USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1949 > Part 24
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Irina
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
A Marble
M. D.
(Address) Boston. Mass
Date 6-9
1949.
Dr Theo Herzl
Place of Burial or Cremation
(City or Town)
Everett
DATE OF BURIAL. June ... 10
19.49
21
Informant
(Address)
S Paul
7 NAME OF
FUNERAL DIRECTOR
H J Torf
ADDRESS
Chelsea ....... Mass
Received and filed.
June ..... 13
19. 49
JUN 2 4 1949
(Registrar of City or Town where deceased resided)
PARENTS
18 BIRTHPLACE OF FATHER (City) .Russia (State or country)
19 MAIDEN NAME
OF MOTHER
Ida
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
A TRUE COPY
ATTEST:
(Registrar of City or Down where death occurred)
DATE FILED
19
X
That I attended deceased from
10a If married, widowed, or divorced
HUSBAND of
Clara Kapalovitz
(Give maiden name of wife in full)
have occurred on the date stated above, at
1:55 PM
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) Acute coronary.
occlusion
1 hr
ANTE
Due To
Arteriosclerosis
CEDENT (b) .
CAUSES
generalized & coronary
yrs
Due To
Diabetes mellitus
Chronic nephritis
Hypertension
1 yr
OTHER SIGNIFICANT CONDITIONS
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No. (Usual place of abode)
M R-301A 1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 52 Bartlett Road 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.
Registered No.
J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME.
John D. Mackinnon
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 52 Bartlett Road (Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years months. days. In place of residence 5
.years.
.months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDSingle
4 Į HEREBY CERTIFY,
19
May
46
to ...
freue 14
49
I last saw
6 IM alive on
June 14
19
_19.
death is said to
have occurred on the date stated above, at
5 35
.m.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Coronary.
thrombosis
2 day
ANTE
Due To
Coronary and
CEDENT (b)
CAUSES
hypertensie heart disease 3 year
Due To
(c)
Hypertension
OTHER
SIGNIFICANT
CONDITIONS
Obesity
Major findings:
Of operations
Date of operation.
.Was autopsy performed?
What test confirmed diagnosis?
clinical
5 Was disease or injury in any way related to occupation of deceased?
If so, spe
Paul Weinsaft 6 /14
(Signed) ...
vinthuong, man
Date 19 Ya
Winthrop
Winthrop
6
Place of Burial or Cremation
(City of Town)
DATE OF BURIAL
June
17 1949
19
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop Mass
Received and filed 19
JUN 2.3 1949
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Cape Breton.
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Margaret MacEachern
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Cape Breton. Nova Scotia
21
Informant
Isabelle Mackinnon
(Address 52Bartlett Road Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or trapsit permit was issued: Walter A. Bakery
(Signature of Agent of Board of Health or other)
Health Officer 6/15/49
(Official Designation9
(Date of Issue of Permt)
TRUCTIONS FOR L CERTIFICATE
giving OF DEATH not enter than one e for each (b) and (c)
does not mean of dying, such ilure, asthenio .. cons the discose. icotions which oth.
bid conditions. ving rise to the se (o) stoling erlying couse
itions contrib- se deoth but not the disease or cousing death.
100M-(D)-10-48-24858
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
67
12
AGE
Years
Months
Days
If under 24 hours
Hours
.. Minutes
13 Usual
Occupation :
Retired
(Kind of work done during most of working life)
)14 Industry
or Business:
Carpenter
15 Social Security No.
Cape Breton
16 BIRTHPLACE (City).
(State or country)
Nova Scotia
17 NAME OF
FATHER
Dougall Mackinnon
· years
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
3 DATE OF
DEATH
June 14
1949
(Day)
(Month)
(Year)
That I attended deceased, from
(Was deceased a U. S. War Veteran, if so specify WAR)
PHYSICIAN - IMPORTANT -
M. D.
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 eath of a person whom he has attended during his last illness, at the request f an undertaker or other authorized person or of any member of the family of ne deceased, furnish for registration a standard certificate of death, stating to the est of his knowledge and belief the name of the deceased, his supposed age, the isease of which he died, defined as required by section one, where same was ontracted, the duration of his last illness, when last seen alive by the physician r 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 receding section or by section forty-five of chapter one hundred and four- en, shall, if the deceased, to the best of his knowledge and belief, served in the rrny, navy or marine corps of the United States in any war in which it has been gaged. insert in the certificate a recital to that effect, specifying the war, and all also certify in such certificate both the primary and the secondary or imme- iate cause of death as nearly as he can state the same. For neglect to comply ith any provision of this section, such physician or officer, shall forfeit ten dollars. or the purposes of this section and of sections forty-five, forty-six and forty-seven said chapter one hundred and fourteen, the word "war" shall include the China lief expedition and the Philippine insurrection, which shall, for said purposes, be eemed to have taken place between February fourteenth, eighteen hundred and nety-eight and July fourth, nineteen hundred and two, and the Mexican border rvice of nineteen hundred and sixteen and nineteen hundred and seventeen. . L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body a town, or remove therefrom a human body which has not been buried, until he as received a permit from the board of health, or its agent appointed to issue ich permits, or if there is no such board. from the clerk of the town where the erson died; and no undertaker or other person shallexhume a human body and move it from a town, from one cemetery to another, or from one grave or tomb her than the receiving tomb to another in the same cemetery, until he has ceived a permit from the board of health or its agent aforesaid or from the clerk the town where the body is buried. No such permit shall be issued until there all have been delivered to such board, agent or clerk, as the case may be, satisfactory written statement containing the facts required by law to be turned and recorded, which shall be accompanied, in case of an original inter- ent, by a satisfactory certificate of the attending physician, if any, as required by w, or in lieu thereof a certificate as hereinafter provided. If there is no attending hysician, or if, for sufficient reasons, his certificate cannot be obtained early ough for the purpose, or is insufficient, a physician who is a member of the board health, or employed by it or by the selectmen for the purpose, shall upon pplication make the certificate required of the attending physician. If death is used by violence, the medical examiner shall make such certificate. If such a ermit for the removal of a human body, not previously interred, from one town another within the commonwealth cannot be obtained early enough for the urpose. the certificate of death made as above provided and in the possession of e undertaker desiring to make such removal shall constitute a permit for such moval; provided, that such body shall be returned to the town from which it was moved within thirty-six hours after such removal, unless a permit in the usual rm 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
M R-301 A
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or' Town) 11 Pearl Ave
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
SO ...
