USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 31
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by section teu of chapter toriy-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 and the physician certifying tbe cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to tbe manner or cause of the death, which the_clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners sball 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 wbich bave been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home 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 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
+
Suffolk (County)
Boston /2/48
Winthrop (City or Town) 93 Hermen .... St.
The Commontoralil 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.
8.1.
S ( If death occurred in a hospital or institution, give ite NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
12 Princeton St.
(Usual place of abode)
St.
East Boston Mass
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
May
7
1948
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
January
to
..
That I attended deceased from
19.
48
May 7
19
I last saw her
alive on
mais
20, 19 48,
h is said to
have oocurred on the date stated above,
at
11 00
P.m.
6 Age of husband or wife if alive years
> IF STILLBORN, enter that fact here.
8
AGE
75 Years
5
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
nme
Industry
10 or Business : at .... home
11 Social Security No.
none
Harcourt
12 BIRTHPLACE (City)
(State or country)
New Brunswick
13 NAME OF
FATHER
John D.Ward
14 BIRTHPLACE OF
FATHER (City)
Bass River
(State or country)
New Brunswick
15 MAIDEN NAME
OF MOTHER
Henrietta McPherson
16 BIRTHPLACE OF
MOTHER (City)
Unknown
(State or country)
New Brunswick
17
Informant ... Frank .... H. Robertson ... s.o.n.
( Address)
65 Cushing St. Cambridge
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed, with me BEFORE the burim or transit permit was Issued : Walter A. Gallery
(Signature of. Agent of Board of Health or other)
5/10/48 (Official Designation) \ \/ (Date of Issue of Permit)
20 Was disease or injury in any, way related to oooupation of deceased ?
If so, specify
Taux 1. Wevw2
M. D.
(Address) 38 Shove En. Wintham Date 15/8
19
21
Woodlawn
everett
Place of Burial, Cremation or Removal.
(City or Town)
19.4.8
DATE OF BURIAL ..
LE Parku
ADDRESS
300 Meridian St .E. Boston
Received and fled 19
MAY 1 31948
(Registrar)
100M-€ · 2·42-8855
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requirss physicians to insert a recital to that ofisot. PARENTS
3 SEX -
4 COLOR OR RACE) 5 SINGLE
( write the word)
Female White
MARRIED
WIDOWED
or DIVORCED
Widow
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in fill)
(or) WIFE of
Artemus .... Robertson.
( Husband's name in full)
Immedlate oause of death.
Carcinomatoses
1
IMPORTANT
J mos
Due to
Carcinoma It colon and
Due to
uterus
. / year
Other conditions
Hypertension
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Man. gen-Hosp. Du. 1947
Can colon
Date of.
Dec -1947
Of autopsy
clinical
What test confirmed diagnosis ?
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
(Signed)
.....
Relation, if any
-301 A 1
PLACE OF DEATH
No.
St.
2 FULL NAME
Ella .... Elizabeth .... Robertson noe ...... "and ..
( If deceased is a married, widowed or divorced woman, give also maiden name.)
years
months
days.
In this community53 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
22 NAME OF
FUNERAL DIRECTOR .......
Duration
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physloian or regiatared hospital medioai officer shall forthwith, after the death of a person whoin he has attemied during his last illness, at the request of an undertaker or other authorized person or ol ans meniber 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 aame was contracted. the duration of hia last flinesa, when laat seen alive hy the physician or officer and the date of his death ... Geu. Laws, Chap. 46, Sec. 9.
A' physician or officer furnishing a certificate 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 I'nited States in auy 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 suy provision of this section, such physician or officer shall forfeit ten dollars. For the purposes 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. he deenicd to have taken place hetween February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chiap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not heen huried, until he haa received a permit 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 person died; and no undertaker or other person ahall exhume a human body and remove it froin a town. from one cenietery to another, or from oue grave or tomh other than the recelving tomh 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 hoily is huried. No such permit shall he issued until there shall have heen delivered to such board, agent or clerk, as the case inay he, a satisfactory written statement containing the facta 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. o1 in lieu thereof a certificate aa hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or ia insufficient, a physi- cian who is a member of the board of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence. the medi- cal examhier shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as ahove 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 hody 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 countersigo 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 nf death shall thereafter furnish for registration any other nece+ 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).
No undertaker or other person shall hury a human hody or the ashes thereof which have been brought Into the commonwealth until lir has re- ceived a permit so to do from the board of health or its age appointed to issue such permita, or if there is no such hoard, from the clerk nf 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. C. L., (Tercentenary Edition).
