USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 85
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20 Accident, sulolde, of homiplde (specify)
accidental
Date of ooourrenoe.
Sept - 20
1946
Where did
Datteren
{City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publio
place ?
(Specify type of place)
Manner
Injury
Fell to Hear accidentally in
Injury
Nature of
her home on Jeft-20-1946
While at work ?
.Was there an autopsy?
200
21 Was disease or Injury In any way related to ocoupation of deceased?
If so, speolfy
Hm Bricklen
M. D.
(Signed)
(Address)
Boter
006-14-1946
22
Forest Hills
Boston
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
Den 17
1.945
19
23 NAME OF
FUNERAL DIRECTOR ..
Johnet Or males
ADDRESS
Winthrop
Reoelved and filed .......
DEC 171949
1
19
(Registrar) X
extracts from the laws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to Insert a recital to that effeot
50m-(f) -6-43-12056
1
PLACE OF DEATH
(City or Toprn)
No.
Winthrop Commento Hospital Corbett atherine now
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
MARRIED
WIDOWED
or DIVORCEDWidowed
18 DATE OF
Dec- 14-1946
Injury oocur?
10 or Business :
PARENTS
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 au undertaker or other authorized person or of any mientber of the family of the deceased, furnish for registration a standard certificate of deatlı, stating to the best of his knowledge and belief the natne of the deceased, his supposed age, the disease of which he died, defined as required by section one, where sathe was contracted, the duration of his last illness, wheu last seen alive by the physician or other and the date of bis death ... Gen. Laws, Chap. 16, 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, iusert in the certificate a recital to that effect, specl- fying the war, and shall also certify in such certificate both the primary and the secondary or inimmediate cause of death as nearly as he can state the sanie. 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-sevett of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the l'hilippine 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 Mexi- can border service of nineteen hundred aud sixteen and nineteen 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 tuwu, or remove therefrom a human body which has not been buried, until he has received a permit froin the board of health, or ita agent appointed to Issue such permits, or if there is no such board, from tlie clerk of the town where the person died; and no undertaker or other person slrail exhumte a liuman body and remove it from a town, from one cemetery to another, or from one grave or tomb other thau the receiving tomb. to another in the same cettetery, until he has received a permit from the board of health or its agent aforesald or front the clerk of the town where the body is buried. No such perutit shall be issued until there shall have been delivered to such board, ageut 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 uo attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- clan 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 medical examiner shall make such certificate. If auch a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such renovai 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 re- moval, 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, wavy or marine corps of the United States in any war in which
it has heen engaged. such recital shall sppear 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 regis- tration. The person to whom the permit is so given and the physician cer tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to tbe manner or cause of the death, which the clerk or registrar may re- quire .- Clap. 114, Sec. 15, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought luto the commonwealth until he has re- ceived a perutit so to do from the board of health or its agent appointed to issue suclr permits, or if there is no such board, from the clerk of the town where the body is to be huricd or the funeral Is to be held, or from a per- son appointed to have the care of the cenietery or burial ground in which the intermeut is niade. ... Chap. 114, Sec. 46, G. L., (Terceutenary Edi- tion).
Medical examiners sliall 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 hia county the body of such a person, lie shall forthwith go to the place where the body lles and take charge of the same; ... - General Laws, Chap. 3S, Sec. 6.
... He shall in all cases certify to the town clerk or registrar in the place where the decessed died his name and residence, if knowu; otherwise a description as full as may be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
. . . The medical examiner certifies the cause and manner of death to the best of his kuowledge and belief.
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 persona to wliont they liave given bedside care during a last Illness from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deaths only an those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physi- cian is absent from home when the certificate of death la needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deatha caused directly or In- directly by trsuinatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents. aud deaths following abortion, but also deaths from disease resulting from Injury or Infootion related to occupation, the sudden deaths of persons not disablad by recognized disease, and those of persons found daad.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify : (1) Under cause, the nature of an Injury aud of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gaa bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether adininistered as a aurgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circutistances unkuown."
If disease or injury was related to occupation, specify. If Investigation shows the death to have been due to disease, specify: (1) Under cause it's known or presumahle nature; and (2) under manner, Indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basal ganglis) ( found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
-301 A
DCC Instructions and catfacts noif 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.
100m-9-44-14955
PLACE OF DEATH
+ 1 Suffolk (County) winthrop (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 240
St. 3 § (If death occurred in a hospital or institution, § give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a 3. S. War Veteran, if so specify WAR) . NO.
(If nonresident, give city or town and State)
In this community
35 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4
COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widowed
5a If married, widowed or divorced HUSBAND ot ..
(or) WIFE of
(Give maiden name of wife in full)
Edgar
Watson Birkby
'(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter fhat facf here.
