USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 12
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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 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 & 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 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 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
ORM R-302
Boston
(City or town making return)
Registered No.
12885
No.
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
-
2 FULL NAME
Hadda G Sheinsohn
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
21 Hutchinson
St.
Winthrop .. Mass ..
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ...
(Before death)
(Specify whether)
.....
years
months 14 days.
6
In this community
yTs.
mos.
daye.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
(Month)
(Day)
(Year)*
19 I HEREBY CERTIFY,
Feb .4 /47
19.
to ..
That i attended deceased from
Feb .8/47
19
I last saw h ........ O.r ... alive on.
Feb 8 47
have ooourred on the date stated above, at
5:30₽
m.
Duration
Immediate cause of death
Broncho Pneumonia
2-7-47
...
7 IF STILLBORN, enter that fact here.
8 AGE.84. Years. Months. Days
If less than 1 day
Hours
.Minutes
Usual
9 Ocoupation :
Housewife
Industry
10 or Business :
At Home
11 Social Security No ..
None
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Henry Waldman
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Faige
Russia
17 Informant (Addreee)
L .. Soni.s .... ( ..
Reiation, If any Daughter
DATE OF BURIAL
(Cemetery)
Feb.9/47
(City or Town)
19
A TRUE OQPY. -
ATTEST :
(Registrar of city ,or town, where death occurred) feb .11 19
47
22 NAME OF
FUNERAL DIRECTOR
I Einstein
ADDRESS
Roxbury #858.
Received and filed MAR 10 1947 19
(Registrar of City or Town where deceased resided)
50m- (b) -6-44-14607
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk
PLACE OF DEATH
Suffolk ... (County)
1
Boston
(City or Town)
Hebrew Ladies Home for Aged
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
PARENTS
Of autopsy
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to cooupation of deceased ?
If so, specify
B. A Udelson
(Signed)
M. D.
(Address)
Boston Mass
Date.
2-8 19 47
21 PLACE OF BURIAL,
CREMATION OR REMOVALLiberty Progressive Everett
Underltne the cause to which death
Date of
should be
charged sta-
tietically.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Due to
Acute Congestive Heart Failure 2-4-47
Due to
Arterio Sclerosis
?
19.
.. , death is said to
(or) WIFE of
(Give maiden name P& TVfis FH)
(Husband's name in full)
6 Age of husband or wife if ailve
years
5a If married, widowed, or divorced HUSBAND of
18 DATE OF
DEATH
Feb.8/47
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF ? CERTIFICATE OF DEATH
DATE FILED
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
-
M R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop ..........
(City or Town)
The Commontoralth 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.
3.6.
S ( 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 apeolfy WAR)
(a) Residence. No.
181 Pleasant St.
.......
St.
Winthrop
Mas.s ..
(If nonresident, give clty or town and State)
Length of stay: In hospital or Institution
(Refore desth)
(Specify whether)
years
months
days.
In this community 40 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
. 4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIOOWEO
or DIVORCEO
Widower
5a If married, widowed, or divorced
HUSBAND of
Alice .... D.Hall
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name -in full)
6 Age of husband or wife if alive
years
> IF STILLBORN. enter that fact here.
8
AGE ... 80 Years
2 Months 21 Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Hardware merchant
10 or Business :
retired
11 Social Security No.
none
12 BIRTHPLACE (City)
East Boston
(State or country)
Mass
13 NAME OF
FATHER
Oscar Healy
14 BIRTHPLACE OF
FATHER (Clty)
Rockland
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Elmira Hosmer
16 BIRTHPLACE OF
MOTHER (Clty)
Ellsworth
(State or country)
Mai ne
17 Mrs .Eliot R.Howard 1 daughter (Address) 25 Monument St. Concord Mass
I HEREBY CERTIFY that a satisfactory standard certificata of death was filled with me BEFORE the Cusist or transit permit was Issued : Tratte A. Dakein
(Signature of Agent of Board of Health or other) /
/ Me aute Spice 2/11,47
(Oficial Designation) ( Date of IRque of Permit)
18 DATE OF
DEATH
February
10
1947
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That J attanded deceased from
1946,
to
Feb 10
19.47
Plast saw h ............... alive on.
7 b 10
19%) , death Is said to
have oocurred on the date stated above, at ...............
15
m.
Immedlate cause of death
IMPORTANT
...........
Due to
Que to
10 days
Other conditions.
( Include pregnancy within 3 months of death)
Major findings : Of operations
Physician
Underline the cause to which death should b & charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased? My If so, spaolfy ............................
M. D.
(Signed) .
(Address) 175 Ptservis it
Oste (2-1-11 19 (7
21
Woodlawn
Everett.
Place of Burial, Cremation or Removal.
(City or Town)
OATE OF BURIAL.
February 18,
19.47
22 NAME OF
FUNERAL DIRECTOR
ADORESS
300 Meridian St. E.Boston
Rsoaivad and Aled
19
FLO
....
( Registrar)
100M- 6 - 2-42-8855
+
No. 181 .... P.leasant ..... S.t .....
St.
