USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 44
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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
extracts from the laws relative to the return of certificates of death. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to Insert a reoltal to that effeot
$0m. (f) -6-43-12056
1 HEREBY CERTIFY that a satisfactory standard certificate of death was flied with my BEFORE the burial of transh permit was issued ; Walter A- B alles. 8
(Signature of Agent of Board of Health or other) Jealthe Office 4/1/47
( Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Year) June - 29-1947 (Month)
(Dấy)
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 gras involves state fully.)
fractured
Lacerations y Brain:
20 Accident, suloide, or homiolde (specify)
accidental
Date of ooourrence.
June-29-1947
Where did
Winthrop
Injury ooour ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publio
place ?
Manner
Found collapsed at uty
Injury
Nature of Stains at her home Injury
While at work?
Was there an autopsy ?.
400
21 Was disease or Injury In any way related to oooupation of deceased ?. -
If so, speolty
Un N. frickley
(Signed)
M. D.
(Address)
Britan
Porotce - 291947
22 Winthrop Winthrop
(City or Town)
Place of Burial, Cremation or Removal.
July
1
1947
19
23 NAME OF
FUNERAL DIRECTOR
Winthrop
ADDRESS
Received and fied
JUL 2 1947
......
19
1
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDSingle
5a If married, widowed, or divoroed
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
8 76
AGE. Years. Months .Days
If less than 1 day Hours .. .Minutes
Usual
9 Occupation :
Housekeeper
Industry
10 or Business :
Home
11 Social Security No ..
12 BIRTHPLACE (City)
(State or country)
Pittsburgh
Pa ...
13 NAME OF
FATHER
Thomas
Murray
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary A. Stirrup
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
17
Informant
Mary
Murray
183 Cottage PK. Rd
Heog if any DATE OF BURIAL
To be filed for burial permit with Board of Health or Its Agent.
Registered No.
131
St. [ ( If death occurred in a hospital or institution, { give its NAME instead of street and number)
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
(a) Residence. No.
183 Cottage Park Rd Watterson
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
months
days.
(If nonresident, give city or town and State)
In this community5
yra.
mos.
days.
Laf. ) -6767
PLACE OF DEATH
-303-A + Suffolk (Gounty) Winthrop 1 (City or Town) 183 College Park Rd
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
No.
Hande
Murray
(If deceased is a married, widowed or diyorced woman, give also maiden name.)
2 FULL NAME
( Registrar)
(Specify type of place)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shell forthwith, after the death of a person whom he has attended during his last illness, at the request of au undertaker or other suthorized person or of any nieniber of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the naine of the deceased, his supposed sge, the disease of which he died, defined as required 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. 16. Sec. 9.
A physician or officer furnishing a certifleste of death as required hy 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 sny war in which it has been engaged. iusert 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 innnediate canse of death as nearly ad be can state the same. For neglect to comply with any provision of this section. such physician or officer shall forfeit ten dollars. For the purposea of thia 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 ex- pedition 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 Mexi- can border service of nineteen hundred and sixteen aud nineteen hundred and seventeen. G. L. Chap. 16, 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 huried, until he has received a perinit froin the board of health, or ita 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 exhunre a human hody 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 aame cemetery, until he has received a permit from the board of health or its agent aforessid or from the clerk of the town where the lody is huried. No such permit shall be iaaued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written ststenient containing the facts required by law to he returned and recorded, which shall he accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or If, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a meinher of the hoard 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 medical examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to an- other within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as ahove provided and in the pos- session of the undertaker desiring to make such removal shall constitute a perniit for such remove !; provided, that such hody shall be returned to the town from which it was removed within thirty-six hours after such re- moval, unless s permit in the usust forni for the reinoval of such body baa heen sooner obtained hereunder. If the desth certificate contains a recital, as required by section ten of chapter forty-six, that the decessed served in the army. navy or marine corps of the I'nited States in any war in which
it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, ujnih receipt of such statement and certificate, shall forthewith 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 the manner or cause of the death, which the clerk or registrar may re- quire .- Chap. 114, Sec. 15, G. L., (Tercentenary Edition).
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 huricd or the funeral is to be held, or from a per- son appointed to have the care of the cenretery or burial ground in which the interment is niade. ... Chap. 114, Sec. 16, G. L., (Tercentenary Edi- tion).
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 withiu his county the body of such a person, he shall forthwith go to the place where the hody liea and take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may he, 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 knowledge and helief.
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 illnesa from disease unrelated to any forin of injury.
