USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 57
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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 body is to he huried 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 hy 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 hy 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 canse.
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 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
301 A
(County) PLACE OF DEATH Suffolk 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.
154
Winthrop Community Hospital No.
Lillian A. (WRy) Smith
(If deceased is a married, widowed or divorced woman, give also maiden name.)
15 Buchanan
(a)
Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
1 0 months
days.
In this community
mos.
days,
PERSONAL AND STATISTICAL PARTICULARS
3 SEX 4 COLOR OR RACE FEMALE While
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
widowEd
5a If married, widowed or divorced HUSBAND of .. ALBERTS Smith (or) WIFE of
mi (Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 AGE 14 Years Months 2 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation: .
Housewife
Industry
AT Home
10 or Business:
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or Country)
SACKville
NEW BRUNS WICK
13 NAME OF
FATHER
Valentine WRy
14 BIRTHPLACE OF
FATHER (City).
SACKville
(State or Country) NEWBrunswick
15 MAIDEN NAME
OF MOTHER
FRANCES WEAthEREAd
16 BIRTHPLACE OF
SACKVille
MOTHER (City)
(State or Country) VIEW BRUNSwick
VERginia WAY
17 Informant (Address 15 Buchanan St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was Tiled with me: BEFORE the burial or transit permit was issued: Walter & Bakes (Signature of Agent of Board of Health or other)
Health Africa
8/ 20/46
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH august (Month)
19
(Day)
1946
(Ycar)
19 I HEREBY CERTIFY, That I attended deceased from
October 15,
, 19 45, to august 19, 19 46
I last saw h.& alive on
august 18
, 19 46 death is said to
have occurred on the date stated above. at 5 15 A . m.
Duration
IMPORTANT 3 months
10 months
2 years
IMPORTANT
Major findings:
Of operations
none
Date of.
Of autopsy
HOVE
What test confirmed diagnosis?
Clinical + Laboralany
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed) Maurice Traunstein dr.
(Address) 562 Shirley St.
winthrop.
, M. D.
Date Dug. 19 1946
21
Winthrop
Place of Burial, Cre ation or Removal.
Aug. 21
76
DATE OF BURIAL
19
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
Howard S. Reynolds- (VR)
ADDRESS
180 cmshop St. winthrop theas
Received and Filed AUG 2 : 1946.
19
Registrar)
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
(Official Designation):
(Date of Issue of Permit)
(If death occurred in a hospital or institution, give its NAME instead of strect and number) !
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
St.
(If nonresident, give city or town and Statc)
48 yrs
Immediate cause of death Chronic Glomerulonephoitin Cerebral Hemorrhage
Due to
arteriosclerosis + artesão~
schematic heart disease
Other conditions
none
(Include pregnancy within 3 months of death)
Physician Underline the cause to which death should be
charged sta-
winthrop
1
2 FULL NAME
- years
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 othcer 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 ten of chapter fully-sia, But 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 forth with 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 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 deathis 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
Y
1 A
Kulfalls
County
1
Ett, or Town) Peuttack Gom Track No.
§ (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).
(a) Residenca. No.
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
( write the word) Mariel
HUSBAND of
Edith To Miller
(Give maiden name of wife in fill)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if elive
30
years
7 IF STILLBORN, enter that fact here.
8 AGE 33 Years
Months Days
If less then 1 dey
Hours
Minutes
Usual
9 Occupetion :
Lavie Service
Industry
10 or Business :
11 Social Security No. 036-07-1676
12 BIRTHPLACE (City)
( Siste or country)
marc
13 NAME OF
FATHER
Jahn a Visconte
PARENTS
14 BIRTHPLACE OF
FATHER ((City)
(State or country)
Mary
15 MAIDEN NAME
OF MOTHER
Mary Landry
16 BIRTHPLACE OF
MOTHER (City)
Flowester
(State or country)
mais
17 Informant ( Address)
Caithe Visconteo worfe
I HEREBY CERTIFY that a satisfaotgry standard certificate of death wea filed with og BEFORE the fourial of Transit germit was Issued : Walter S. Bakery
(Signature of Agent of Board of Heaith of other) 46 Health Officer 8/22/44
(Official Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
15 1946
(Asfonth)
(Day)
(Year)
HEREBY CERTIFY,
That I attended deosased from
May 1,
194/6
Can 19.
194/6
I last saw h./ ............. aliva on
Guy. 19, 1946 dos
have occurred on the dato stated above, at 6:30 Pm.
Immediate oguse of death
Cerebral Hewasbag
Duration
IMPORTANT Sudden
Due to
Due to
Other conditiona
(Include pregnancy within 8 months of death)
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 debeesed? 200 If so, specify
one 7. M. D.
(Signed)
(Address) Hanthrop, Juan Datelep 191946
Place of Burial, Cremation or Removal.
DATE OF BURI
duy, 22
(City or Town)
1946
Z ....
22 NAME OF
FUNERAL DIRECTOR.
ADDRESS
Denby Bras
Received and fied
19
SEF 3 1946
( Regletrar)
100m. (g) - 1-45-15510
PLACE OF DEATH
2 FULL NAME
Edward I Visconte
( If deceased is a married, wid wed or-divorced woman, give also maiden name.)
22 Woodside Que
St.
(If nonresident, give city or town and State)
months days.
In this community 50 yrs.
mos.
days.
years
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.
155
Registered No.
Data of
Of autopsy
Whet test confirmed diegnosis?
Mejor findings:
Of operations
2
Boston
21
Relation, If Any
Bank Boston
" Is sald
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 by 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 helief, 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 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, he deemed to have taken place hetwecn 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 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 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 tomh other than the receiving tomh 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 he, a satisfactory written statement containing the facts required by law to he 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 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- eal 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 ahove 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 hereunder. If the death certificate contains a recital, as required
by section ten of chapter torty-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 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 body 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 body is to he huried 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 disahled 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 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
305
25m-10-'39. No. 8427-g alter the close of the month in which the death occurred. (Scc Cap. 70, 004. 16, 0. 2.) PARENTS
a
AGE ...... 5.7 ... Years
.Months.
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