USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 41
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Chelsea Mars
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place? Stone
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.) Pulmonar edema following
11a If married, widowed, or divorced HUSBAND of. (Give maiden name of wife in full) alexandro Dulona
PHYSICIAN - IMPORTANT J (Was deceased a U. S. War Veteran, ( if so specify WAR).
(If nonresident, give city or town and State)
76 years
M R-303 A 1 Will (City or Town) Winthrop Community Hay No
Gluk= masa
7 Place of Burial, or Cremation. (City or Pown)
20 MAIDEN NAME OF MOTHER
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. as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931. No undertaker or other person 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., as amended.
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.
.... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 us 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident.""Pistol shot wound of the chest with associated hemorrhage, hom- icidal."" "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown.''
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1)Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)'
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
......
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
....
RM R-301A 1
50M-2-19-25666
PLACE OF DEATH
Suffolk (County) Winthrop (City or Toyn)
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.
125
St. Į give its NAME instead of street and number) No. Winthrop Community Hospital. f(If death occurred in a hospital or institution.
Benjamin D. 7 medman 2 FULL NAME ..
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, ( if so specify WAR)
NO
(a) Residence. No. (Usual place of abode)
sa married, widowed or divorced woman, give also maiden name.) 203 Shore Drive
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .. years. .months
3 days. In place of residence 20 .years months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
July
(Monthy
(Day)
28 1950 (Year)
8 SEX
male
9 COLOR OR RACE
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
marmed
4 I HEREBY CERTIFY,
Jan.
19
48
to.
July 28
...
1950
I last saw him alive on.
July 28/ 1950, death is said to
have occurred on the date stated above, at 8:00 A.m.
INTERVAL BE-
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
: 61
Years
Months.
Days
If under 24 hours
Hours ...
. Minutes
13 Usual Occupation : Chiropodest
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No mone
16 BIRTHPLACE (City) Boston (State or country)
mais
17 NAME OF FATHER Judah Freedman
18 BIRTHPLACE OF FATHER (City) (State or country)
Poland
19 MAIDEN NAME
OF MOTHER
Sarah Solomon
20 BIRTHPLACE OF MOTHER (City) (State or ,country)
mrs Benj. D. Freedman
21 Informant (Address) 203 Thone Drive Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burialpr transit permit was issued: Walter . Bakerz.
(Signature of Agent of Board of Health or other)
Health ofice 7/28/30
(Official Designation) (Date of Issue of Permit)
(Registrar) 1
2 days
CONDITIONS
(Terminal)
Major findings:
Of operations.
Date of operation ..
What test confirmed diagnosis?
clinical
200
Was autopsy performed? 200
5 Was disease or injury in any way related to occupation of deceased?
If so, specis
Charles Liberman
M. D.
(Signed)
(Address) 7 6 Way Way Wirth Date, 7/28/ 1950
6 HAND IN HAND CEM.
WIRDX 1
Place of Burial or Cremation (City or Town)
July 30
1950
DATE OF BURIAL ..
7 NAME OF
Benjamin F. Salomon
FUNERAL DIRECTOR
ADDR
420 Forward It Brookline
Received and filed. JUL 3 1 1950
19
10a
If married, widowed, or divorced
HUSBAND of.
Frances Roce
(Give maiden name of wife in full)
(or) WIFE of
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
)Cerebral Thrombosis
TWEEN ONSET AND DEATH 3 days
ANTE CEDENT (b)
Hypertension and Que.
CAUSES ceteris Aclarasia
5. yra
Due To (c)
OTHER
SIGNIFICANTBroncho Pneumonia
PARENTS
England
STRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean de of dying, such failure, asthenia, means the disease, plications which death.
orbid conditions, giving rise to the ause (a) stating derlying cause
nditions contrib- the death but not to the disease or n causing death.
Registered No.
(If deceased
That I attended deceased from
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 mace 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 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 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 occup :- 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
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.
Winthrop Community. Ilook. No.
(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)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 145 main
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .years months. days. In place of residence
35, .. years months. . .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE 2
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
single
10a If married, widowed, or divorced HUSBAND of ..
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
TWEEN ONSET AND DEATH 36 hrs 12 AGE 4
Years Months ... Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Photography
(Kind of work done during most of working life)
14 Industry or Business:
Journalism
15 Social Security No.
16 BIRTHPLACE (City) (State or country)
17 NAME OF FATHER
Louis Anty Simard
18 BIRTHPLACE OF FATHER (City) (State or country)
Russia
19 MAIDEN NAME
OF MOTHER
marian alexander
20 BIRTHPLACE OF MOTHER (City) (State or country)
Quasia
21 Ada Blumenthal
(Address) 4F Ruth RT. Worcester
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter S. Makers
(Signature of Agent of Board of Health 6r other)
Thealth Check 7/28/50
(Official Designation)
(Date of Issue of Permit)
50M-2-19-25666
7 NAME OF George & Perlman ADDRESS 026 main ST. Worcester
Received and filed. 19
JUL 3 1 1950.
(Registrar)
deceased from
4 I HEREBY CERTIFY.
50
July 27
19
to
July
That I attended
28
...
19
I last saw him alive on July 281 19 death is said to
have occurred on the date stated above, at
Coronary throm-
ANTE
Due To
Coronary arterio
CEDENT (b) CAUSES sclerosis !
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation
.Was autopsy performed?
What test confirmed diagnosis?
5 Was disease orinjury in any way related to occupation of deceased ?. no Il So, specify toud PWeinsaft (Signed)
... M. D. (Address) 238 Shore Drive Winthrop Worcester 7/28 6 Place of Burial or Cremation (City or Town) DATE OF BURIAL July 30 1950
PARENTS
Registered No.
126.
2 FULL NAME Harry Simard
(a) Residence. No. (Usual place of abode)
ISTRUCTIONS FOR CAL CERTIFICATE
In giving SE OF DEATH o not enter re than one use for each ), (b) and (c)
his does not mean de of dying, such I failure, asthenia, means the disease, aplications which death.
orbid conditions. giving rise to the ause (a) stating nderlying cause
ditions contrib- the death but not lo the disease or on causing death.
'NAI 'Rith
RM R-301A 1
3 DATE OF
DEATH
July
28 1950 (Year)
(Month
(Day)
10%. .m. INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
basis
? 20 y rs
(Give maiden name of wife in full)
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.
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