(2) Board of Health physicians will certify to such deaths only aa those of persons who, though disabled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physi- cian ia ahsent fromn hoine 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 deathe caused directly or lo- directly by trauinatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut stso desths from disease resulting from Injury or Infection related to occupation, the sudden deaths of persons not disahled by recognized disease, and those of persons found dead.
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 and of ita 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 (gas hacillus) caused hy a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, auicida !. " "Syncope while under the influence of ether adininistered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unkuown."
If disease or injury was related to occupation, specify. If investigation shows the death to have heeur due to disease, specify : (1) Under cause ita known or presumahle nature; sud (2) uller manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the hrsin ( basal ganglia) (found dead in hed)." "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
R-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) Winthrop Community Hospital No. Joseph
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, 132
Registered No.
st & (If death occurred in a hospital or institution, (.give its NAME instead of street and numher)
maril
(If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence No. 222 River Road
(Usual place of abode)
Length of stay: In nocoital or Institution hospital-1 hour
years
months days.
In this community
yes.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX male white
4 COLOR OR RACEI
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEmarried
Sa If married, widowed, or divorced Nettie Cohen HUSBAND of
(or) WIFE of
( Husband's name In rull)
6 Age of husband or wife if allve .50 ... yaars
7 tF STILLBORN, enter that fact here.
AGE
8 52 Years Months Days
If less than 1 day Hours Minutes
Usual
9 Occuoetion :
Wholesale ladies wear
Industry 10 or Business :
11 Social Security No.
028-10-5196
12 BIRTHPLACE (City)
( State or country)
Russia
13 NAME OF
FATHER
Simon Margil
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Russóa
15 MAIDEN NAME
OF MOTHER
Frima Guss
16 BIRTHPLACE OF
MOTHEP. (City)
(Stale or country )
Russia
17 Alexander Margil Informant ( Address) 190 Woodcliff Rd-Newton Mass
I HEREBY CERTIFY that a satisfactory standard oartifiosta of death was Aled with me BEFORE the carrial, of transit/permit was Issued? Walter A. Bauer
(Shnatury of Agrat of Board of Health of other)
Health Ofrecer 4/1/47
( Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
1947 (Year)
THEREBY CERTIFY .
Cepril.
That mattended deosased from
1938.
to.
30 free
19
47
I last saw h. les alive on
30 Once. 1947 death is said to
have occurred on the date stated ebeye, at.
10:00 Pm
Duration
Immediate oause of death acute Coronary Pasaules
IMPORTANT
Due to
Due to
Other conditions
Diabetes mellitus
(Include pregnancy within 3 months of death)
Majot Andings :
Of operations
Date of
of
Autopsy
Clinical.
What test ' confirmed diegnosis ?
20 Was disease or injury in any way related to doounation of deceased ? (Ar) If so, daolty
M. D.
( Signed ) ...
(Address)WiecThrough
Date 30 Guy 19 47
2) Dor, Hebrew Helping Hand, Everett
Place of Burial, Crematinn or Removal.
19
(City or Town)
July 1,
47
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
420 Harvard Street, Brookline.
ADDRESS
Received and Allad
JUL 2 1947
19
......
( Registrar)
9 yrs IMPORTANT
Physician Underline the cause (o) which death should be charged se ... cistically
(Oficial Designation) // /
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that offact. PARENTS
100m-(g)-1-45-15510
2 FULL NAME
( Before death )
(Specify whether )
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR). no
(If nonresident, give city or town and State)
30
(Give malden name of wife in full)
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 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, he 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 hody 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 hoard, 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 he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed hy it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human 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 he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained herennder. If the death certificate contains a recital, as required
by section ien 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 hodies 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 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 hury 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 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 Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any 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 deaths 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 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
R-301 A
1
PLACE OF DEATH No.
Suffolk (County) . Winthrop (City or Town) 295 Winthrop St.
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, 133
St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number) )
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No.
295 Winthrop St
(Usual place of abode)
St.
(If nonresident, give city of town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4
COLOR OR RACE
Male White
5a If married, wid Amelifoged Stempien
HUSBAND of ..
(or) WIFE of
(Husband's name in full)
41
years
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
43
8
AGE
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual 9 Occupation:
Dental Technician
Industry
Dental Labortory
10 or Business:
11 Social Security No. 029-07-5702
12 BIRTHPLACE (City)
(State or Country)
East Boston
Masg
13 NAME OF
FATHER
John Thibeau
14 BIRTHPLACE OF
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