USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 28
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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 tomh 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 he 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 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 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 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 hody, 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 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 herennder. 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 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 and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body 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 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 hody 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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled 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 hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier 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 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 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-302
SUFFDLB
803 (County)
(City or Town)
No. Beth Israel Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return)
3694
Registered No.
(If death occurred in a hospital or institution, St. give ita NAME instead of street and number)
2 FULL NAME Esther Phillips
(If deceased is a married, widowed or divorced woman, give also maiden name.)
14 Trident Ave
stWinthrop
Mass
(a) Residenoe. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ..
(Before death)
(Specify whether)
16 Hrs
PERSONAL AND STATISTICAL PARTICULARS
3 SEX F
4 COLOR OR RACE
5 SINGLE
(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 allve years
7 IF STILLBORN, enter that fact here.
8 AGE.
73 Years .Months .. Days
If less than 1 day .Hours
Minutes
Usual 9 Occupation :
None
Industry 10 or Business :
None
11 Social Security No. None
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Abraham Phillips
14 BIRTHPLACE OF
Russia
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Rachel R.Palais
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Informant (Address)
C ... Shape.ro
A TRUE COPY.
1
ATTEST:
(Registrar of city or town where death occurred) April 22 19
46
DATE FILED
MEDICAL CERTIFICATE OF DEATH
April 18/46
(Day)
(Year)
19 | HEREBY CERTIFY,
April 17
19.46
to ..
That_ I attended deceased from
April 18
186
1 last saw h ....... e.r .... alive on
April 18/46
death Is said to
have occurred on the date stated above, at
2:35AM
m.
Immediate cause of death.
Myocardial infarction
Due to.
Due to
Other conditions
Pt.deaf and dumb
(Include pregnancy within 3 monthe of death)
Major findings :
Of operations
Date of.
Physician Underline the cause to which death should be charged sta- tistically.
What test oonfirmed diagnosis ?.
20 Was disease or injury in any way related to occupation of deceased ?.. No ...
If so, specify
(Signed)
S .... H .Hoffman
M. D.
(Address)
Beth ... Israel ... Has.p.t .... Date.
4-18- 46
21 PLACE OF BURIAL,
Phel Jacob Cem-Woburn Mass.
CREMATION OR REMOVAL
(Cemetery )
Relation, if any
Siste
DATE OF BURIAL
April 18/46
19
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
H J Torf
ADDRESS
Brookline Mass.
Received and filed
APR 27 1946
19
( Registrar of City or Town where deceased resided) T
50m-(b)-6-44-14607
----- Copies of returns of deaths recorded daring tue previous modta which utturted in your giftsaringwin fast me of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
1
PLACE OF DEATH
(If U. S.
War Veteran,
speolfy WAR)
months
da y 8.
In this community
yrs.
mos.
1
days.
years
MARRIED
WIDOWED
or DIVORCED
18 DATE OF
DEATH
(Month)
Duration 16 Hr's
PARENTS
Of autopsy
001 A T
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) Winthrop Community Hospital
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.
25
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
24 Winthrop St.
St.
(Usual place of abode)
Length of stay: In hospital or Institution
Hospital
years
months
1
days.
In this community
35 yrs.
mon.
days.
( Before death)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
"hite
5 SINGLE
( write the word)
MARRIED
WIDOWED
Or DIVORCEMarried
18 DATE OF
DEATH
april
( Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
September
19
That I. attendad deosasad from
46
april 19
19
I last saw h 22
.alive on
april 19
1976
death is aald to
hava occurred on the date stated above, at.
Duration
7 IF STILLBORN, enter that fact hera.
AGE
8
65
Years
Months
Days
lass than 1 day Hours Minutes
Usual
9 Ocoupation :
Housewife
Industry
10 or Businass :
Own .... Home
11 Social Security No.
Boston
12 BIRTHPLACE (City)
( State or country)
Massachusetts
PARENTS
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Anastasia Sullivan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Newfoundland
17 Informant Samuel J Devlin (Address) 24 Winthrop St Winthrop
I HEREBY CERTIFY that a satisfactory standard oartifioste of death waa filed with me BEFORE the burial or transit permit was Issued : William D. Childress -
(Signature of Agent of Board of Health or, other)
agent abril 21/46
(Official Designation) ( Date of Trque of Permit)
20 Was diseasa or injury in any way related to occupation of decaased ?
If so, specify.
Tout Aweins att
( Signad)
M. D,
(Address)
238 Phore Drie
Oate ..
4/17
19.16
inthrop
21
Winthrop
Place of Burial, Cremation or Removal. DATE OF BURIAL.
April
(City or Town) 2946/
22 NAME OF
FUNERAL DIRECTOR ..
ADDRESS
Received and flad
APR 27 1946
.19
......
( Registrar)
100m-(g) - 1-45-15510
IMPORTANT
12 tys
Due to ...
arterio sclerotic heart
disease and chronic
Due to
nephritis
8 mos
Other conditiona
Cardiac cirrhosis of liver
( Include pregnancy within 8 moutba of death) /
with
ascites
Major findinga:
Of operations
keit
Date of
Of autopsy.
What test confirmed diagnosis?
chmical
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
13 NAME OF
FATHER
Michael D. Kelley
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a reoltal to that offoot. L.AL
No.
Catherine A. Devlin
(
Kelley )
St( (If death occurred in a hospital or institution,
{give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
....
(If nonresident, give city or town and State)
19
1946
1210
.m.
6 Age of husband or wife if alive
- 73
years
Immadlate cause of death.
Cardiac decompensation
5a tf marriad, widowed, or divoroed
HUSBAND of
(or) WIFE of
Safiye gaden mame de vein fyll)
( Husband's name in full)
PERSONAL AND STATISTICAL PARTICULARS
Registered No.
Holm FIC male Winthrop .. . Ma.ss ...
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 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 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 aud 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
IR-301 A
1
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.
76
St. § (If death occurred in a hospital or institution. § give its NAME instead of street and number) }
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence.
No.198 Leyden St. East Boston
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4
COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
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
7 IF STILLBORN, enter that fact here. Stillborn
8
AGE
Years
Months
Days
If less than 1 day Hours Minutes
Usual 9 Occupation:
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country)
Winthrop
a88.
13 NAME OF
FATHER
William Conway
14 BIRTHPLACE OF
Boston
FATHER (City) (State or Country) Mass .
15 MAIDEN NAME
OF MOTHER
Norma Cristoforo
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Boston
Mass.
17 William Conway Informant (Address) 198 Leyden St. Fast Boston, Mass. I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Wmf Children (Signature of,
afAset of Board of Health or other)
4/22/ 46
(Official Designation) (Date of Issue of Permit)
19 I HEREBY CERTIFY, april 20 1946
That I attended deceased from
. 19
I last saw h
olive off
, 19
, death is said to
m.
Duration IMPORTANT
Due to
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased? If so, specify
0
(Signed)
305 Janes Emregion
(Address).
21
St. Michael
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
April 22
1946 19
22 NAME OF
FUNERAL DIRECTOR
cro Michael Fl nella
ADDRESS 10 No. Bennet St. Boston
Received and Filed APR 2 7 1946
19
1
(Registrar)
See instructions and extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
100m-9-44-14955
PLACE OF DEATH
Suffolk (County)
-
No.
Winthrop Community Hospital
2 FULL NAME
Stillborn Conway -( Male)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
20 1946 (Ycar)
(Day)
have occurred on the date stated above, at Immediate cause of death Stillborn
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
, M. D. Date apaso 196 Boston
Registered No.
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 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 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, 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.
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