USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 8
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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 forth with countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE -
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any forum of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only 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
NYWITS
1
×
PLACE OF DEATH
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.
Registered No.
-
No.
Winthrop Community Hospital
1 (If death occurred in a hospital or institution, { St. { give its NAME instead of street and number) f
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. 14 Belcher Street St.
(Usual place of abode)
"(If nonresident, give city or town and State)
17
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4
COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed or divorced
Hilda Reynholds
HUSBAND o1 .. .
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
58
years
7 IF STILLBORN, enter that fact here.
8
12
ÅGE
7.2
Years
2
Months
Days
If less than 1 day
Hours
Minutes
Usual
Captain (Retired)
9 Occupation:
Industry
Ferry Boat
10 or Business:
11 Social Security No ..
021-14-1411
12 BIRTHPLACE (City)
(State or Country)
Sweden
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
home
Date of .. .
Of autopsy
What test confirmed diagnosis?
Clinical + Laboratory
15 MAIDEN NAME
OF MOTHER
Amalia Johanson
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Sweden
17 Hilda Broberg
( Rokyop of any
Informant (Address' 14 Belcher St Winthrop I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial oftransit permit was issued: Walter .
(Signature of Agengof Board of Health of other)
officer
Health Official Designation) (Date of Issue of Permit) 1/27/47
MEDICAL CERTIFICATE OF DEATH
25
1947
(Year)
19 47
1 HEREBY CERTIFY,
That Inattended deceased from
December 9,
,19
I last saw him alive on
Jamany 25, 1947, death is said to
have occurred on the date stated above, at
11 th A. m.
Immediate cause of death
Hypertensive and
arterioscleratic heart disease
with cardiac decompensation
Due to Bronchial asthma
Due to
Chronic cholecystitis
Duration IMPORTANT 1 1/2 years 5 years 6 months
IMPORTANT
Physician Underline the cause to which deatlı should be charged sta- tistically.
20
20 Was disease or injury in any way related to occupation of deceased?
If so, specity
(Signed) Maurice Traunstein
, M. D.
(Address) 562 Shirley St. Winthrop Date Jan 251947
21
Winthrop.
Winthrop
DATE OF BURIAL
Jan 28
1947
22 NAME OF
FUNERAL DIRECTOR
Howard S Runollo
ADDRESS
W minas Timais.
Received and Filed
JAN 29 1947
19
(Registrar)
100m-9-44-14955
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. 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 3
13 NAME OF
FATHER
Johan Kristenson (ok.)
14 BIRTHPLACE OF
FATHER (City).
(State or Country)
Sweden
PARENTS
M R-301 A
1
Length of stay: In hospital or institution
Hosp.
years
In this community
yrs.
(Before death)
(Specify whether)
2 FULL NAME
John Otto Broberg
(If deceased is a married, widowed or divorced woman, give also maiden name.)
months
1
days.
18 DATE OF
DEATH
Ja
mary
(Month)
(Day) )
45
. to
January 25. 1947
hove
Place of Burial, Cremation or Removal.
(City or Town)
-
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or othcer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec. tion and of sections forty-five, forty-six and forty seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety. eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section teu of chapter torty . six, luat 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 permita, 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 forin 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
1
PLACE OF DEATH
Essex
(County) Danvers (City or Town) No anvers State Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
Registered No.
25
(If death occurred in a hospital or inetitution, St.
give its NAME instead of etreet and number)
2 FULL NAME.
Charles Markell
(If deceased ie a married, widowed or divorced
woman, give aleo maiden name.)
(a) Residence. No.
173 Shirley
(Usual place of abode)
Length of stay : In hospital or Institution.
(Before death)
(Specify whether)
...
5 years /
monthe 20
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE|
male White
5 SINGLE
(write the word)
married
MARRIED
WIDOWED
or DIVORCED
( Month)
(Day)
(Year)
5ª If married, widowed or divorced HUSBAND of
JeShine Looney
(Give maiden name of wife in full)
(Husband'e name in full)
6 Age of husband or wife If alle cannot be learned
7 IF STILLBORN, enter that faot here.
8
AGE.
73 Years
Months. Days
If less than 1 day
.. Hours
.. Minutes Due to.
ash Collector (retired)
11 Soolal Security No.
12 BIRTHPLACE (City)
(State or country)
Turkey
13 NAME OF
FATHER
martin markell
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Turkey
15 MAIDEN NAME
OF MOTHER
Mary Donohue
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Jurken
Mary
mc Philly Relation, if any
17 Informant ... (Address) Hathorne Mass
A TRUE COPY. ATTEST :
(Registrar of city or town where death occurred)
1947
DATE FILED
18 DATE OF
DEATH
Jan
26
19 1 HEREBY CERTIFY,
Lec. 6
1941
to ...
