USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 25
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No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until ire has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from tire clerk of the town where the body is to be buried or the funeral is to be heid, or from a per- son appointed to have the care of the cenietery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
Medical examiners shali make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of sucii a person, he shail forthwith go to the piace where the body lles and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
. He shall in all cases certify to the town cierk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as fuli as may be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfiliment of the purpose of these laws calla for the observance of the following rules of practice :
(1) Attending physicians wlli certify to such deaths only as those of persons to whom they have given bedside care during a last iliness from disease unrelated to any form of injury.
(2) Board of Health physlolans wili certify to suchi 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 wbose phyaf- cian is absent from hoine when the certificate of death Is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably dus to Injury. These include not only deatha caused directiy or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electricai agents, and deaths foliowing abortion, but also deaths from diseass resulting from injury or infeotlon related to occupation, ths sudden deaths of persons not disabled by rsoognized diseass, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a deatb 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 : "Com- pound fracture of tbe femur with ensuing septicentia (gas bacilius) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidai." "Asphyxiation by suspension, suicidai." "Syncope while under the influence of ether adinlnistered as a surgical anaesthetic." "Fracture of the skull with associated internai injury mus- tained under circunstances 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 it's known or presumable nature; aml (2) umler manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basai Kungiis) (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
PLACE OF DEATH
Suffolk (County)
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.
62
((If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT -
(Was deceased a U. S. War Veteran, if so specify WAR) NO
St. .
(If nonresident, give city or town and State)
Length of stay: In place of death years months. days. In place of residence 50
years
.months
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
Female
White
10 SINGLE
(write the word)
MARRIED Vidowed
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
Edgar Fr Power
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE81
.Years
2
Months
6
Days
If under 24 hours
Hours . Minutes
13 Usual
Occupation :
at home
(Kind of work done during most of working life)
14 Industry
or Business:
no
15 Social Security No.
Ellsworth
16 BIRTHPLACE (City)
(State or country)
Maine
17 NAME OF
FATHER
Jellison
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
19 MAIDEN NAME
OF MOTHER
unable to obtain
20 BIRTHPLACE OF MOTHER (City) (State or country)
21 Qtty. Edward R. Thomas
Informant
(Address)
181 Court Rd.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Waller 2. Parce (Signature of Agent'of Board of Health or other)
Health Queer (Official Designation)
(Date of Issue of Permit)
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 1h.
id conditions, ing rise to the e (a) stating rlying cause
tions contrib- e death but not the disease or causing death.
.50M (B)- 12-49-900722
6
Winthrop Cemetery
Place of Burial or Cremation
Winthrop
(City or Town)
DATE OF BURIAL
March. 21,
1951
7 NAME OF
FUNERAL DIRECTOR
Defred B. March
ADDRESS
174 Winthrop St.
Received and filed 19
MAR 21 1951
(Registrar)
1951
(Month)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Fele.
1947.
to
marche 17.
1951
I last saw her-alive on Marchen 17, 19 31 death is said to
have occurred on the date stated above, at 9:30 A.m.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Terminal
ANTE
Due To
artemisclerotic
CEDENT (b) .. CAUSES heart disease
Due To (c)
cigitity OTHER Contato, andenodalent 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? no
If so, specify ....
(Signed)
(Address ) and workandembert)
M. D.
Date 3-18 1907
I R-301A 1 Winthrop (City of Town)
No. WinduapCa - alice Many TowerX
2 FULL NAME .
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
51 Fremont st.
1
3 DATE OR Marche
DEATH
18
(Day)
Registered No.
3/2015
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 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 hoard 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 been delivered to such board, agent or clerk, as the case may he, 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 hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section 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 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 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 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 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
R-303-A Y
PLACE OF DEATH No .
Sulluck
(County)
(City or Town) Ocean Of Warthanh Beach
The Commonwealth uf Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or Its Agent.
1544 63
Sh [ ( If death occurred in a hospital or institution, ( give its NAME instead of street and number)
2 FULL NAME
Harold & Namn fr.
(If deceased is a married, widowed or divorced woman, givel also maiden named
(a) Residence. No.
27 Jagamore are Winthrop
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution.
( Before death)
( Specify whether)
years
months
days.
In this community
yra. / 0 mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
(write the word)
single
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If allve
years
7 IF STILLBORN, enter that fact here.
8
AGE 15
Years.
