USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 84
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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 a town, from one ceinetery 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, tuat the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died 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 asbes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of bealth 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 sucb 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-303-A
Suffolk (County)
Wathne (City or Town) 30 Dolphin ave
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH Withrok
To be filed for burial permit with Board of Health or Its Agent.
Registered No.
25.6.
St. [ { If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. Ne.
68 Beacon St. Winthrop
(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 community Kyrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
(write-the word)
single
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If allve
7 IF STILLBORN, enter that fact here.
8 AGI 49 Years
.Months. Days
If less than 1 day
Hours ........
.Minutes
Electrician.
Genere Work
11 Soolal Security No ..
CNBC
12 BIRTHPLACE (City)
(State or country)
Out Boston
13 NAME OF
FATHER
James 21. Kelley
14 BIRTHPLACE OF
FATHER (City)
(State or country)
mass
New Bedford
15 MAIDEN NAME
OF MOTHER
China Mullen
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
maine
17 Informant ( die) Flacon SD dc idag
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial og transit permit was Issued : Matter & Paper (Signature of Agent of Board of Health or other) sealle ORheter / omcial Designationy (Date of Issue of Pepmit)
12/12/44
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December-20-1947
( Month)
(Day)
(Year)/
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) acute Cardiac Probables Bilateral Pneumonia
20 Aocident, sulaide, or homlolde (specify)
Date of occurrence.
.19
Where did
Injury ooour ?
(City or town and State)
Did Injury ooour în or about home, on farm, In Industrial place, or In publio
place ?
(Specify type of place)
Manner
"Clapped i died quickly while
Injury
Nature of
visiting men friends
Injury
While at work ?
.Was there an autopsy ?.
21 Was disease or Injury In any way related to occupation of deceased ?.
If so, speolfy
(Signed)
M. D.
(Address)
Britan
Colin-20-29:7
22
Haly Torres
Malden
Place of Burial, Cremation Or Removal.
(City or Town)
DATE OF BURIAL.
Dec 23
19.2 ...
23 NAME OF
FUNERAL DIRECTOR
Fishy Bras
ADDRESS
Windhop, Mare.
Received and fled.
19
DE6 2-2 1947
(Registrar)
50m. (f)-6-43-12056
1 3 SEX Male (or) WIFE of Usual 9 Occupation : PARENTS should be carefully supplied. MEDICAL EXAMINERS Should state CAUSE AND MANNER OF DEATH In plain Terms, Industry 10 or Business : If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to insert a reoltal to that effeot extracts from the laws relative to the return of certificates of death. so that it may be properly classified under the International Classification of Causes of Death. See reverse side for
PLACE OF DEATH
No.
George E. Kelley
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
no
St.
years
Manal moynihan Relation til any
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registsred hospital medloal offioer shall forthwith, after the death of a person whom he has attendeil during his last illness, at the request of an undertaker or other authorizeil person or of any menther 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 age, the disease of which he dieil. defined as required by section one, where saine was contracted, the duration of his last illness, when last seen alive by the physiciau or officer and the date of his death ... Gen. Laws, Chap. 16. Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teet, 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 iuimmediate cause of death as nearly as he can state the sanie. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-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 aud July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and aixteen and nineteen hundred and seventeen. C. L. Chap. 16, Sec. 10.
No undertaker or other parson shall bury or otherwise dispose of a human body in a tuwu, or remove therefrom a human body which has not been buried, until he has received a permit froin the board of health, or ita agent appointed to Issue such permita, or if there is no such hoard. from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body Is buried. No auch 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 aud 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 niake the certificate re- quired of the attending physician. If death is caused by violence. the medical examiner shall make such certificste. If such a permit for the removal of a human body, not previously interred. from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that suchi body shall be returned to the town from which it was removed within thirty-six hours after such re- moval, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-xix, 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, upmin receipt of such statement and certificate, shall forthwith countersign It ant transmit it to the clerk of the town for regis- tration. The person to whom the periuit 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 manter or cause of the death, which the clerk or registrar may re- quire .- Chap. 114, Sec. 45, G. L .. (Tercentenary Edition).
