USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1952 > Part 55
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
301A 1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Towy
No. 30
Sajam Gertrude €
mc Eachen
(If deceased is a married, widowed or divorced woman, give also maiden name.)
30
Sagamore
St. .
(If nonresident, give city or town and State)
Length of stay: In place of death. 6 .years .. months. .days. In place of residence.
6
.years
.months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX F
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) marined
10a If married, widowed, or divorced HUSBAND of.
(or) WIFE of
(Give maiden name of wife in full) Herman Machen (Husband's name in full)
11 IF STILLBORN, enter that fact here.
12 AGE SI .Years Months .
Days
If under 24 hours
Hours
Minutes
13 Usual Occupation : Clerk
(Kind of work done during most of working life)
14 Industry
or Business :..
Drug Store
15 Social Security No ...
16 BIRTHPLACE (City) .. (State or country)
Cambridge mass.
17 NAME OF FATHER wremich wells
Major findings:
Of operations
Date of operation.
Was topsy performed ?. جما
What test confirmed diagnosis?
Y - Ray
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
(Address).
M. D
Date . ~ 29 19.5
6 Winthe
Place of Burial of Cr manon
(Cw or Town)
DATE OF BURIAL ..
19
7 NAME OF FUNERAL DIRECTOR.
ADDRESS Ho With St.
Received and filed JUL -58 19
(Registrar)
PARENTS
18 BIRTHPLACE OF FATHER (City) (State or country)
Canbring man
19 MAIDEN NAME OF MOTHER Rosalie Delinin
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
me
21 Informant (Address) 30 5mg
Herman Me Enferme
I HEREBY CERTIFY tha a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter A. Hhaker. (Signature of Agony of Board of Health or other)
Hallo Officer 7/25/52
(Official Designation)
(Date of Issue of Permit)
ONS IFICATE 8 EATH ter one ach d (c)
ot mean ng, such asthenia .. e disease, s which
ditions. se to the stating cause
contrib- but not sease or g death.
50M (B)-1.51 903586
July (Month)
23 1952
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
1952
(last saw h ... alive on.
19 death is said to
have occurred on the date stated above. at m. INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY 1 EAD TO DEATH (a)
aironia Bradent
1946
ANTE CEDENT CAUSES
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
dirovio Colitis
1650
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.
159
Registered No.
f(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME ..
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. (Usual place of abode)
Mannie W King
Wisconsatt DiscussET
3 DATE OF
DEATH
19
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 scen 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 he 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.
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
.- 302 1
PLACE OF DEATH
SUFFOLE
(City or 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.
6659160
J(If death occurred in a hospital or institution, .Sh give its NAME instead of street and number)
2 FULL NAME
ABRAHAM WARSHOFSKY
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
26 Seafoam Ave.,
xx ...
Winthrop Mass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death
.years.
15
months
.days.
In place of residence
10
.years
1
months
5
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED Married
4 I HEREBY CERTIFY,
Thathe attended deceased from
19
52
to
7/23
19 .... 52
We last saw h.
im
alive on
7/23
19.5.2, death is said to
have occurred on the date stated above, at.10 .: 50a ....... m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADIN
TO DEATH (a)
cerebral thrombosis
15days
12
AGD7
Years.
Months.
.Days
If under 24 hours
Hours.
Minutes
Carpenter
13 Usual
Occupation:
(Kind of work done during most of working life)
14 Industry
or Business:
Carpenter Construction
15 Social Security No ..... 109-05-11.904
16 BIRTHPLACE (City).
(State or country)
Russia
NAME O
FATHER
D Warshofsky
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER Fannie
.-
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21
Informant
(Address)
D Warshofsky
DATE OF BURIAL
July. ... 25,
19.52
7 NAME OF
FUNERAL DIRECTOR
H Torf
ADDRESS Chelsea Mass
Received and filed
AUG
7 1952
19
(Registrar of City or Town where deceased resided)
PARENTS
5 Was disease or injury in any way related to occupation of deceased?
(Signed)
E Neumann
M. D.
(Address) MGH
Date.
19
6 Jewish Cem Place of Burial or Cremation
New York, N.Y.
(City or Town)
25M-(B)-11-51.905807
7/8
Major findings:
Of operations
If so, specify
Copies of returns of deaths which occurred in your city of town in case the deceased resided in another city of town at the time
CONDITIONS
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. Sec. 12. G. L.)
