USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 38
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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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. ... - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4. Acts of 1945.
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 issuc such perinits, 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 deathsonly 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
RM R-305 1
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-305 to the clerk of the city or town in which the deceased resided as soon as possible
PLACE OF DEATH
BOSTON
(County)
SUFFOLK
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
5000
Registered No.
115
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME Rachel Kahn
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
43 Tewksbury
St.
WINTHROP.
(If nonresident, give city or town and State)
Length of stay: In place of death ........ ... years. months. .days. In place of residence. .years. months days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF DEATH July 10, 1950
(Month) (Day)
(Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.)
Multiple fractures-Fall from hospital window while disoriented Boston 7-10-50
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
FEM.
10 COLOR OR RACE
WHITE
11 SINGLE
MARRIED
(write the word)
WIDOWED
or DIVORCED WIDOWED
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE OfSIMON .... KAHN
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
73
AGE
Years
Months.
Days
If under 24 hours
Hours .....
.. Minutes
14 Usual
Occupation : Housewife.
(Kind of work done during most of working life)
15 Industry
or Business:
AT HOME
16 Social Security No.
None
17 BIRTHPLACE (City)
(State or country)
Russia
18 NAME OF
FATHER
ABRAHAM KAUFMAN
19 BIRTHPLACE OF
FATHER (City) (State or country)
P.u.s.s .1 ... ...... .. . . . . .. .. ........
20 MAIDEN NAME
OF MOTHER
Dessie Levenson
21 BIRTHPLACE OF MOTHER (City) (State or country)
RUSSIA
Sharon hier, Pk. Sharon
7 Place of Burial, or Cremation. (City or Town)
DATE OF BURIAL. July 11, 1950 19
8 NAME OF
FUNERAL DIRECTOR 3. Schlossberg & SONS
ADDRESS.
MATTAPAN
Received and filed. JUL 17 1950 19
(Registrar of City or Town where deceased resided)
PARENTS
22 Informant
JEANETTE Rampell, deu
(Address)
A TRUE COPY:
ATTEST: 10
(Registrar of City or Town where death occurred)
DATE FILED
JUL 13,1950
............... .19
..............
5 Accident, suicide, or homicide (specify).
Date and hour of injury 19
Where did Injury occur?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place?
Manner of
(Specify type of place)
Injury
(How did injury occur?)
Nature of
Injury
While at work?
Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
Richard Ford
M. D.
(Address)
Date-10-50
25m-(h)-10-48-24658
(City or Town) Mass. Memorial Hospital No.
(Was deceased a
U. S. War Veteran,
if so specify WAR)
+
PLACE OF DEATH
(County)
(City or Town) 48 Vin View
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
116
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME.
No. plomme
marotta
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death 27 years months .days. In place of residence
27,
.years
... months
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
July 10 - 1950
(Month) .
(Day)
(Year)
4 I HEREBY CERTIFY.
Summe 14. 19.47.
to
July 10
That I attended deceased from
1950
I last saw her alive on July/ 10, 1900 death is said to have occurred on the date stated above, at 11:20Am. INTERVAL BE- DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) "Brain Tumor. TWEEN ONSET AND DEATH 1/2yrs
ANTE Due To CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings: Of operations. Brain tumor left (MAS? GEM HOST)
Date of operation. 1949 .......... 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
(Signed)
(Address)
o Holycross martin Place of Burial or Cremation (City or Town)
DATE OF BURIAL Turkey /2 19.50
7 NAME OF
Aementa FUNERAL DIRECTOR Mannens caminin ADDRESS 215 North Sr. Bo con
Received and filed. JUL 12 1950 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Formula
9 COLOR OR RACE hijo .
10 SINGLE
(write the word)
MARRIED WIDOWED or DIVORCED
Single
10a If married, widowed, or divorced HUSBAND of .. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE.7. . Years
Months
.. Days
If under 24 hours
Hours .. ... Minutes
13 Usual
Occupation:
Factory worker
(Kind of work done during most of working life)
14 Industry
or Business:/
Blouses
15 Social Security No. 611-20 H540
16 BIRTHPLACE (City) ..
(State or country)
17 NAME OF
FATHER
Loren o malattia
18 BIRTHPLACE OF FATHER (City) (State or country)
19 MAIDEN NAME OF MOTHER Maria Pitillas
20 BIRTHPLACE OF MOTHER (City) (State or country)
Itrily
21 Lorenzo Invalla-Fitter
(Address) 19 over view inth op.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter S. Bakery (Signature of Agent of Board of Health or other) Health Office 7/12/50
(Official Designation)
(Date of Issue of Permit)
.
