Town of Winthrop : Record of Deaths 1949, Part 11

Author: Winthrop (Mass.)
Publication date: 1949
Publisher:
Number of Pages: 456


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1949 > Part 11


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70


Minutes


13 Usual


Occupation:


Housewife


(Kind of work done during most of working life)


14 Industry


or Business:


none


15 Social Security No ...


none


16 BIRTHPLACE (City) ... Russia (State or country)


OTHER


SIGNIFICANT


Hypertension


f yrs


Major findings:


Of operations.


Biopsy in 1945


Date of operation


.Was autopsy performed?


What test confirmed diagnosis?


Clinical


5 Was disease or injury in any way related to occupation of deceased? no


If so, specify


Paul P. Weinsaft


(Signed)


230 Shore Drive Date


2/24 1049


B'nai Brith


6


WinthropWorcester


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


February


24


19


49


Informant


Anna Friedberg


(Address) 159, Loc ist St., Winthrop


A TRUE COPY


ATTEST:


(Registrar of City of Town where death occurred)


Received and filed. 19


MAR 16 1949


(Registrar of City or Town where deceased resided)


DATE FILED


February


25.


19 49


×


M R-302 1


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


50m-(e)-10-48-24658


3 DATE OF


DEATH


ANTE


CEDENT (b)


(Address)


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time


after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible


CONDITIONS


Due To


Carcinoma of


CAUSES


uterus


? 3yrs


Due To (c)


17 NAME OF


FATHER


Abraham Cohen


PARENTS


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Russia


19 MAIDEN NAME


OF MOTHER


Lena (Cannot be learned )


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Russia


21


Registered No.


(City of Town)


Grover Manor Hospital


No.


2 FULL NAME ..


(a) Residence. No. (Usual place of abode)


21


(Was deceased a


U. S. War Veteran,


if so specify WAR)


no


April 5


45


to.


Feb. 244


19


7 NAME OF


FUNERAL DIRECTOR


Benjamin Birnbach


ADDRESS .... Washington ..... St .... Dorchester


1


PLACE OF DEATH


Hampden


(County)


Monson


(City of Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


(City or town fra Manso Nium)


Registered No.


32


No.


Monson State Hospital


J(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)


2 FULL NAME


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


St.


Winthrop


(a) Residence.


No.


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death. 13 ... years. ]


.. months


15days. In place of residence


13 ... years. 1


months.15


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March 8 1949


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


Dec ..... 20


19.


.4.5,


to


Lar ..... 8


19.49


I last saw am .....


... alive


Mar. 8.


....... , 19 .. 4.9 death is said to


10a If married, widowed, or dargeth Teed


HUSBAND of.


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Epilepsy


TWEEN ONSET AND DEATH 56


11 IF STILLBORN, enter that fact here.


12


AGE7.2


1


Years


Months


12


Days


If under 24 hours


Hours.


Minutes


13 Usual


Occupation :


(Kind of work done during most of working life)


14 Industry or Business:


15 Social Security No.


Chelsea


16 BIRTHPLACE (City)


(State or country)


Mass ..


OTHER


SIGNIFICANT


CONDITIONS


Major findings:


Of operations


Date of operation


.Was autopsy performed?


What test confirmed diagnosis? clinical & lab.


5 Was disease or injury in any way related to occupation of deceased?


If so, specify


Nathan ... Baratt


M. D.


(Signed)


(Address).


Monson State Hosp 3/8/49


6 Holy Cross-Cem. Malden. Mass.


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


March 11


149


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


21 Monson State Hospital Records


Informam


(Address)


A TRUE COPY.


Jury Canasson


ATTEST:


...


(Registrar of City or Town where death occurred)


DATE FILED


March 19


.....


19


49


X


M R-302 1


WKIIE PLAINLY , WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible


50m-(e)-10-48-24658


7 NAME OF


FUNERAL DIRECTOR.


Frank A. Welsh


ADDRESS


721 Broadway Chelsea


Received and filed 19


APR 1 10,49


(Registrar of City or Town where deceased resided)


8 SEX male


9 COLOR OR RACE


White


10 SINGLE (write the word). MARRIED separated WIDOWED or DIVORCED


have occurred on the date stated above, at.


6:45P.


m.


INTERVAL BE-


ANTE


Due To


CEDENT (b)


CAUSES


Due To (c)


17 NAME OF


FATHER


Charles Mccarthy


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Ellen M.c. Donald


PARENTS


James L. McCarthy


(Was deceased a


U. S. War Veteran,


if so specify WAR)


×


PLACE OF DEATH


Essex


(County)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Danvers (City or town making return)


Registered No.


33


Danvers State Hospital, Hathorne, Mas(.death occurred in a hospital or institution. No.


