USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 78
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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 fromn 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 fromn a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114, See. 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 eaused 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 honie. 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-301A 1
K
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 11 Revere
St
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.
237
[(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME Bridget Fitzgibbons Christopher
(If deceased is a married, widowed or divorced woman, give also maiden name.)
11 Revere St
.. St.
(If nonresident, give city or town and State)
years months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
December (Month) (Day)
11
1950
(Year)
4 I HEREBY CERTIFY,
That I attended decease1 from
may 8
19
46
to
December 11. 1950
I last saw
ber
alive on december 1650 death is said to
(or) WIFE of
Peter Christopher (Husband's name in full)
DISEASE OR CONDITION
DIRECTLY
acute Coronary
TO DEATH (a)
Occlusion
ANTE CEDENT (b) CAUSES arterioscleratic Heart Disease
Due To (c)
Senility
OTHER SIGNIFICANT CONDITIONS
Blindness both eyes (cataract) years.
Major findings:
none
Date of operation none
What test confirmed diag
Was autopsy performed? clinical + laboratory
5 Was disease or injury in any way related to occupation of deceased? If so, specify. (Sig
Jacob J. abrams M.W , M. D. (Add: 6) 562 Sharpay St War. 12/1/50
6 Winthrop Place of Burial or Cremation DATE OF BURIAL ...
Dec. 14
1950
7 NAME OF FUNERAL DIRECTOR.
ADDRESS
Winthrop
Received and filled ..
DEC 13 1950
19
(Registrar)
8 SEX
9 COLOR OR RACE
(write the word)
Female White
10 SINGLE
MARRIED
WIDOWED
or DIVORCE dowed
10a If married, widowed, or divorced HUSBAND of .
(Give maiden name of wife in full)
have occurred on the date stated above, at 6:45 pmINTERVAL BE.
TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.
12
1 hourAGE
Years
82
Months
Days
If under 24 hours
Hours .
Minutes
13 Usual
Occupa
Housewife
(Kind of work done during most of working life)
2 years 14 Industry
or Business: Own Home
1 year 15 Social Security No.
16 BIRTHPLACE (City) (State or country) Ireland
17 NAME OF FATHER Michael Fitzgibbons
18 BIRTHPLACE OF FATHER (City) (State or country) Ireland
19 MAIDEN NAME OF MOTHER Cannot be learned
20 BIRTHPLACE OF MOTHER (City) (State or country)
Ireland
21 Informant (Address)
Cecelia Christopher 11 Revere St
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the barial or transit permit was issued:
Walter (Signature o gent of Board of Health (or other) Health Officer 1211250
(Official Designationy
(Date of Issue of Permit)
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 use (a) stating derlying cause
nditions contrib- the death but not to the disease or n causing death.
PARENTS
VWinthrop
( City OF Town )
'50M (B).12-49.900722
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, ( if so specify WAR)
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death years.
months days. In place of residence 38
Registered No ..
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 ched, 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, See. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or hy 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 heen 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 he accompanied, in case of an original inter- ment, hy 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-siv. 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 pernr. 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 registr .- tion. The person to whom the pernuit 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 of 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 disahled 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 th . 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 traumatismi (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 no.le.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
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.
233
6, Wave Way ave- No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Samuel Skpunk 2 FULL NAME
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
(If deceased is a married,(widowed or divorced woman, give also maiden name.) 6 Wave Way ave Winthrop
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or yown 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
Dec (Month)
(Day)
11 1950 1 (Year)
8 SEX
male White
9 COLOR OR RACE
(write the word)
10 SINGLE
MARRIED/
WIDOWED
or DIVORCED Lower
Edelstein
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
12
AGE
79 Years
Months .. .. Days
If under 24 hours Hours .. Minutes
13 Usual
Occupation:
Upholstere Manufactura
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No. cannot be learned
16 BIRTHPLACE (City). (State or country)
17 NAME OF FATHER abraham Shpunk
18 BIRTHPLACE OF FATHER (City) (State or country)
Russia
19 MAIDEN NAME OF MOTHER Deborah (cannot Learne
20 BIRTHPLACE OF MOTHER (City) (State or country)
Russia
21 Informant (Address)
Harry Lapunk An 167 Fuller St. Brooklin
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)
Health Office (Official Designation) (Date of Issue of Permit)
12/11/50
(Registrar)
8 wks
Due (c)
· Diabetes mellitus
25 yrs.
10 years
CONDITIONS
Major findings:
Of operations.
Date of operation.
Was autopsy performed? wo
What test confirmed diagnosis? Clinical
+ Lab.
5 Was disease or injury in any way related to pecupation of deceased? - If so, spequeles Liberman D
(Signed) (Address) 26 Wave Way Chee. Date 12/11/ 19.50
6 Winthrop Place of Burial or Orematig
Lim- Everett (City of Town)
DATE OF BURIAL. Dec. 12 . 1.50
7 NAME OF Benjamin Birnbach
ADDRESS 1000 ashington AV . Klar.
Received and filed. DEC 13 1950 19
50M-2-19-25666
PLACE OF DEATH
RM R-301A 1
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.
rbid conditions. giving rise to the use (a) stating derlying cause
ditions contrib- the death but not to the disease or n causing death.
PARENTS
PERSONAL AND STATISTICAL PARTICULARS
10a If married, widowed, or divorced HUSBAND of .. ..
19
I last saw h _
AMalive on Dec .... 19 death is said to
have occurred on the date stated above, at 8:30 Am.
DISEASE OR CONDITION DIRECTLY LEADOG TO DEATH (a) Septicemia
INTERVAL BE- TWEEN ONSET AND DEATH 5 m/s
ANTE Due To Gangane Left leg
CEDENT (b) .. CAUSES
That I
attended deceased from
4 I HEREBY CERTIFY.
July
19 47 to.
Wie. 11
No
42
Registered No.
Suffolk (County) Winthrop (City or Town)n
OTHER Ciestrio sclerosis
منسيناء
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 persons as are supposed to have died by violence, or by the action of chemical, thernial 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.
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