7
Months.
19
.. Days
If less than 1 day
Hours .........
.Minutes
Date of ooourrenoe.
march -18-
1957
Usual
9 Occupation :
Student
Industry
10 or Business :
High School
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Harold E. Main
15 MAIDEN NAME
OF MOTHER
Georgina Osterhout
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Тасс.
17 Harold 6. Sorin
Relation y a .. K
I HEREBY CERTIFY What a satisfactory standard certificate of death was filled with me BEFORE IM burlal or transit permit was Issued : Watter T. Baker (Signature of salt (of Board of Health or other) , 2015/ ,
(Omcial Designation) (Date of, Iamue of Permit) -
MEDICAL CERTIFICATE OF DEATH
18 DATE OF March-18-1951
DEATH
( Month)
(Day)
(Year)
19 | 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.)
Drowning
20 Acoldent, sulolde, or homiolde (specify) accidental
Where did
was
Injury ooour ?
(Clty or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publie
place?
ocean
(Specify type of place)
Injury
Nature of Hruthing Was-18-1951
Injury
While at work ?
Was there an autopsy?
no
21 Was disease or Injury In any way related to occupation of deceased ?
If so, speolfy
Hum Buckler
M. D.
(Signed)
62-19 - 195
2 North Burial Ground, Fall River, Mase.
Place of Burial, Cremation or Removel.
(City or Town)
DATE OF BURIAL
March 22.
1951
23 NAME OF
FUNERAL DIRECTOR
Try. C. Goodrich
ADDRESS
128 Washington AX, Tyran
Received and filed
MAY 22 1951
19
(Registrar)
1
3 SEX
Male
(or) WIFE of
11 Soolal Security No ..
14 BIRTHPLACE OF
PARENTS
Informant
( Address)
extracts from the laws relative to the return of certificates of death.
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for
if deceased was a U. S. War Veteran. G. L. Chap. 46, Seotion 10, requires physicians to insert a recitai to that effeot
FATHER (City)
(State or country)
50m-(i)-1.45-15510
Hr
Тасс.
Berere
(Address)
Manner
Retobrat ufinetun Ocean ff
Registered No.
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR) 200
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 niember of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of bis 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 seett alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 16, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-tive 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, Invert in the certificate a recital to that effect, speci- fying the war, and shail also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or offleer shall forfeit ten dollars. For the purposes of this sec- tion and of actions forty five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the ('hina relief ex- pedition and the l'hilippine Insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen bundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred and seventeen. O. L. Cbxp. 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 perinit froin the board of bealth, or its agent appointed to issue auch 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 recelving tomb to another in the same cemetery, until he has received a permit .from the board of heaith or its agent aforesald or from the clerk of the town where the body is burled. 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 interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate caunot be obtained early enough for the purpose, or is insufficient, a physi- clan who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medical examiner shail make such certificate. If such a permit for tbe removal of a human body, not previously Interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided und in the pos- session 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 re- moval, uniesa a permit in the usual form for the removal of such body hes been sooner obtained hereunder. if the death certificate contains a recital, as required by section ten of chapter forty-xix, 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, umum receipt of such statement and certificate, shall forthwith countersign it amt transmit it to the clerk of the town for regis- tration. The person to whom tlte permit ia so given and the physician cer- tifying the cause of death shail thereafter furnish for registration any other necessary information which can be obtained as to the deccaaed, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- Chap. 114, Sec. 15, O. L., (Tercentenary Edition).
No undertaker or other person shail bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue sucht 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 per- son appointed to have the care of the cemetery or burial ground in which the interment is made. .. . Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion ).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;... - General Laws, Chap. 38, Sec. 6.
. . He shali in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .-- General Laws, Chap. 38, Sec. 7.
... 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 following rules of practice :
(1) Attending physloians will certify to sucb deaths only as those of persons to wlioni they have given bedside care during a last illnesa from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deaths only aa those of persona wbo, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or wbose phyaf- cian is absent from home wlien the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to Injury. . These include not only deaths caused directly or in- directly by trautnatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseasa resulting from Injury or Infeotion 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 Examilners in certifying to a death will state the cause and manner tbereof, 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 : "Com. pound fracture of the femur with ensuing septicemla (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with aseo- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether adininistered an a surgical anaesthetic." "Fracture of the skull with associated internal injury sus tained under circuilistances unknown."
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