St. [ give its NAME instead of street and number)


2 FULL NAME George F. Floyd


(If deceased is a married, widoweu or divorced woman, give also maiden name.)


41 Washington Ave., Winthrop,


Mass.


if so specify WAR)


(a) Residence. No. . (Usual place of abode)


St. (If nonresident, give city or town and State)


Length of stay: In place of death.


.years ...


7


months.


7.days. In place of residence.


......


.years.


.. months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March


13


1949


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


Feb ....... 6


46


19.


to


March 13


19


4


I last saw h


imalive on


March 13 1949


death is said to


10a If married, widowed, or divor


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


Arteriosclerotic


TO DEATH (a)


heart disease


2 yrs


12


77


"AGE


Years


7


Months.


8


Days


If under 24 hours


Hours .....


Minutes


ANTE


Due ToGeneralized Arterio


CEDENT (b)


CAUSES


sclerosis


5 yrs-


14 Industry


or Business:


15 Social Security No.


None


16 BIRTHPLACE (City)


(State or country)


Mass.


OTHER


SIGNIFICANT


CONDITIONS


Major findings:


Of operations.


Date of operation.


Was autopsy performed?


No


What test confirmed diagnosis?


Clinical


No


(Address) Hathorne Mass. Date 3/18


194.9.


6 .Winthrop .... Cemetery.


Winthrop


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL.


March 15


.19.49


21


Informantmary E. Sheehan


(Address)


Salam Wass


7 NAME OF


FUNERAL DIRECTOR


Howard S. Reynolds


ADDRESS


Winthrop, Mass.


Received and filed.


APR 9 ...... 1949


19


(Registrar of City or Town where deceased resided)


PARENTS


18 BIRTHPLACE OF


Chelsea


FATHER (City).


(State or country)


Mass.


19 MAIDEN NAME


OF MOTHER


Adaline Leonard Peirce


20 BIRTHPLACE OF


MOTHER (City)


Malden


(State or country)


Mass.


A TRUE COPY.


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED March 19


19


49


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Widowed


Lillian A. Howard


have occurred on the date stated above, at


6:55 a


m.


INTERVAL BE-


TWEEN ONSET AND DEATH


11 IF STILLBORN. enter that fact here.


13 Usual


Occupation :


Unable to work


(Kind of work done during most of working life)


Due To (c)


Winthrop


17 NAME OF


FATHER


Benjamin Tappan Floyd


5 Was disease or injury in any way related to occupation of deceased?


If so, specify


(Signed) Francis X. Sullivan


M. D.


50m-(e)-10-48-24658


M R-302 1 Danvers


(City or Town)


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible


That I attended deceased


from


8 SEX


Male


9 COLOR OR RACE


White


(Was deceased a


U. S. War Veteran,


+


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town) 171 Bowdoin Street


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.


34


J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)


Henry Wadsworth Longfellow Huffman


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


(a) Residence. No.


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of dead 28 .years. months.


days. In place of residence 8 years months .days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March


14


1949


(Year)


8 SEX


Male


9 COLOR OR RACE


Colored


10 SINGLE


MARRIED


WIDOWED


(write the word)


or DIVORCED


Widowed


4 I HEREBY CERTIFY,


That I attended deceased from


I last saw h .............. alive on


death is said to


have occurred on the date stated above, at


8 P.


m.


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Presumably


Сотопаточеногом


ANTE


Due To


CEDENT (b)


CAUSES


Due To


(c)


OTHER


SIGNIFICANTO


CONDITIONS


Lung abscess


Renown 2 yrs


Major findings:


Of operations


none


Date of operation


Was autopsy performed?


no


What test confirmed diagnosis ?.


clinical


5 Was disease or injury in any way related to occupation of deceased? no


If so, specify ......


10 / Human


(Signed) Detming


(Ad


ss) Winthrop Board, Date Mar 14 1949


M. D.


6


Winthrop


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL ..


March


17


19


49


7 NAME OF


FUNERAL DIRECTOR ..


Howard S Pernolds


ADDRESS


Winthrop milas.


Received and filed .19


MAR 1 2 1949


(Registrar)


PARENTS


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Unable to obtain


DUTTON


19 MAIDEN NAME


OF MOTHER


Lizzie Dutton


20 BIRTHPLACE OF MOTHER (City) (State or country)


Unable to obtain


21 Ellen Jones


Informant (Address) 171 Bowdoin Street winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter A. Baker & (Signature of Agent of Board of Health or other)


Whatthe oficer 3/16/49


(Official Designation)


(Date of Issue of Permit)


UCTIONS FOR CERTIFICATE


giving OF DEATH t enter han one for each b) and (c)


oes not mean f dying, such ure, asthenia. as the disease, ations which h.


