USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 5
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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, sucb recital shall appear upon the permit. The board of bealth, 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, be shall forthwith go to the place where the hody 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 he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to 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 sucb 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 ahsent 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 pur suits 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 Sulfalls (County) Minchrap 1
PLACE OF DEATH
(City or Town) Minatural Ccm No.
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.
11
Mary G (Doherty) Placey
2 FULL NAME
(It deceased le a married, widowed or divorced woman, give fao maiden name.)
24/Maktani
St.
(If nonresident, give ctty or town and State)
Length of stay : In hospital or Institutton.
(Before desth)
( Specify whether)
years
months
days.
In this community/
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3. SEX
Anale
4 COLOR OR RACEĮ 5 SINGLE
MARRIED
WIDOWED
or DIVORCEO
( write the word)
Il lule
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
22 (Give maiden name of write in fult)
" Husband's name In full)
71
years
7 IF STILLBORN, enter that fact here.
8
AGE
70 Years
Months
Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( State or country)
13 NAME OF
FATHER
Temattu furtunty
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Eulaurel
15 MAIDEN NAME'
OF MOTHER
L'altraune Water
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 tnforment ( Address} 294614 a.u
Relation, if any
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
19.45
22 NAME OF
FUNERAL DIRECTOR:
ADDRESS
Reonived and Aled. JAN 20 1943
.. 19.
( Registrar)
100m-(g)-1-45-15510
I HEREBY CERTIFY that a satisfactory standerd certificate of deeth was Ated with me BEFORE the burial or transit permit was Issued : Walter R. Makers
(Signature of Agent of Board of Heatth or other) Hatte fleur 1/27/48
(Official Designation) ( Date of Inque of Permity
18 DATE OF
DEATH
January 24 1948
( Month)
/ (Day)
(Year)
19 1 HEREBY CERTIFY,
Thet 1 attended deosased from
June 23, 1947.
to .
January 24, 1948
1 last saw h .........
allve
January 24/1948,
ath Is said to
have occurred on the date stated above, at.
2 1/25 A. m.
Immediate ocuse of death
Coronary thrombosis
Due to
artewondertic Heart
disease
Due to
Other conditions Carcinoma ofbreath
( Include pregnancy within 3 months of death)
Mejor findings:
Of operations
auchutation rt brand
oderocarcinoma Date of July, 1946
Of autopsy
What test confirmed diagnost Clinical+ Laboratory
Duration
IMPORTANT
16 hours
2 years
IMPORTANT
Physician Underline the cause to which death should be
tistically.
20 Was disease or injury in any way ralated to oooupation of deocesed ?......
If so, spaolfy.
(Signed) Maurice Traunstein
. M. D.
(Address) 562 Shirley St Witha
Deto Jose 24, 1948
21
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 If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a reoltal to that effect. PARENTS
Registered No.
(If death occurred in a hospital or institution, ott give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(e) Residence. No.
(Usuat place of abode)
S
6 Age of husband or wife if elive
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 hest of his knowledge and helief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate hoth the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican horder service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury 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 tomh to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the hody is huried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he 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 hy it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence, the 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 carly 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 hody has heen sooner obtained herennder. If the death certificate contains a recital, as required
by section teu 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 and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died 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 hody 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 heen hrought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to he 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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, thoughi disabled hy recognized disease unrelated to any fort 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 hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can he known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation hy the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
301
Suffolk
(County) Winthrop
(City or Town)
No.
5 Ocean View St
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registrar's No.
12
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)
2 FULL NAME
Frederick Gould Knell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
5 Ocean View St.
(Usual place of abode)
Length of stay: In hospital or Institution (Before death)
(Specify whether)
years
months
days.
In this commun
+++7 yrs.
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 divgregdora B Bell
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
68
6 Age of husband or wife if alive .. years
7 IF STILLBORN, enter that fact here.
8
AGE77
Years
9
Month:27
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Retired
Industry
10 or Business:
Wholesale Picture Frames
11 Social Security No.
None
Cambridge
12 BIRTHPLACE (City)
(State or country)
Mass .
13 NAME OF
FATHER
Frederick G Knell
14 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Cecelia Blaisdell
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
17 Flora Knell Wifeelation, if any
Informant
(Address)
5 Belcher ST Winthrop, Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death wy Aled with me BEFORE the burial or transit permit was issued : Walter A. Bakerf.
(Signature of Agent of Board of Health or other) Hallte Officer 1/30/48 (Odclal Designation) (Date of Issne/of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
28
1948
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY
may 15
1947
to
9cm 28
That I attended deceased from
1942
I last saw how alive on
Q dn 27, 1942, death is said to
have occurred on the date stated above, at 5+ M.
Immediate cause of death
Chronic Endocarditis
Duration IMPORTANT 5 years
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings:
Of operations.
Date of
Of autopsy What test confirmed diagnosis?
Underline the cause to which death should be charged sta- tistically.
20 Was disease or Injury in any way related to occupation of deceased ? 240
(Signed).
If so, specify
Foris 7 Salerno
M. D.
(Address) 25 Plansand St Date Aa 2 8 1948
21
Mt Aubørn
Cambridge
Place of Burial, Cremation or Removal.
(City or Tows)
DATE OF BURIAL
Jan. 31
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed FEB G 1948
19
A TRUE COPY ATTIST:
(Reglatrar)
from the laws on back of certificate.
Uf deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to Insert a recital to that effect. PARENTS
100m- (f) . 1-45-15510
1
PLACE OF DEATH
Boston
St.
(If nonresident, give city or town and State)
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 hy 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 heeu 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, See. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been huried, until he has received a 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 he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed hy it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is cansed hy violence, the medi- cal examiner 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 be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has been sooner obtained herennder. 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 ageut, 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 regist, ir 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 hury a human hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is 110 such board, from the clerk of the town where the body is to he buried or the funeral is to be held, cr 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 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 by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut 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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