Medical examinera shall make examination upon the view of the dead bodies 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 aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the observance of the following rules of practice :
(1) Attending phyalcians will certify to such deatha only aa those of persona to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deatha only aa those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medicai attemlance or whose phyaf- cian is ahsent from home when the certificate of death is needed.
(8) Madloal Examinera will investigate and certify to all deaths sup- posably due to Injury. These Include nnt nnls deaths cansed directly or in- directly by traumatism (including resuiting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deatha from diseass resulting from Injury or Infection ralated to occupation, the audden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statement of Cause of Death. Cause of deathı meana the disease, or complication which causes death, not the moile of ilying. e. g., heart failure, asphyxia, asthenia, etc. As principai cause name the disease caualug death. A related causes, name earlier morbid conditions, If any, related to the principal cause and any important complication of the principal cause.
Statemant of Oooupation .-- Precise statement of occupation ia 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 an at school or at boine. For a woman whose only occupatiou was that of home housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
+
R-301 A
See instructions and 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 effect.
100M-10-47-22153
I HEREBY CERTIFY that a satisfactory standard certificate of death was Hied with me BEFORE the burial or transit permit was issued ; Taller A Pakle (Signature of Ageof of Board of Health or other ) Health Officer 5/10/48
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATII
Ma.v.
(Month)
(Day)
(Year)
I HEREBY CERTIFY,
That I attended deceased from
May 8, 19
48
I last saw h .......... afive on
death is said to
have occurred on the date stated above, at
Immediate cause of death metastatic metastatico cummings
Due to.
Due to.
Other conditions (Include pregnancy within 3 montlis of death)
Major findings:
Of operations.
CA heart
Date of
cant 1 947
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
... M. D. (Address) Yhosannastre wn Date 5-62 Winthrop
21
Winthrop
Place of Burial, Cremation or Removal. DATE OF BURIAL
70
(City or Town) 7
22 NAME OF
FUNERAL DIRECTOR.
LowO Maley
ADDRESS
Winthrop Mass
Received and Filed .: MAY 1 3 1948
19
(Registrar)
X
1
(City or Town)
No.
105 Cottage Ave
(Usual place of abode)
Length of stay : In hospital or institution.
(Before death)
(Specify whether)
3 SEX
Female
4 COLOR OR RACE
White
5a If married, widowed or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
George H
Beaudoin
(Husband's name in full)
48
7 IF STILLBORN, enter that fact here.
8
AGE
39 Years
Months
.Days
Usual
9 Occupation :
Housewife
Industry
10 or Business:
11 Social Security No.
033-22-8722
12 BIRTIIPLACE (City)
Boston
(State or Country)
Masg
13 NAME OF
14 BIRTHPLACE OF
TATHER (City)
(State or Country)
Italy
15 MAIDEN NAME
OF MOTHER
Eugenia Faure
16 BIRTHPLACE OF
PARENTS
MOTIIER (City)
(State or Country)
France
17
Informant
UMAIrIn plain tennis, So that it may be properly classified. Exact statement of ULVorAllem is very important.
FATHER
Hector Brugnani
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
arried
6 Age of husband or wife if alive. years
If less than 1 day
Hours
Minutes
PLACE OF DEATH
Suffolk (County)
Winthrop. ..... ...
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
85
Registered No.
St. § (If death occurred in a hospital or institution, 1
give its NAME instead of street and number)
2 FULL NAME
Letitia Beaudoin
(
Brugnani
)
PHYSICIAN-IMPORTANT
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
105 Cottage Ave
St.
(If nonresident, give city or town and State)
months
days.
years
In this community
25
yrs.
mos.
days.
1948
6 A
.m.
Duration
IMPORTANT
IMPORTANT
Underline the cause to which death should be charged sta- tistically.
.19.34
George F. Beaud-in (Rehtira Barnd
(Address)
105 Cottage Ave Winthrop
.8.
(Was deceascd a
U. S. War Veteran,
if so specify WAR)
PERSONAL AND STATISTICAL PARTICULARS
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, bis 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, wben 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 bundred 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 sball 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 fourteentli, 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 sball 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 clark, as the case may be, a satisfactory written statement containing the facts required by law to bc returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the awending physician, if any. as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration, The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thercof 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 discase unrelated to any form of injury, have dicd without recent medical attendance or whose phy- sician is absent from home wlien 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.
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