That I attended
deocased from
Jan. 26 1947
I last saw h.
Un alive on Jan/26, 1941, death is said to
have occurred on the date stated above, at
6.150
.. m.
Duration
Immediate oause of death, arterio sclerotic heart
7 ypro.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of.
should be
Of autopsy Clinical
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to oooupation of deceased ?.
If so, specify, (Signed) Laquale Buoniconto M. D. (Address) Hathorne Mas Date 1/3/1947
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
DATE OF BURIAL
Winthrop Cem Wirth
(Cemetery)
Jan. 29
(City or Town)
1947
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop mars.
Howard D. Reynolds
Reoelved and filed FEB 7 1947 19
(Registrar of City or Town where deceased resided)
1
50m . (b).6.44-14607
3 SEX
(or) WIFE of
Usual
9 Occupation :
PARENTS
WRITE PLAINLY, WTTTT ONPAVING BLACK INK THIS IS A PERMANENTE KEUVRE
Industry
10 or Business :
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-302 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
Danvers
(City or town making return)
(If U. S.
War Veteran,
spoolfy WAR)
Winthrop
St.
(If nonresident, give city or town and State)
1947
disease
Underline the cause to
which death
charged sta- tietically.
-
I R-301 A
-
PLACE OF DEATH
1 Suffolk. (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
To be filed for burial permit with Board of Health or its Agent.
26 ....
gide its NAME instead of street and number)
2 FULL NAME
Nell Mae ( Batchelder ) Spooner.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR) ... NO.
(a) Residence. No.
40 Temple Ave
St.
(It nonresident, give city or town and State)
Length of stay: In hospital or institutionnursing home.r. 8
months
days.
in this community
14 yrs.
mos.
daya.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January ..
26
1.9.4.7
( Month)
( Day)
( )'ear)
19 1 HEREBY CERTIFY,
That i attended deosased from
19.
45.
to Bancarie 26
19
47
....
I last saw hrdin alive on
January 26. 1977
have occurred on the date stated above, at7:0/2
m.
death Is said to
Immediate oouse of death
IMPORTANT
4 core les
Due to
2 years
Due to
lex -
Life hemiplejia
10.
Other conditions
( Include pregnancy within 3 months of death)
IMPORTANT
Major findinga:
Of operations
Date of
Of autopsy
nial
0
What test confirmed diegnosis?
20 Was disease or Injury in any way ralated to Jooupation of deoeesed ? If so, spaoify
( Signed)
5) 238 these Gray With Date 11/17/1997
(Addr
21
Cedar Grove Cemetery Dorchester
Piace of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
January 28, 1947
19
22 NAME OF
FUNERAL DIRECTOR
DR alfred B. March
ADDRESS
174 ..... Winthrop, St ..... Winthrop.
Received and fled
JAN 29 1047
19 .....
(Oficial Designation)
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
widowed
years
If less than 1 dey
Houra
Minutes
13 NAME OF
FATHER
John Nelson Batcheller
100m- 1g) - 1 - 15.15510
Informent ( Address ) 40 Washington St Newton Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the butter or transit perrait was issued: Walter A Pavlice
(Signature of Agent of Board of Health of other) Thatthe appear
( Date of Theuse of Dermit)
( Registrar)
Duration
1 year
Physician Underline the cause to which death should be charged st .. tistically .
....
1
(Usual place of abode)
( Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
female
white
Sa If married. widowed, or divorced
HUSBAND of
(or) WIFE of
william H. Spooner
( Husband's name in full)
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
8
AGE 73 Years
3
Months 27 Days
Usual
9 Occupation :
retired
Industry
10 or Business :
11 Social Seourity No.
none
12 BIRTHPLACE (City)
Hampden
( State or conulry)
Maine
14 BIRTHPLACE OF
FATHER (City)
Hampden
15 MAIDEN NAME
OF MOTHER
Eliza Sawyer
16 BIRTHPLACE OF
MOTHER (City)
Hampden
( State of country)
Maine
17
Dorothy M. Haas
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PARENTS
(kww har. march)
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
(State or country)
Maine
Winthrop. CERTIFICATE OF DEATH Registered No. (City or Town) 46 Washington Ave Kirkpatricks N. I. (If Aeath occurred in a hospital or institution. No.
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, he 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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