USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 93
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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 done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER .
-
PLACE OF DEATH
Suffolk (County) Winthrop
(City or Toyn)
Winthrop Comm Hospital No.
j(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Barnet Koplowitz 2 FULL NAME ..
(If deceased is a married, widowed or divorced woman give also maiden name.)
(a) Residence.
No.
. 200 Shirley
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years ... . . months. 1 .days. In place of residence 3.6
months~days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Now
(Month)
21,
(Day,
(Year)
1951
4 I HEREBY CERTIFY,
That I attended deceased from
June
49
to ....
La0. 21
I Just saw h mmm alive on.
200-21, 19 51, death is said to
HUSBAND of
Rebecca Cohen
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
62
-
Months
Days
If under 24 hours
Hours .....
Minutes
13 Usual
Occupation :
Real Estate dealers ( Retired)
(Kind of work done during most of working life)
14 Industry
or Business :.
Real estate
15 Social Security No. non
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
Gershon Koplowitz
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
Das Sarah (BL)
20 BIRTHPLACE OF
MOTIIER (City)
(State or country)
Russia
21 Informant Rebecca Kaplovit
(Add 200 shuly & Winedrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filedwith me BEFORE the burial or transit permit was issued:
Walter
A. Baker
(Signature of Agent of Board of Health or other)
11/21/51
(Official Designation) (Date of Issue of Permit)
1
TIONS RTIFICATE
ing DEATH enter n one · each and (c)
not mean ying, such , asthenia, he disease. ons which
onditions, rise to the 1) stating 18 cause
s contrib- th but not disease or ing death.
50m-(b)-11-49-920,560
5 Was disease or injury in any way related to occupation of deceased to
If so, spo
(Sig
Chiades Liber man
M. D.
(Address) 26 Wanewas que. Winthe Rate 11/21/195/
adach geshurum cem &W. Roxbury
Place of Benal or Cremation
DATE OF BURIAL
nov 22
195/
7 NAME OF
FUNERAL DIRECTOR
N. J. Jorf
ADDRES 15) Nachugh hun cheluca
Received and filed NOV 2-6 1951 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED Married
or. DIVORCED
have occurred on the date stated above, at 12:30 P.r m. INTERVAL BE- TWEEN ONSET AND DEATH e 5 horas 12 AGE
DISEASE OR CONDITION Lubarachnia DIRECTLY LEADING TO DEATH (a) Jubarachupic Hemorrhage
ANTE CEDENT (b) CAUSES
Due To!
Hypertension
..
10 yrs.
Due To (c)
OTHER
Post- Carcinoma
5 grs.
CONDITIONS
I sigmoid
Major findings:
Of operations.
Caminotum of Sigmoid.
Date of operation.
1946
Was autopsy performed? 200
What test confirmed diagnosis? Clinical
-
YCity or Town)
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.
281
Registered No.
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, no ( if so specify WAR)
(Usual place of abode)
R-301A 1
PARENTS
(write the word)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec, 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen, G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as arc 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 bv Chap. 632, Sec. 4. Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereot 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 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
-305
1
BOSTON
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
1029.2
262
(City or Town) Mass. General Hospital
J(If death occurred in a hospital or institution.
St. [ give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Off Bowdoin St
St.
Winthrop
Mass.
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death .years. months .. 7 .days. In place of residence 1.1.3 ..... years. .. months. .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Nov.22/51
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Flame burns of body and of extremities
11a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
43
Years
Months.
.Days
If under 24 hours
Hours.
Minutes
14 Usual
Occupation:
(Kind of work done during most of working life)
15 Industry or Business:
16 Social Security No.
17 BIRTHPLACE (City).
(State or country)
18 NAME OF
FATHER
Dudley McDonough
19 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
20 MAIDEN NAME
OF MOTHER
Margaret Walsh
21 BIRTHPLACE OF
MOTHER (City).
(State or country)
Ireland
(Address)
Winthrop em-Winthrop Mass.
7 Place of Burial, or Cremation. (City or Town)
DATE OF BURIAL
Nov. 24/51
19
8 NAME OF
FUNERAL DIRECTOR
E ... P ..... Caggiano
ADDRESS Winthrop Mass.
