USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 13
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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 110 undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifylng the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the 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 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
EC
R-301 A
1
Suffolk (County) Winthrop. (City or Town) 131 Bartlett Road. { (If death occurred in a hospital or institution, No. st. give its NAME instead of street and number) C PLACE OF DEATH
To be filed for burial permit with Board of Health or its Agent. Registered No. 38.
2 FULL NAME Emily Lena (Douglas) King ( if deceased is a married, widowed or divorced woman, give
also maiden name.)
(a) Residence. No.
131 Bartlett Road.
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 5
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
Female White
MARRIED
WIDOWED
or DIVORCED Widowed
5a If marrled, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Frederick Winthrop King
( Husband's name in fult)
6 Age of husband or wife if eliva yaars
7 IF STILLBORN, enter that fact here.
8 AGE 8.7 Years 0 Months .8 ..... Days
If less than 1 dey
Hours
Minutes
Usual
9 Occupetion :
At ..... Home
Industry 10 or Business :
11 Social Security No. none
12 BIRTHPLACE (City)
Prince Edward Island
( State or country) Canada
13 NAME OF
FATHER
Edward W. Douglas
PARENTS
14 BIRTHPLACE OF
FATHER (Clly)
Prince Edward Island
(State or country)
Canada
15 MAIDEN NAME
OF MOTHER
Hettie Cooke
16 BIRTHPLACE OF
MOTHER (City)
Irince .... Edward ..... Island
(State or country)
Canada
17 Mrs. Lorenze Goriost
Informent !
Garnies toutes Mener (Address) 13]Bartlett Road Winthrop
I HEREBY CERTIFY that a satisfactory standard oartifloate of death waa filled with me BEFORE the burfal or transit permit was Issued:
(Signature of Agent of Board of Health of other)
7(6melai Designation) 2/15/47
( Date of Issue of Permit)
18 DATE OF
DEATH
February
13
1947
(šfonth)
(Day)
(Year)
19 I HEREBY CERTIFY, Feb. 2
Thet I attended deosased from
19.40, 10.
Feb 13
1947
I last saw h ... LA.
.alive on
7 mb
23.
194.2. death Is sald to
have occurred on the date stated above, at. SP m.
Immedlate oause of death.
IMPORTANT .........
Chronic muncadity
Due to
Hypertension
Due to.
Other conditiona
(Include pregnancy within 3 montbe of death)
Mejor AndInga:
Of operations
Data of
Of eutopsy
What test confirmed diagnosis?
IMPORTANT
Physician
Underline the cause to which death should he charged sta- tistically.
20 Was disease or injury in any way related to occupation of deocesed ? 200
If so, spaoify
Louis 7Salerno
( Signed)
(Address) 125 Plans aux St
M. D.
Date 7 eb 14 1957
21 Winthrop Cemetery, Winthrop Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
Feb. 15,1947.
19
22 NAME DF FUNERAL alfred B. March
. .......
ADDRESS
174.Winthrop St, Winthrop
Received and Alad ..
MART
1947
19
( Registrar)
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
If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, requires physicians to insert a recital to that offoot.
100m(i).1.44.13634
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
PHYSICIAN . IMPORTANT
(Was deceased a
U. S. War Veteran, NO /
if so specify WAR).
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
Duration
2 gr.
4 yra
...
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 relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician 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
RM R-302 t
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.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
PLACE OF DEATH
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
1470
Registered No.
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
2 FULL NAME
Sarah Schwartz
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoo. No.
111 Locust
St.
Winthrop Mass.
(Usual place of abode)
(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
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
Joseph ... Schwartz
(Husband's name in full)
6 Age of husband or wife if allve
55
years
7 IF STILLBORN, enter that faot here.
8 AGE ... 5.6 .... Years. .Months. Days
If less than 1 day
Hours
.. Minutes
Usual
9 Ocoupation :
Housewife
Industry
10 or Business :
At Home
11 Soolsl Seourlty No ...
12 BIRTHPLACE (City)
(State or country)
Lithuania
13 NAME OF
FATHER
Gerson Cohen
14 BIRTHPLACE OF
FATHER (City)
Lithuania
(State or country)
15 MAIDEN NAME
OF MOTHER
Annie E
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Informant (Address)
Husband (
A TRUE COPY. ..
