Town of Winthrop : Record of Deaths 1948, Part 28

Author: Winthrop (Mass.)
Publication date: 1948
Publisher:
Number of Pages: 524

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 28

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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 cemetery to another, or from one grave or tomh 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 hoard of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).

Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.

No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).

RULES OF PRACTICE

The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.

(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to any forin of injury, have died without recent medical attendance or whose phy- sician is absent from home wben 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 heen 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-301 A

PLACE OF DEATH

Suffer County) Winthrop (City or Toyn) 255 main

main 5/6/4.8

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.

[ {If death occurred in a hospital or institution. { give its NAME instead of street and number) St.

Olof Sundstrom

( If deceased Is married, widowed or divorced woman, give also maiden name.)

(a) Residence. No.

Mo, Berwick maine

....... .......

St.

(maine)

(If honresklent, give city or town and State)

Length of stay: In hospital or Institution

............

(Specify whether)

years

months dayy.

In this community 3

yrs.

mon.

days.

PERSONAL AND STATISTICAL PARTICULARS

( write the word)

5 SINGLE

MARRIED

WIDOWED

D Manrid

Sa 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 aliva 6.9

yeers

If less than 1 day

Hours

Minutes

Retined- Former

Industry

Quan Cam.

11 Social Security No.

Bygdia-

12 BIRTHPLACE (City)

(Siate or country)

Sweden

13 NAME OF

FATHER

neilson Sundstrom

14 BIRTHPLACE DF

FATHER (Clty)

Bygdea

(State or country)

Sweden

15- MAIDEN NAME

OF MOTHER Mitilda Johnson

16 BIRTHPLACE OF

MOTHER (City)

Bygdia

(State or country)

Sweden

17 mmm Claro Sundstrom (. Relation & any (Address) no. Berwick, maine

I HEREBY CERTIFY that a satistaotory standard certificate of death was filed with meBEFORE the burtal or transit permit was Issued : Vater 2. Vakler

(Signature of Agent of Board of Health or other) 4/23/48

(Official Designation) ( Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Cifial

23,1948

(Day)

(Year)

19 | HEREBY CERTIFY,

That, I attended deocased from

Schli 6

1945.

to.

april20

I last saw hf

alive on

ajul 23

.... 19 40 death is said to

have occurred on tha date stated above, at

Duration

Immediate cause of death IMPORTANT Pulman Ede Ce//19/48

Due to Gebelial Hamlangue Day 14 Fenderbenen ! Due to ...

1940

Other conditions.

( Include pregnancy within 3 months of death)

IMPORTANT

Physician Underline the cause to which deith should be charged sta- tistically

20 Was disease or injury in any way related to oooupation of deceesed ? 22

If so, spaoify ...

( Signed)

(Address) (443

Date 9/23

. M. D.

Hillside

no. Benich, marie (City or Town)

Place of Burial, Cremation or Removal.

DATE OF BURIAL Carne 25

1948

22 NAME OF

.....

FUNERAL DIRECTOR David Judge + Son

ADDRESS 100 Highland are, Somenilles

Recaived and Aled

APR 23 1948

19 ......

( Registrar)

Major findings: Of operetions

Date of.

Of autopsy.

What test confirmed dlegnosis?

100m. (g)-1-45-15510

1 No. 2 FULL NAME (Usual place of abode) ( Before death) 3 SEX 4 COLOR OR RACEĮ male White (or) WIFE of 7 IF STILLBORN, enter that fact here. Usual 9 Ocouoetlon : 10 or Business : PARENTS If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requirss physiolans to Insert a recital to that effeot. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and 8 AGE 67 Years 3' Months 19 Days

Erickson

PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)

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 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 iu the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.

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 tomh 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 herennder. If the death certificate contains a recital, as required

by section ten of chapter orty-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).

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 hy 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 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-301 A

extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS

100m- (g)- 1-45-15510

Informent

( Address) 45 Pearl St.

Relation, tf any father Medford

I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with one BEFORE the Dustal of transit permit was Issued : Walter S. Baker

(Signature of Agent of Board of Health or other)

Health Office 4/30/48

(Official Designation) (Date of Issue of Pergilt)

18 DATE OF

DEATH

April

(Stonth)

(Day)

(Year)

19 | HEREBY CERTIFY. Thet I attended deosased from Cepat 23 1945 to Cazul 24 19.0 ...

I last saw h.k .............

192 .. 0, desth Is sald to

have occurred on the dete stated above, a $ 2528 m.

6 Age of husband or wife if allve ysers

7 IF STILLBORN, enter that fact here.

AGE

Years

Months Days

If less than 1 day

Hours

Minutes

Usual

9 Oooupation ;

Industry 10 or Business :

11 Social Security No.

12 BIRTHPLACE (City)

( Siate or country)

Winthrop

13 NAME OF

FATHER

Joseph Butare

14 BIRTHPLACE OF

FATHER (Clty)

Boston

(State or country)

15 MAIDEN NAME

OF MOTHER

Louise Alderizzio

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Haverhill Mass.

Date 2/04

Boston

19.545

St. Michael Cemetery

Place of Burial, Cremation or Removal.

(City or Town)

DATE OF BURIAL

April 28

4.8

Lapino

ADDRESS

22 NAME OF

FUNERAL DIRECTOR

9 Chelsea ... St. Fast Boston

Received and flied MAY 3 1948 19

( Registrar)

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 3 .with Board of Health or its "Agent.

Registered No.

[ {If death occurred in a hospital or institution, St { give its NAME instead of street and number)

2 FULL NAME

Baby (boy) Butore Butare

( If deceased Is a married, widowed or divorced woman, give also maiden name.)

(.) Residence. No.

45 Pearl St.

St.

Medford

(If nonresident, give clty or town and State)

Length of stay: In hospital or Institution

(Before death )

Hosp

years

months

days.

In this community

yra.

mos.

days.

(Specify whether)

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE| 5 SINGLE

MARRIED

WIDOWED

or DIVORCED

Single

( write the word)

Male White

Sa If married, widowed, or divoroed

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

( Husband's name In full)

Immedlate oause of death. atelect atelectasia

IMPORTANT ... ..........

Due to.

Prematunte 6% mo

Due to.

Other conditions

( Include pregnancy within 8 mouths of death)

Major findIngs:

Of operations

Date of

Of autopsy

What test confirmed dlegnosis ?.

DIPORTANT

Physician

Underline the cause to which death should be charged sta- cistically.

20 Was disease or injury in any way related to occupation of deceased ? If so, spoolfy

(Signed)

(Address $ 4 Ban

M. D.

17 Joseph Butare

PLACE OF DEATH

Suffolk (County)

No. Winthrop ... Community ... Hospital

PHYSICIAN · IMPORTANT

(Was deceased a

U. S. War Veteran,

if so specify WAR).

( Usual place of abode)

MEDICAL CERTIFICATE OF DEATH

Duration

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 hest 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 helief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert iu the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.

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 10 undertaker or other person shall exhume a human body and remove it from a towy 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).

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Town of Winthrop : Record of Deaths 1948, Part 28

Author: Winthrop (Mass.) Publication date: 1948 Publisher: Number of Pages: 524

Author: Winthrop (Mass.)
Publication date: 1948
Publisher:
Number of Pages: 524