USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 60
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6 Calvary
Place of Burial or Cremation
DATE OF BURIAL. 7 July 24
51
7 NAME OF
FUNERAL DIRECTOR.
John F. O malley
ADDRESS
Winthrop Mass
Received and filed .. 19
JUL 23 1951
(Registrar)
A TRUL COPY VETL ..
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
(write the word)
Female White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEISingle
10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Carcinoma al Signoral ¿ metastases
ANTE Due To
CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Carcinoma of Sigmoide metastases
Date of operation 9.21.51 Was autopsy performed ?. What test confirmed diagnosis? Pash report
18 BIRTHPLACE OF FATHER (City) (State or country) Ireland
21 Anna Johnstone
Informant (Address) 43 Franklin Street Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transit permit was issued: Walter I Makelele (Signature of Agent of Board of Health of other) Halite Officer 7/23/5/
Official Designation) (Date of Issue of Permit)
(Was deceased a U. S. War Veteran, if so specify WAR›
no
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death. . years.
months 4 days. In place of residence 40
CTIONS R RTIFICATE
ving DEATH enter an one r each and (c)
es not mean dying, such re, asthenia, the disease, ions which
conditions, rise to the (a) stating ing cause
ns contrib- eath but not disease or sing death.
OM AJ 12 49 900722
(Day)
4 I HEREBY CERTIFY,
That I attended deceased from
Boston (City or Town)
CERTIFICATE OF DEATH
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 behef 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 hundre land fourteen, the word "war" shall include the China rchef 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 pernuit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment. by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient. a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal. unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical 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.
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 elerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-302 1
PLACE OF DEATH
(County> SUFFOLK
B(City of Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No
6632 163
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
38 FORREST
St.
WINTHROP
(If nonresident, give city or town and State)
Length of stay: In place of death
......
... years.
1
months
2
days. In place of residence
years.
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
MALE
9 COLOR OR RACE
WHITE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
MARRIED
4 I HEREBY CERTIFY,
That I attended deceased from
JUL
23 51
JUN 21 19
51
to
I last saw h ...... M.
.. alive on
JUL 23 1951
death is said to
have occurred on the date stated above, at
5:55 ₱
.m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
2018
11 IF STILLBORN, enter that fact here.
12
AGE: 62 Years
.Months.
Days
If under 24 hours
Hours .....
Minutes
13 Usual
Occupation:
TAILOR
(Kind of work done during most of working life)
14 Industry
or Business:
SCOTT & CO
15 Social Security No
029 10 6466
16 BIRTHPLACE (City).
(State or country)
RUSSIA
17 NAME OF
FATHER
LOUIS SINGER
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
RUSSIA
19 MAIDEN NAME
OF MOTHER
PESSIE CNBL
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
RUSSIA
21 PHILLIP GOLD
Informant.
(Address
A TRUE
Charles 21
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
JUL 26 1951
Mac
ADDRESS
DORCHESTER
Received and filed
AUG 10-1951
.. 19
(Registrar of City or Town where deceased resided)
5YRS
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation
Was autopsy performed?
NO
What test confirmed diagnosis?
ECG & CLIN
5 Was disease or injury in any way related to occupation of deceased?
If so, specify ...
G COHEN
(Signed)
(Address) JMH
Date
7/ 23
19.
15 P-
6 CHEVRA MICHNIA L.Y.N.N (City or Town) Place of Burial or Cremation DATE OF BURIAL. JUL 24 1951 19
7 NAME OF
FUNERAL DIRECTOR
B BIRNBACH
25M (E)-6-50.902253
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Ser 12, G. L.)
MORRIS SINGER
(Was deceased a
U. S. War Veteran,
if so specify WAR)
NO
(a) Residence. No. (Usual place of abode)
35
10a If married, widowed, or divorced
HUSBAND of ..
ANNA RADETSKY
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
MYOCARDIAL INFARCT
ANTE CEDENT (b)ANTERIOSCLEROTIC HEART DIS Due To CAUSES
3 DATE OF
DEATH
JUL 23 1951
(Day)
(Year)
(Month)
No. JEWISH MEM HOSP
19
.........
WO
1
1
R-303-A + Suffolk (County ) Winthrop - 1 (City or Towo No. 154 June
The Commontoralth of 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.
Registered No.
164
-
St. § (If death occurred in a hospital or institution, ( give its NAME instead of street and number)
2 FULL NAME
Thomas
€ Fillon
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, If(so Specify WAR) No
(If deceased Is a married, widowed or divorced woman, give also malden name.) 154 Jenaplan It Withiran
(a) Residence. No.
(Usual place of abode)
Length of stay : In hospital or Institution.
( Before death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDDWED
or DIVORCEDIdowed
5a If married, widowed, or divoroed
HUSBAND of
Alice ......
Warren
(or) WIFE of
(Husband's name in full)
6 Aga of husband or wife If allve years
7 IF STILLBORN, enter that fact here.
8
AGE 68
Years Months. Days
If less than 1 day
Hours .........