2 FULL NAME
Fred .... A.Healy
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(Usual place of abode)
White .
1 3 SEX Male Informant If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physicians to insert a recital to that effect. PARENTS extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain Industry
IMPORTANT
Date of.
Of autopsy
What test confirmed diagnosis?
0
cuRu
Duration
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physloian or registered hospital medical officer shall forthwith, after the death of a person whoin he has attended during his last illness, at the request of an undertaker or other authorizeil person or of ans member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and behef 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 Ilinesa, when last seen alive by the physician or officer and the date of his death ... Gen. 18ws, Chap. 46, Sec. 9.
A physician or officer furnishing s 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, aerved In the army. navy or marine corps of the I'nited States in any war in which It has been engaged, insert in the certificate a recital to that effect, speci- fylng the war. and shall also certify in such certificate both the primary and the secondary or immeiliate cause of death as nearly as he can state the ssine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of thla aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall inchule the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes. he deencd to have taken place hetween February fourteenth, eighteen hundred and ninety- eight and July fourth. nhueteen hundred and two, and the Mexi- can horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury 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 ita agent sppointed to issue such permits, or if there Is no such board, from the clerk of the town where the person dled; and no undertaker or otber person shall exhume a human body and remove it froin a town, from one cemetery to another, or from one grave or tomh other than the receiving tonth 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 he issued until there sbali have been delivered to such board, agent or clerk, as the case inay he, a satisfactory written statement containing the facta 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. oi 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 pbysl- cian who is a member of the board of health, or employed by It or hy the aelectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death Is caused by violence. tbe medl- cal examiner shali make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the cominonwealth cannot he ohtsined 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 hody has been sooner ohtalued hereunder. If the death certificate contains a recitai, as required
by section ten of chapter forty-six, that the deceased served In the army, navy or marine corps of the [hiited 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 statenient 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 giveu and the physician certifying the cause of death shall thereafter furnish for registration any other nece+ sary information which can he obtained as to the deceased. or aa to the manner or cause of the death, which the clerk or registrar unay require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall hury 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 permita, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as sre 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 lles and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
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 deatha only aa those of persons to whom they have given hedside care during a last iliness from disease unrelated to any form of injury.
(2) Board of Health physlolans wili certify to such deaths only aa those of persons who, though disahled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose phyaf- cian is absent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to ali deathe sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatiam (including resuitIng 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 dlacase, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death. not the moile of dylng. e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease caualng 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 illuese. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfuily employed may be returned aa at school or at hoine. For a woman whose only occupatiou waa that of honie housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa housekeeper-private family, cook- hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
1 R-301 A +
1
PLACE OF DEATH
Sur fock Winthrop (City or Town) 78 TEMPLE. AVE
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.
32 ....
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
78 TEMILILE AVE
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 20 yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
+
4 COLOR OR RACE1
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
July 1946,
19 46
to .
Thet i attended deoeased from
February 10
19
47
I last saw h 21
700 11
aliva on
1947
death is said to
have occurred on the dato stated above, at.
6 50 P
m.
6 Age of husband or wife if eliva years
7 IF STILLBORN, enter that fact here.
AGEO
8 86 Years Months Days
If less than 1 dey
Hours
Minutes
Usual
9 Ocoupetlon :
at home
Industry 10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
(Siate or country)
Bostry Marc
13 NAME OF
FATHER
Michael Müller
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ouland
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (Clty)
( State or country)
iann
Inland
Relation, If
17 Informant ( Address Y
8 TETALLE an darytito
Place of Burial Cremation or Removal.
(City or Town)
DATE OF BURIAL et, 134
1947
22 NAME OF
FUNERAL DIRECTOR
COSTELLO
-...
ADDRESS 13Chamber Boston
19
(Oftelai Designation)
( Date of Trque of Permit)
18 DATE OF
DEATH
11
1747
Sa If married, widowed, or divorced
HUSBAND of
2.
(Give maiden name of wife in full)
Thomas
(or) WIFE of
( Husband)g/name in full)
Immedlate oouse of daath
IMPORTANT
Cerebro vascular accident
6 mis
Due to.
Generalized arterio seleveris
1 year
Due to
Other conditions.
(Include pregnancy within 3 months of death)
Mejor findings : Of operations
Date of.
Of autopsy.
Whet test confirmed diegnosis?
clinical
IMPORTANT
Physician
Underline the cause to which death should be charged sta- tistically .
20 Was discese or injury in any way related to occupation of deceased ?
.....
....
(Signed)
238 Shore Drive Lernen M. D.
( Address)
Date 2/1. 1977
21
Holy wood
I HEREBY CERTIFY that a satisfactory standard oertifloata of death was fleg with me BEFORE the butlal or transit permit was Issued : Marie
(Signature of Agrot .f Board of Health or other)
Heath
2/11/47
Received and fled FEB1/1947
( Registrar)
100m. (g)-1-45-15510
If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, requires physiolans to insert a recital to that effeot. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
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)
Comma S. LAWLER
Registered No.
Duration
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 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 belicf, 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.
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