I conditions. ng rise to the : (a) stating ying cause


ions contrib- death but not e disease or using death.


Corrections 3/18/49


Bounds Prymotels 100M-(D)-10-48-24686 /


I R-301A 1


No.


2 FULL NAME


(Month)


(Day)


19. to


19


10a If married, widowed endivedord Deamus


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.


none


12


AGE


58Years


Months


Days


If under 24 hours


Hours .. .. Minutes


13 Usual


Occupation:


Maintenance


(Kind of work done during most of working life)


14 Industry


or Business:


Real Estate


15 Social Security No ...


029-07-3884


0


16 BIRTHPLACE (City)


(State or country)


Kentucky


17 NAME OF


FATHER


John Huffman


1 of Health Winthrop


Registered No.


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR)


lal Bowdoin Street St.


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 required 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. specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 section 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 nineteen 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 shallexhume 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 inter- ment, 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 physician 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 required of the attending physician. If death is caused by violence, the medical 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 registra- tion. The person to whom the permit is so given and the physician certifying 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 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 persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received 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 follow- ing 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 physician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposably 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,-Physicians: see explanatory instructions on face side of standard certificate of death.


Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. 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, however, 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-301A 1


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


To be filed for burial permit with Board of Health or its Agent.


Registered No.


35


No. Winthrop Community Hospital


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


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


(if so specify WAR)


No


(a) Residence. No. 43. Lewis Ave., Winthrop (Usual place of abode)


St.


(If nonresident, give city or town and State)


.months


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March (Month)


14 (Day/


1949 (Year)


8 SEX


Male


9 COLOR OR RACE


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married


4 I HEREBY CERTIFY,


That I attended deceased from


February 19 19 48


to ..


March 14


19


49


March 14, 1949, death is said to


8:10 A.m.


INTERVAL BE- TWEEN ONSET ANO DEATH IWEEK


11 IF STILLBORN, enter that fact here.


12


AGE


58 Years


.4.


.Months


3. Days


If under 24 hours


.. Hours .. .. Minutes


13 Usual


Occupation :


(Kind of work done during most of working life)


14 Industry


or Business:


Railroad


15 Social Security No. 714-09-21.94


16 BIRTHPLACE (City) (State or country) Boston Mass


17 NAME OF FATHER John T. Wickson


PARENTS


Oxford:1


18 BIRTHPLACE OF


FATHER (City)


(State or country)


England


19 MAIDEN NAME


OF MOTHER


Emma Hiltz


20 BIRTHPLACE OF


MOTHER (City)


Chester


(State or country)


Nova Scotia


21


Informant


Mary.C.Wickson-wife


(Address) 43 Lewis Ave., Winthrop


7 NAME OF


Richard .... C ...... Kirby


ADDRESS Boston, Mass.


Received and filed 19


MAR 2 1 1949


(Registrar)


year


1 year


OTHER SIGNIFICANT CONDITIONS


Duodenal Ulcer-Chance


Major findings:


Of operations.


hore


Date of operation.


Was autopsy performed? Ho


What test confirmed diagnosis ?.


Clinical+ Laboratory No


5 Was disease or injury in any way related to occupation of deceased? If so, specify ... (Signed) Maurice Traunstein 1562 Shipley St. Withrogate earch 14 10 49 (Addres


M. D.


6 Winthrop Cemetery , Winthrop Place of Burial or Cremation (City of Town)


DATE OF BURIAL


March .... 17th


19.49


100M-(D)-10-48-24658


DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Coronary thrombosis


ANTE


CEDENT (b) ...


CAUSES


anteriorclastic Heart


Quéare


Due To


Generalized Cartório -


(c)


sclerosis


10a If married, widowed, or divorced


HUSBAND of


Mary C. Hancock


(Give maiden name of wite in full)


(or) WIFE of


(Husband's name in full)


have occurred on the date stated above, at


I last saw have alive on


riving OF DEATH t enter han one For each b) and (c)


oes not mean f dying, such ure, asthenia, as the disease. ations which h.


conditions. ng rise to the (a) stating ying cause


ons contrib- death but not e disease or using death.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter L. Baker


(Signature of Agent of Board of Health or other) Healthe Office 3/6/49


(Official Designation)


(Date of Issue of Permit


UCTIONS FOR CERTIFICATE


2 FULL NAME .. John Harry Wickson (If deceased is a married, widowed or divorced woman, give also maiden name.)


Length of stay: In place of death .. years. .months.6. days. In place of residence .3.O ... years.


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 required 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 section 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 nineteen 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 shallexhume 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 inter- ment, 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 physician 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 required of the attending physician. If death is caused by violence, the medical 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




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