.Minutes
Usual
9 DcoupatiBe tired
Fish Buyer
Industry
10 or Business :
Fish
Il Soolal Seourity No ...
12 BIRTHPLACE (City)
(State or country )
Provincetown
Magg
13 NAME OF
FATHER
Cannot be learned
14 BIRTHPLACE OF
Cannot be learned
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE OF
MDTHER (City)
Cannot be learned (State or country)
17 Informantarren Gillon (Idiferen) / Joy le central California
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issuede Watter &. Rates.
(Signature oldsent of Board of Health or other)
truly 26, 1931
(Official Designation) (Date of Issue of Perfilty
MEDICAL CERTIFICATE DF DEATH
18 DATE OF
DEATH
(Month)
(Day)
1951 (Year)
19 | HEREBY CERTIFY that I have Investigated tha death of the person above-named and that the CAUSE AND MANNER thereof are as follows : (If an injury was involved, state fully.)
2
20 Accident, sulolde, or homlolde (specify)
Data of ooourrence
19
Whera did Injury ooour ?
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publio
place ?
(Specify type of place)
Manner of
Injury
Nature of
Injury
While at work ?. Was there an autopsy?
21 Was disease or Injury In any way related to oooupatton of deceased?
if so, spretty ....
20
M. D.
(Address) 25 Saatchichst Date 1/251951
22 Winthrop Winthrop
Place of Burial, Cremation
or Removal.
July
28
1951
19
(Clty or Town)
DATE OF BURIAL
23 NAME OF
FUNERAL DIRECTOR .....
HolmSe@malec
ADDRESS
Winthrop Mass
Reoelved and filed JUL.301951 ... 19
(Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to Insert a reoltal to that effeot
extracts from the laws relative to the return of certificates of death.
PARENTS
50m. (f) -6-43-12056
H-0.
PLACE OF DEATH
years
months
days.
In this community
mos.
days.
(If nonresident, give city or town and State)
40yrs.
24
Male
White
(Give maiden name of wife in full)
0/2 - .... : 01-2736A
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medloal offioer shall forthwith, after the death of a person whom he has attendeil during his last illness, at the request of an umlertaker or other authorizeil person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of bia knowledge and belief the naine 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 aud the date of bis 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 humired 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 shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the sanie. For neglect to comply with any provision of this section, sucb physician or officer shall forfeit ten dollars. For the purposes of this sec- tion 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 ex- pedition and the l'hilippine insurrection, which shall, for saldl purposes, be deelliei to have taken place between Feliruary fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred aud sixteen and nineteen hundred and seventeen. G. L. Chap. 16, Sec. 10.
No undertaker or other person shali 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 health, or its agent appointed to issue such perniita, or if there is no such board, from tlie clerk of the town where the person died; and no undertaker or other person shall exhume a liuman 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 be 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 interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu tbereof 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 pbysi- cisn 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 attemling physician. If death is caused by violence, the medical examiner shall make such certificste. If auch a permit for the 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 proviiled and in tbe pos- session of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such bndy shall be returned to the town from which it was removed within thirty-six hours after sucb re- moval, 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 aerved in the army. navy or marine corps of the United States in any war in which
it has heen engaged, such recitai shall appear upon the permit. The board of health, or its agent, ujuin receipt of such statement and certificate, shalt forthwith countersign it aml transmit it to the clerk of the town for regis- tration. The person to whom the permit Is so given and the physician cer- tifying the cause of death altall 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 re- quire .- Chap. 114, Sec. 15, G. L., (Tercentenary Edition).
No umlertaker or other person shall bury a buman' 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 such permits, or if there is no such board, from the clerk of the town where the bnily is to be buried or the funeral ia to be held, or from a per son appointed to have tbe care of ille cemetery or burial ground iu which the intermeut 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 withiu bis county the body of such a person, he shall forthwith go to the place where the body iies and take charge of the same; ... - General Lawa, Chap. 38, Sec. ...
... He shall 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 inay be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
... The medical examiner certifes 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 physioiana will certify to sucb deaths only as those of persons to whom they have given bedside care during a last illnesa from disease unrelated to any form of injury.
(2) Board of Health physlolana 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 wbose pbysi- cian is absent fromn hoine when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sap- posably due to Injury. These include not only deaths caused directly or, in- directly 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 persona not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will atate the cause and manner tbereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) unger manner, tbe mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of tbe femur with ensuing septicenua (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope wbile umler the influence of ether adininistered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- 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 its known or presumable nature; aml (2) unter manner, indicate tbe circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basal ganglia ) ( found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death. )"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
R-302 1
PLACE OF DEATH
(County) HUSTON
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
(City or town making return)
Registered No.
6725 165
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME
Wellington Douglas
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Winthrop Conval, Home
St.
Winthrop Mass.
(a) Residence. No.
.... P.Leasant St.
(If nonresident, give city or town and State)
3
Length of stay: In place of death
.years
days. In place of residence.
.years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
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