8
AGE 82
Years
1
Months
12
Days
If less than 1 day
.Hours
Minufes
Usual
9 Occupafion:
at home
Indusfry 10 or Business:
11 Social Security No.
none
Baltimore
12 BIRTHPLACE (City)
(State or Country)
Maryland
13 NAME OF
FATHER
Thomas Bailey
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Plymouth
(State or Country} England
15 MAIDEN NAME
OF MOTHER
Frances Shaffer
Baltimore
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Maryland
17 Informant Mrs. Adelaide Murch( sisteany ) (Address} 153 Winthrop St, Winthrop I HEREBY CERTIFY fhaf a satisfactory standard certificate of death was filed wifh ma BEFORE the burial or trapsit permif was issued;
(Signature of Agent of Board of Health as other
Health (Official Designation) (Date of Issue of Permit)
12/16/46
18 DATE OF
DEATH
December(Month)
15
(Day)
1946 (Ycar)
19 I HEREBY CERTIFY, That I atfended deceased from
Sent , 1946, to Hu !! . 19
I last saw
alive on
have occurred on the date stated above, at
3.5
Duration
IMPORTANT
dominal
Due fo
Due to aster. 4 ...
Other conditions (Include pregnancy within 3 months of death)
IMPORTANT
Physician
Major findings: Of operations
Date of
Of aufopsy
Whaf fesf confirmed diagnosis?
20 Was disease or injury in any way related to opoupation of deceased ?. If so, specify
(Signed)
(Address)
myxw.
/ . M. D. Date 19 1946 Winthrop
21 Winthrop Cemetery Place of Burial, Crenfation or Removal. (City or Town) DATE OF BURIAL December 17.1946
19
22 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
174 Winthrop St, Winthrop
Received and Filed
DEC 17.1945 (Registrar)
19
46
₹ 19 Y death is said to P. m.
Immediate cause of death Cardiac
·
(a) Residence. No. 153 Winthrop St. St.
(Usual place of abode)
Length of stay: In hospital or institution
Hospital
(Before death)
(Specify whether)
years
months
5
days.
Registered No.
No.Winthrop Community Hospital
2 FULL NAME
Mary Frank Birkby
(If deceased is a married, widowed or divorced woman, give also maiden name.)
female
MEDICAL CERTIFICATE OF DEATH
Underline the cause to which death should be charged sta- tistically.
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 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 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 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 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 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 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, satisfactory written statement containing the facts required by law to he 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 hy 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 hody shall he returned to the town from which it was removed within thirty-six hours after such removal, unless apermit 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 or chapter ionty- six, tuat 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 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 hy 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 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 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 hy traumatism (including resulting septicemia), and hy 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 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
R-305
PLACE OF DEATH
SUFFOLK 1 BOS Tegunty)
(City or Town)
No.
818 Harrison.A.v.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
1065841
(If death occurred in a bospital or institution, give ite NAME instead of street and number)
Fred A Knabo
2 FULL NAME
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
57 Read
(Usual place of abode)
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
monthe
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
5 SINGLE
(write the word)
DEATH
Decomber 16 1946
MARRIED
WIDOWED
or DIVORCED
Carried
5a If married, widowed, or divorced Florence F Keefe HUSBAND of
(or) WIFE of
(Husband'e name in full)
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that faot here.
8 AGE .Years 58 Months. .Days
If less than 1 day Hours .. .Minutes
Usual
9 Occupation :
General Overseer
Industry Maverick Cotton Mills
10 or Business:
11 Soolal Security No. ... 033-05-7982
12 BIRTHPLACE (City)
(State or country )
Mass
Adama
13 NAME OF FATHER Ernst Knabe
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Germany
15 MAIDEN NAME
OF MOTHER
Ida Heffner
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
17 Mrs Florence F Knabe
Relation, if any
Informant. (Address) 57 Road St Winthrop Mass
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
.Dec .... 19 .... 1946
19
21 Was disease or Injury In any way related to oooupation of deceased ?
if so, speolfy.
(Signed)
Timothy Leary
M. D.
(Address)
Date.
12/1719 46
22 Bellevue Adams .. Mass
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Dec 19 1946
19
23 NAME OF
FUNERAL DIRECTOR
John C Kelly
ADDRESS
East ... Boston Mass
Received and filled. 19
DEL JU 1945
(Registrar of City or Town where deceased resided)
of the city or town in which the deceased resided as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
25m-(d) -6-43-12056
20 Acoldent, sulolde, or homlolde (specify) Date of ooourrenoe 19
Where did Injury ocour ?
(City or town and State)
Did Injury ooour In or about the home, on farm, in Industrial place, or in publlo place?
(Specify type of place)
Manner of Injury
Nature of
Injury
While at work?
.Was there an autopsy ?.
No
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that i have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Coronary sclerosis. Treated therefor.
Terminal edema of lungs
3 SEX male
4 COLOR OR RACE
White
(Give maiden name of wife in full)
(If U. S. War Veteran, speolfy WAR)
No
1
St.
-301 A
1
PLACE OF DEATH No.
Suffolk (County) Winthrop (City or Town) 4 Atkinson Circle
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent,
Registered No. .
St. § (If death occurred in a hospital or institution, } give its NAME instead of street and number) )
2 FULL NAME
Robert James Black
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 4 Atkinson Circle (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.
5
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.
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 50
AGE
Years
Months
Days
If less than 1 day
.. Hours
Minutes
Usual
9 Occupation:
Mining Engineer
Industry
10 or Business:
Mining
11 Social Security No.
Boston
12 BIRTHPLACE (City) ..
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