Road
I HEREBY CERTIFY that a satisfactory standard certificate of death was Aled, with me BEFORE the burial or Wantit permit was Issued : Vms. Children
(Signature of Afront of Board of Health or other)
1 Match Officer
12/24/45
(Omelal Designation) ( Date of Irque of /Permit)/
. V
18 DATE OF
DEATH
December
21
1.9457
eat)
(fonth)
(Day)
19 + HEREBY CERTIFY.
That I attended deceased from
Tauch 15.
1945, to
Ale 21,
......
1945
I last saw h .......... ) ... allve on
Dec 21
. 19 4/2 death is said to
have occurred on tha date stated above, at ..
12:30 Pm.
Immediate gause of death ..
Coronary Heart Disease
IMPORTANT
.... ....... One year
Due to
Due to.
Other conditions.
( Include pregnancy within 8 months of death)
Mejor findings:
Of operations
Data of.
Of eutopsy
Whet test confirmed diegnosis?
Clinical Signs
IMPORTANT
Physician
Underline the cause to which death should be charged sta. tistically.
20 Was diseese or injury in any way related to occupation of deceesed ? If so, spaoify.
( Signed)
Finchraph
Data Dec 23 194/5
. M. D.
(Address)
21 Winthrop Cemetery".
Winthrop Masg.
Place of Burial, Cremation or Removal
(City or Town)
DATE OF BURIAL
Dec.24.1945.
19
22 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
174 .Winthrop St, Winthrop ......
Reoalved and flad
DEC 20 1945
19
( Registrar)
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to Insert a recital to that effect.
PARENTS
100m. (g) -1 45-15510
Relation, if any
17 Arthur .F.Verney. ( ...... S.on.
=
=
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War VeteranTO.
if so specify WART.
Duration
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 persou whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty five of chapter one hundred and four- teen, shall, if the deceased, to the best cf 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 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 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 ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . - General Laws, 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 forum of injury, have died without recent medical attendance or whose phy- sician is absent from home wben 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
RM R-301 1
Suffolk (County) Winthrop (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop (City or town making return)
Registered No.
245
(If death occurred in a hospital or institution, No Winthrop Comm. Hook
St. ( give its NAME instead of street and number)
2 FULL NAME
Mrs. Dora Barent
(If U. S.
War Veteran.
specify WAR)
If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No 10 Beach Rd Winthat Mais. St.
(Usual place of abode)
Length of stay : In hospital or institution
(Specify whether)
months
/ O days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female White
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
of DIVORCED
Widow
5a If married, widowed, or divorced
HUSBAND of
aler Give maiden name of
m Garent
(Husband's name in full)
6 Age of husband or wife if clive.
.years
7 IF STILLBORN, enter that fact here.
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Housework
Industry
athome
II Social Security No ...
quasia
Charles Bubin
14 BIRTHPLACE OF
FATHER (City)
....
Russia
VE dal
cannotly
learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Lionel Barent Relation, if any (Address) 164 Fuller St, Dov.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or Hansit permit was issued: Www. D. Childress
(Signature of Agepy of Board of Health or other) Healthe Officer
...... 12/26/45 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
25
1945
(Month)
(Day) )
(Year)
19 | HEREBY CERTIFY. That I attended deceased from november 15,, 1945, to December 25, 1945 I last saw her alive on December 25, 1945, death is said to have occurred on the date stated above, at. 10:25Pm
Immediate cause of death .............
2 Coronary Thrombosis
10 minute
Due to
Arterioscleratic Heart
Disease
3 years
Due to
Other conditions
Diabetes mellitus
years
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Of autopsy
elcharged sta- What test confirmed diagnosis? Clinical+ Laborator ically.
20 Was disease or lojury lo any way related to occupation ef deceased ? no
If so, specify.
) Maurice Tramvatria dr.
..... , M. D.
(Signe
(5) 562 Shirley St. Winterand Date 12/25 1945
21
Winthrop - Everett
Removal
(City of Town)
Place of Burial, Cremation
DATE OF BURIAL ..
210
19 45
22 NAME OF
FUNERAL DIRECTOR
Manuel Staneteby
ADDRESS
washington ff, Dar
Received and filed.
DEC 2-6-4945.
.19
A TRUE COPY ATTEST: (Registrar)
PHYSICIAN Underline the cause to which death should be
Date of ..
Duration
Months
Days
(write the word)
DEATH
DE December
1 PLACE OF DEATH a (or) WIFE of 8 70 AGE .Years. 10 or Business: 12 BIRTHPLACE (City) (State or country) 13 NAME OF FATHER 15 MAIDEN NAME OF MOTHER PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country) 200m-10-'39. No. 8427-d
hosp.
...
years
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physlelan or registered hospital medleal oficer 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 huried, 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 hody and remove it from a town, from one cemetery to another, or from one grave or tomh 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 such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be 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 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 certificatc. 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 ahove 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 ohtained 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 fur- nish for registration any other necessary information which can be
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