ANTE
Due To arteriosclerotic cardio-
CEDENT (b)
CAUSES
vascular disease
8yrs.
Due To (c)
OTHER
SIGNIFICANT
Date of operation
. Was autopsy performed?
.. N.o
What test confirmed diagnosis ?.
Clinical
10a If married, widowRebeccasilverman
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
(write the word)
3 DATE OF
DEATH
July
23,
1952
(Month)
(Day)
(Year)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
No
(Registrar of City or Town where death occurred)
A TRUE COPY
ATTEST:
Tack
DATE FILED
July 25.
.
19.5.2
No.
Mass General Hospital
RECEIVER
..
AUG -- '?
01 A
If deceased was a U. S. Wer Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
00M-10-47-22153
4.
(Signature of Agent of Board of Health or other) July 28, 1992
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
-
4 COLOR OR RACE
White
5 SINGLE (write
MARRIED
WIDOWED
or DIVORCED
MaFYTed
18 DATE OF
DEATH.
July
24
1952
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
19.
to
19 ......
I last saw h ............ alive on
19
death is said to
have occurred on the date stated above, at 2 30A.
Immediate cause of death Natural Causes
Due to .... Presumably
Due to
Coronary
Occlusion
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
-
20 Was disease or injury in any way related to occupation of deceased?(O
If so, spe
Wirthure many eth M. D.
(Signed) .......
(Address) anthrop brand
21.
Holy cross
Date 2 4 July 1952 Malden/
Place of Burial, Cremation or Removek-1v28 (City or Town) DATE OF BURIAL.
1952
22 NAME OF
FUNERAL DIRECTOR
William E. Pepi
ADDRESS
971 Saratoga St. E.B.
Received and Filed 19
(Registrar)
.
July
To be filed for burial permit with Board of Health or its Agent
Registered No.
161
St. § (If death occurred in a hospital or institution, 1 { give its NAME instead of street and number) } PHYSICIAN-IMPORTANT
2 FULL NAME.
Adolfo Anzalone
(If deceased is a married, widowed or divorced woman, give also maiden name. )
480 Pleasant .St.
St.
(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
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
5a If married, widowed or divorced
HUSBAND of
Anna (DeIorio)
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive ..
70
years
7 IF STILLBORN, enter that fact here.
8
AGE.5.7
Years
Months.
Days
If less than 1 day
.
Hours.
Minutes
Usual
9 Occupation :
InsuranceAgent
Industry 10 or Business :.
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country)
ITALY
13 NAME OF
FATHER
Mathews
Arzale-wee
14 BIRTHPLACE OF
FATHER (City).
(State or Country)
Italy.
15 MAIDEN NAME
OF MOTHER
Antomette
16 BIRTHPLACE OF
MOTHER (City).
(State or Country)
..... Italy ... .....
17 Informant. (Address)
Anna (DeIonio) Wif (Relation, if any)
480 Pleasant St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
PLACE OF DEATH
Suffolk (County)
1
Winthrop (City or Town)
No ..... 480 Pleasant St.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(Official Designation)
Duration IMPORTANT
IMPORTANT Physician
Underline the cause to which death should be charged sta- tistically.
m.
That I attended deceased from
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(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 dedul of a person w.iomn 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 Lest of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired 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 certiicate a recital to that effect, speci- fying the war, and sh .. Il also certify in such certincate 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 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 "wer" 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 nine- teen hundred and seventeen. G. L. Chap. 46, Scc. 10.
No undertaker or other person shall bury or otherwise e'isposc 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 onc grave or tomb other than the receiving tomb to another in the somc cemetery, until he has received a permit from the board of health or its atent aforesaid or from the clerk of the town where the body is buried. No such permit shall 1 . issued until there shall have been delivered to such board agent or clo-k, as the case may be. a satisfactory written statement containing the f ::. 's required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory cer:iscate of the a. . nding 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 physi- cian 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 medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from onc 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 sconer 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 registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary 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 person shall 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 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 following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside carc during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths orly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certincate of death is needed.
(3) Medical Framiners will investigate and certify to all deaths sup- posably duc 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 .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions. if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precisc statemert of occupation is very im- portant, 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 occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. 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, how- ever, 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
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