8 § (If death occurred in a hospital or institution, give its NAME instead of street and numbers
2 FULL NAME. Esther Bella Katz
.
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 11 Pearl Ave. (Usual place of abode)
st. Winthrop , Mas.s.
(If nonresident, give clty or town and State)
Length of stay: In Anapital or Institution
(Before death)
( Specify whether )
years
months daye.
In this community
2 yrs.
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE| 5 SINGLE
( write the word)
White
MARRIED
WIDOWED
or DIVORCED Widow
5a If married, widowad, or divoroed HUSBAND of
(or) WIFE of
Mofis I'd K''Ezt wlle in hill)
( Husband's name In full)
6 Age of husband or wife if alive yaars
7 IF STILLBORN, enter that fact hera.
8 AGE 69 Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housework
Industry
At Home
10 or Business :
11 Social Security No.
None.
12 BIRTHPLACE (City)
( State or comitry)
Russia
Other conditions
( Include pregnancy within 3 months of death)
Major AndIngs :
Of operations
Data of.
Of autopsy
What test confirmed diagnosis ?
Clinical
IMPORTANT
Physician Underline the cause to which death should be charged sca- tistically.
15 MAIDEN NAME
OF MOTHER
Rose-Cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
20 Was disease or injury in any way related to occupation of deceased? Led If so, specify Alles february M. D. ( Signad) (Address) 26 Wave Way Luce, Date 6/17/19/04
NE. Lebannon-Shiptolker-West Roxbury
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ..
June.
19.
Mass
1949
22 NAME OF
FUNERAL DIRECTOR
Benjamin Birnbach
ADDRESSLO ... Washington .... St. Dorchester
Health Officer
Sifnature of Asont of Board of Health, or other) · 6/18/40
(Official Designation) (Date of Issue of Perufit) /
18 DATE OF
DEATH
Month)
( Day)
17
1949
(Year)
19 I HEREBY CERTIFY.
april 15.
1949.
Ło
6/17/49 1949
.
i last saw h ........... allva on ....
6/15/1949.
have occurred on the date stated above, at 10:00p
death Is sald to
m.
Duration
Immediate oause of daath
IMPORTANT
1 day
3 yrs.
13 NAME OF
FATHER
Aaron Traiger
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Russia
PARENTS
100m-(g)-1-45-15510
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain
extracts from the laws on back of certificate.
17 Aaron Katz
Relation,
Informant (Address) 27 Fessenden St. Mattapan Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE theburial, of transit parmit was Issued : Walter & Bakes of
Recalved and Aled. JUN 2 3 1949
(Registrar)
Coronary Deroulemais
antilly Hent Disease Due to.
That I attendad , daosasad from
No.
PHYSICIAN - IMPORTANT
(Was deceased 2
U. S. War Veteran,
if so specify WAR) NO
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 persou whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall 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 110 undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such 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 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 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 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 leu 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 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 hury 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 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, 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 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 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
M R-301A 1
PLACE OF DEATH
Suffolk (County)
RET
.. Winthrop (City of 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. 81
J(If death occurred in a hospital or institution, St. | give its NAME instead of street and number)
2 FULL NAME .. Samuel Chipman Doane
(If deceased is a married, widowed or divorced woman, give also maiden name.)
51 Palmyra Street
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years .months. days. In place of residence
43
Pars
months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED Married
(write the word)
4 I HEREBY CERTIFY,
That I attended deceased from
July 16
1948
to
June 18
1949
1 last saw h .L.w .... alive on
June 16 1949, death is said to
have occurred on the date stated above, at 54 m.
INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
7.7
7 Years 5
Months
16Days
If under 24 hours
Hours ..
Minutes
13 Usual
Occupation:
Fish business
( Retired)
(Kind of work done during most of working life)
14 Industry
or Business:
Wholesale
15 Social Security No.
None
16 BIRTHPLACE (City)
(State or country)
Mass.
Wellfleet
OTHER
Hypertension
SIGNIFICANT
CONDITIONS
Chronie myaccenditi 1 yr.
Major findings:
Of operations.
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