Received and filed
NOV 30 1951
19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
M
10 COLOR OR RACE
W
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5 Accident, suicide, or homicide (specify)
Presumably ... accidental
Date and hour of injury. 19
Where did
Winthrop Nov. 21,1951
Injury occur?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place?
Manner of
Injury
shack at Winthrop Nov .21/51
(How did injury occur?)
While at work? ? .Was autopsy performed? No
6 Was disease or injury in any way related to occupation of deceased?
If so, specify W J Brickley
(Signed)
Boston Mass.
Date.
11-23
19.
M. P.
25m-(h)-10-48-24658
PLACE OF DEATH
SUFFOLK (County)
No.
James McDonough
2 FULL NAME
Copies of retums of deaths which occurred in your city of town in case the deceased resided in another city of town at the time Nature of Injury after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible
PARENTS
22 Informant (Address)
B Hill
A TRUE COPY.
ATTEST:
(Registrar of City or Town where death occurred)
DATE PILED
Nov. 26/51
.19
Laborer
Winthrop Mass.
Removed from alburning
(Was deceased a
U. S. War Veteran,
if so specify WAR)
RECEIVED
OF
TOWN
11 72
10.
NOV301951 AM
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
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.
263
j(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
Jotham Franklin Gilpatrick 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
914 Shirley .Street
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. ..... .. years
.months. .days. In place of residence.
55 years
months
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
November 24 1951
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
10/22/89
19
to
200.24 19
51
I last saw h .alive on
nov. 21
1951
.. , death is said to
have occurred on the date stated above, at m. INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a).
general Carcinomatores
ANTE CEDENT (b) . CAUSES
Due To/ Carcinoma left headway
8 mg.
Due To (c) ...
Chimie Bronchites
15 year
OTHER antena selente frantoio CONDITIONS Diabetes mellitus
Major findings:
Of operations.
Carmona
Date of operation /28/51
What test confirmed diagnosis ?.
.Was autopsy_performed ?. Pathological Sman
5 Was disease or injury in any way related to oecup tion of deceased? If so, specify fall boek at cola (Signed) M. D. (Address) 25 Stages St . Winther Pate 11/26 1951 20 BIRTHPLACE OF MOTHER (City) Biddeford.
6 Mount Feake
Waltham, Mass.
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL Nov.27 1951 ... ...
19
7 NAME OF
FUNERAL DIRECTOR
alfred B. Morale
ADDRESS
174 Winthrop St . Winthrop, Mass.
Received and filed
NOV 2 5 1950: 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX male white
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIEDWidowed
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of .. .
Flora Mabel Chase
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
8 ms.
AGE. ....
72
2
Months
27 Days
If under 24 hours
Hours. .. . . Minutes
13 Usual Occupation : Machinist (Kind of work done during most of working life)
14 Industry
or Business :..
Wholesale Plumbing Supplies
15 Social Security No ..
011-07-2486
16 BIRTHPLACE (City)
(State or country)
Christopher
Biddeford Maine
17 NAME OF
FATHER
Christofer Columbus
18 BIRTHPLACE OF
FATHER (City)
Biddeford
(State or country)
Maine
19 MAIDEN NAME
OF MOTHER
Alice Frances Hooper
(State or country)
Maine
21 Informant (Address) 914 Shirley St.Winthrop
Mrs. George T. Williams
I HEREBY CERTIFY that a satisfactory standard 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?
(Official Designation)
(Date of Issue of Permit) 11/26/57
TIONS ₹ RTIFICATE ing DEATH enter an one reach and (c)
s not mean lying, such e, asthenia, the disease, ons which
conditions, rise to the a) stating ng cause
is contrib- ath but not disease or sing death.
Cc 3- 0050
SOM (B). 1-51 903586
R-301A 1
No.
914 Shirley Street
Registered No.
PHYSICIAN - IMPORTANT Į Was deceased a U. S. War Veteran. if so specify WAR) NO.
(a) Residence. No. (Usual place of abode)
That I attended
deceased from
10 yes.
Gilpatrick
PARENTS
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 whoin 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-cight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law. or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death nade as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder, If the
death certificate contains a recital. as required by, section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
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