RM R-301A 1
NSTRUCTIONS FOR CAL CERTIFICATE
In giving SE OF DEATH o not enter ore than one use for each a), (b) and (c)
his does not mean ode of dying, such failure. asthenia .. means the disease. nplications which death.
forbid conditions, giving rise to the cause (a) stating nderlying cause
onditions contrib- o the death but not to the disease or on causing death.
50m-(b)-11-49-900,560
"Parles Valemi M. D. 342 Namewelt Seiten 7/11/ 19 60
PARENTS
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran. if so specify WAR)
Www Wwop mass
St.
Registered 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 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 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 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 cxaminers shall make examination upon the view of the dead bodics of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from discascs resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable discasc, or when any person is found dead. ... - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Scc. 4. Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thercot 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 issuc 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 hell, or from a person appointed to have the carc 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 deathsonly 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 prisons) 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
Rus.
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
117
No. Winthrop Community Hospital .
Margaret Geneva Diggins
(If deceased is a married, widowed or divorced woman, give also maiden name.)
46 Washington Ave
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years .. 2 months. .days. In place of residence 2 .years months. .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
July 11
(Month)
(Day)
(Year)
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCESingle
4 I HEREBY CERTIFY
That I /attended deceased from
Mahoney
19
10a If married, widowed, or divorced HUSBAND of. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
aboout12 AGE 72
1 vr
Years
Months
Days
If under 24 hours
Hours
.. Minutes
13 Usual
Occupation :
Retired Saleslady
(Kind of work done during most of working life)
14 Industry
or Business:
Dep'T Store
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Massachusetts
10 yrs| 17 NAME OF FATHER Patrick Diggins
18 BIRTHPLACE OF
Manset Lake
FATHER (City)
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Sarah A. Clark
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Newfoundland
21 G. Walter Nickerson
Informant (Address) 176 Brooks St Medford Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued:
Walter A. Baker
(Signature of Agent of Board of Health or other) Thealley Check 7/12/50
(Official Designation)
(Date of Issue of Permit)
SOM-2-19-25666
Received and filed ...
JUL 12 050
19
(Registrar)
8 SEX
(write the word)
April 30 1950
anur
to THE,
I last saw h ... ....... alive on
7/11/50
19
death is said to
have occurred on the date stated above. at 1:05 pm
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Carcinure Of colon
ANTE
Due To CEDENT (b) CAUSES
Due To (c)
OTHER
Arteriosclerosis,
SIGNIFICANT CONDITIONS
generalized.
Major findings:
Of operations.
Date of operation
U
Was autopsy performed ?. 0
What test confirmed diagnosis?
Clinical
0
5 Was disease or injury in any way related to occupation of deceased?
If so, specifp
(Signed)
Bydies w. dickinson
M. D.
Somerset Ave Date // 11/500
(Address).
6 Calvary,hrop Gloucester Mass
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
July 13
1950
7 NAME OF FUNERAL DIRECTOR Winthrop Massachusetts
ADDRESS
a
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME
NSTRUCTIONS FOR CAL CERTIFICATE
In giving SE OF DEATH o not enter ore than one use for each a), (b) and (c)
This does not mean ode of dying, such t failure, asthenia. means the disease, mplications which death.
forbid conditions. ,giving rise to the cause (a) staling nderlying cause
onditions contrib- o the death but not to the disease or on causing death.
RM R-301A 1
Registered No
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. (Usual place of abode)
1750
PARENTS
Gloucester
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 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 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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