ATTEST :
(Registrar of city or town where death occurred)
Feb. 17/47
19
22 NAME OF
FUNERAL DIRECTOR
L Schlossberg
ADDRESS
Mattapan .. Mass ...
Reoelved and filed MAR 10 1947 19
(Registrar of City or Town where deceased resided)
50m. (b)-6-44-14607
1
Boston
(City or Town)
No.
Mass.General Hospital
DATE FILED
18 DATE OF
DEATH
(Month)
Feb. 14/47
(Day)
(Year)
19 | HEREBY CERTIFY,
Jan ...... 2.9.
19 ... 4.7 ... ,
to
That I attended, deceased from
eb/14/43
! last saw h
alive on
er
Feb
.14
. 19 .... 4.7 death is said to
have occurred on the date stated above, at.
5,58AM
m.
Duration
Immediate oause of death
Peritonitis generalized
15 Das.
Due to
Pancreatitis, acute hemorrhagic
15Days
Due to.
Other conditions
Arterio sclerotic heart dis.
(Include pregnancy within 3 months of death)
Physician
Major findings:
Ligation of veins of
Of operations.
leg
2-10-47
Date of
Underline the cause to which death should be charged sta- tlstically.
What test confirmed diagnosis ?.... Clinica.1 20 Was disease or Injury in any way related to oooupation of deosased?
If so, speolfy.
J S Lichty
M. D.
(Address)
Mass General HosptDate 2-1419
47
21 PLACE OF BURIAL,
Ind.Workers Order Everett Mass
CREMATION OR REMOVAL
(Cemetery)
Feb 14 47
19
(City or Town)
DATE OF BURIAL
(Signed)
Relstion, If any
Of autopsy
PARENTS
(If U. S.
War Veteran,
specify WAR)
محى
M R-301 A
Suffolk
/(County) Hintlook (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.
40
St. 3 § (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)
In this community 50 yrs.
- mos.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH February (Month)
15 (Day)
1947 (Ycar)/
19 1 HEREBY CERTIFY, That I attended deceased from august 15, 1946, to Feb 15 , 1947
I last saw h I'm alive on
Feb 14
, 19 4 / death is said to
have occurred on the date stated above, at
8.9 m.
Duration
Immediate cause of death Chronic Myocarditis
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?
Clinical Signs
20 Was disease or injury in any way related to occupation of deceased? If so, specity U
(Signed)
M. D.
Calvary Qua
Place of Burial, Cremation o Removal.
DATE OF BURIAL Atab. 18
22 NAME OF FUNERAL DIRECTOR ADDRESS 760 Quai ST.
John M. Jagg
Villaster masaã
Received and Filed MAR 1 1947
(Registrar)
IMPORTANT 3 years
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
21
)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial ør transn permit was issued: Water & Bakery (Stynatury of Agent of Board of Health of other), Health Office 2/17/47 Vorfinal Designation) ( Date of Issue of Permit)
Married
years
If less than 1 day Hours Minutes
Mary Bi Laughlin
100m-0-44-14955
1
PLACE OF DEATH
adams
Edward J . Moram
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 16 adams St.
months days.
Registered No.
1.6 No. 2 FULL NAME (Usual place of abode) Length of stay: In hospital or institution years (Before death) (Specify whether) PERSONAL AND STATISTICAL PARTICULARS 3 SEX 5 SINGLE (write the word) MARRIED WIDOWED or DIVORCED Prale 4 COLOR OR RACE White wirdDor diverses C. Griffin 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 7 IF STILLBORN, enter that fact here. 8 1 AGE Months Days 72 Years Usual State Inspector 9 Occupation: 10 or Business: 11 Social Security No .. . 12 BIRTHPLACE (City) Scotland (State or Country) 13 NAME OF FATHER Edward Moran 14 BIRTHPLACE OF FATHER (City) Ireland (State or Count 15 MAIDEN NAME OF MOTHER 16 BIRTHPLACE OF MOTHER (City), (State or Country) 17 Informant (Address) 16 adams ST. Relation, if any Wife If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF Industry Public Saftey Lafet
N. D. WRITE LAIUM
(Address)) Winthrop Date Feb/61947 Boston, mas. (City or Town 19 47
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 kuowledge 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 ariny, navy or inarine 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 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.
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