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 boily is to be buried or the funeral is to be held, or from a per- son appointed to have the care of the cemetery or burial ground in which the intermeut is niade. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion ).
Medical examiners shall make examination upon the view of the dead bodles 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 body lies and take charge of the sanie; ... - General Laws, Chap. 3S, 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 be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
.. . The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calls for the observance of the following rules of practice :
(1) Attending physioiana will certify to such deatha only as those of persons to whom they have given bedside care during a last Illness from disease unrelated to any forin of injury.
(2) Board of Health whyalolans will certify to such deaths only as those of persons who, though di shled by recognized disease uurelated to any forin of injury, have died without recent medical attendance or whose physi- cian is absent from home when the certificate of death ia needed.
(3) Medical Examiners will investigate aud certify to all deaths up- poaably dus to Injury. These include not only deaths caused directly or, lo- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agenta, and deaths following abortion, but also deaths from diseass resulting from Injury or Infection related to occupation, ths sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will atate the cause and manner thereof. and will specify : (1) Under cause, the nature of an injury aud of its consequences; and (2) under manner, the mode of ita production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether adininlstered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
If disease or injury was related to occupation, specify. If Investigation shows the death to have been due to disease, specify: (1) Under cause it's known or presumahle nature; and (2) umler manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (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
I R-301 A
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. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PLACE OF DEATH
(County)
1 WINTHROP (City or Town)
No.
45 Sed
Form
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.
Registered No.
257
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)
Winthrop
(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
3 SEX
M
4
COLOR OR RACE
W
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed or divorced HUSBAND of .. .
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
63
years
7 IF STILLBORN, enter that fact here.
AGE.
8
63
Years
Months
Days
If less than 1 day
. Hours
Minutes
Usual
9 Occupation:
Interior Decorator
Industry
10 or Business:
DecoRATING. Company
11 Social Security No.
028-01-0107
12 BIRTHPLACE (City)
(State or Country)
N. Y. City
13 NAME OF
FATHER
Louis Schresky
PARENTS
15 MAIDEN NAME
OF MOTHER
Rose (UNKNOWN)
16 BIRTHPLACE OF
MOTHER (City)
(State or Country}
Russia
17 Informant (Address)
Louis SchResky ( Relation if any ) 45 Sea Food Are Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial defranse pafmit was issued:
(Signature of Agentiy Board of Health roth A) Health office (Official Designation)
(Date of Issue of Vermit) 12/22/47
19
I HEREBY CERTIFY,
That I attended deceased from
De05
19 44, to
Dec21.
1947
I last saw him alive on.
De0 21
1947 death is said to
.30 P. m.
have occurred on the date stated above, at
Immediate cause of death
Cerebral hemanlage
Duration
IMPORTANT
Due to
Poget'o disease
Due to
Other conditions
arteriosclerosis
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis? X- Rays
20 Was disease or injury in any way related to occupation of deceased? no
Il so, specity
(Signed+
hidey &r urypara
, M. D.
(Address) 47
Dee 21 19 47
21 Ind. Pride of Boston Woburn Place of Burial, Cremation or Removal (City of Town)
DATE OF BURIAL
Dec 22
1947
22 NAME OF
FUNERAL DIRECTOR
Louis Schleuder
ADDRESS
1272 Blue Hill ave matt
19
Received and Filed DEC 22 1947
( Registrar)
23 years
IMPORTANT
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Russia
2nd
100M-7-46-19068
MORRIS SchResky (If deceased is a married, widowed or divorced woman, give also maiden name.)
2 FULL NAME
(a) Residence. No. (Usual place of abode)
45 Sea toam Ave
St.
December
21.
1947
(Ycar)
(Month)
(Day)
DoRa Wagner
(Give maiden name of wife in full)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
,
Physician Underline the cause to which death should be charged sta- tistically.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired 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
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