USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 15
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I HEREBY CERTIFY that a satisfactory Mandard certificate of death was filati with me BEFORE the burial øy transit permit was issued:
Walter A. Bakery
ngnature of Ageft of Board of Health or other)
3/17/51
(Official Designation)
(Date of Issue of Permet)
If under 24 hours
Hours . . Minutes
13 Usual Occupation : (Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Winthrop
Mass
17 NAME OF
FATHERTheodore Javeli
0
Stillborn
TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here. 5/2ns AGE Years .Months .. Days -
have occurred on the date stated above, at
m.
INTERVAL BE-
I last saw h
alive on
19
, death is said to
Female
1
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure, asthenia, ins the disease, cations which th.
id conditions. ing rise to the e (a) stating lying cause
lions contrib- death but not he disease or ausing death.
·50M (8). 12.49-900722
Winthrop
Informant Feb. 17 151 (Address) Winthrop Community Hospita
Registered No.
A R-301A 1 Winthrop (City of Town)
(a) Residence. No. (Usual place of abode)
(Day)
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 (leath 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, 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-six. that the deceased served in the ariny, 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 cleceased, 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 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work dore 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 domestie serviee 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
IR-301A 1
(County) PLACE OF DEATH Suffolk. Sup Winthrop
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.
40
(City or Town
Winthrop Rest Home Lleand No.
¡(If death occurred in a hospital or institution, St. | give its NAME instead of street and number)
Mary JOB rien neSalman 2 FULL NAME
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.) 6 Jefferson
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years months 0 days. In place of residence . . years
1
months . . days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
February
15
(Month)
(Day)
1951 (Year)
8 SEX
Female Mate
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Wedlow
4 I HEREBY CERTIFY,
That I attended deceased from
non
19
45
to.
Feb 15
19 5.
Fel
15
195 , death is said to
have occurred on the date stated above, at
5.45.P. m. INTERVAL BE- TWEEN ONSET AND DEATH 3 days
ANTE Due To arteriosclerosis CEDENT (b) CAUSES antony fusiones. Congesture Afailure
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation.
Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? 200
If so, s
(Signed)
(Address) 447 theleast, Qui trop Date telat
1951
M. D.
mt Benedict Place of Burial or Crematur
Bostone (City or Town)
DATE OF BURIAL Feb 19
195
7 NAME OF FUNERAL DIRECTORCrmest laggiano ADDRE
Received and filed
19
FEB 19 1951
(Registrar)
11 IF STILLBORN, enter that fact here.
12
AGE
74 Yes
1
Months. .
Days
If under 24 hours
Hours ... . Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
at Home
15 Social Security No. west Roxbury
16 BIRTHPLACE (City). (State or country)
17 NAME OF FATHER Henry Salman
18 BIRTHPLACE OF FATHER (City) (State or country)
Germany
19 MAIDEN NAME OF MOTHER Mary Booming
20 BIRTHPLACE OF MOTHER (City) (State or country)
Unknown
Mrs Mary & Furlong
21 Informant (Address) 6 septerban it Wintherog
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Bakles. 3/19/0/ (Signature of Agent of Board of Health or other) Health officer (Official Designation) (Date of Issue of Porma)
UCTIONS FOR CERTIFICATE giving OF DEATH t enter than one for each b) and (c)
does not mean of dying, such lure, asthenia, ns the disease, ations which h.
d conditions. ng rise to the e (a) stating lying cause
ions contrib- death but not he disease or ausing death.
50m-(b)-11-49-970.560
9 COLOR OR RACE
10a If married, widowed, or divorced HUSBAND of . .. Willi've made of OBrien (or) WIFE of (Husband's name in full)
I last saw her alive on
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Cerebral hemorrhage
1 10 yr
PARENTS
Registered No.
(a) Residence. No. (Usual place of abode)
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 hest of his knowledge and belief the name of the deccased, his supposed age, the clisease 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 samc. 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 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 no undertaker or other person shall exhume a human body and remove it from a town, from one ceinctery 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 hody is buried. No such permit shall be issued until there shall have heen 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 o" 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 oceupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6., as amended hy 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 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 dore 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 oeeupation by the appropriate terms, as housekeeper-private family, eook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
R-301A 1
PLACE OF DEATH
Suffolk. (County) Winthrop
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.
40
(City of Town)
Winthrop Nest Home No.
Lewand.
[(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)
Mary JOB rien ne Salman 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
6 Jefferson (a) Residence. No. (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
1 years .months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
February 15
(Month)
(Day)
1951 (Year)
4 I HEREBY CERTIFY .
That I attended deceased from
non
19.45
to
Feb 15
19 5 €
I last saw her alive on ...
Fel
15
قُد19
, death is said to
have occurred on the date stated above, at
5.45 P. .m. INTERVAL BE-
DISEASE OR CONDITION DIRECTLY LEADING
TO DEATH (a) Cerebral hemorrhage
3 days
ANTE
Due To antonio sclerosis
CEDENT (b)
CAUSES ou antony funciones congestion 10 gr
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation
Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? w
If so, specify.
(Signed)
(Address) 447 theleast, Qui tropDate tebi
195
M. D.
mit Benedict
6
Place of Burial or Crematro
DATE OF BURIAL Feb 19
7 NAME OF FUNERAL DIRECTORCrmest Mangiano ADDRES
Received and filed ..
19
FEB 19 1951
(Registrar)
11 IF STILLBORN, enter that fact here.
12 AGE 74 Years 1
Months Days
If under 24 hours
Hours . . Minutes
13 Usual
Occupation :
Houseurte
(Kind of work done during most of working life)
14 Industry
or Business:
at Home
15 Social Security No. West Roxbury
16 BIRTHPLACE (City) (State or country)
17 NAME OF FATHER Henry Salman
18 BIRTHPLACE OF FATHER (City) (State or country)
Germany
19 MAIDEN NAME OF MOTHER Mary Reming
20 BIRTHPLACE OF MOTHER (City) (State or country)
Mra Mary & Furlong
21 Informant (Address) 6 septerban It Wintherog
I HEREBY CERTIFY that a satisfactory ytandard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Bakes. .
(Signature of Agent of Board of Health or other) Health oficer (Official Designationy
(Date of Issue of Pormi)
Y
Wedlow
10a If married, widowed, or divorced HUSBAND of . .. William
(Give maiden name at wife th fuif) ...
0
(or) WIFE of
9 COLOR OR RACE
8 SEX
Female White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR)
Z
UCTIONS FOR CERTIFICATE
giving OF DEATH
ot enter than one for each b) and (c)
does not mean of dying, such lure, asthenia. ns the disease. ations which th.
d conditions. ing rise to the e (a) stating lying
ions contrib. death but not he disease or ausing death.
50m-(b)-11-49-990,560
Unknown
Boston (City or Town)
PARENTS
1
failure
TWEEN ONSET AND DEATH
(Husband's name in full)
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.
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