USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 54
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d conditions, ng rise to the (a) stating lying cause
ions contrib- death but not he disease or ausing death.
1
50M (B)-1-51 903588
Mis
V
[ R-301A 1
2 FULL NAME
nellie H. mouton
(If deceased is a married, widowed or divorced woman, give also maiden name.)
6 weeks
(City or Town)
(Senten)
PARENTS
What test confirmed diagnosis ?.
1/2 yrs
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 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 que 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 Atusfound dead. 1
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 B&CountyON
(City or Town) Mass General Hospital -
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.
7166 176
Baker Memorial [(If death occurred in a hospital or institution, No.
Il give its NAME instead of street and number)
ISRAEL GINSBERG -also called- ISADORE GINSBERG
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.) 29 Underhill
St.
Winthrop, Mass.
(a) Residence. No.
(Usual place of abode)
2
11
(If nonresident, give city or town and State)
Length of stay: In place of death ..
.....
.years.
months
days. In place of residence ...
... years.
months.
... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
August
13
1953
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
8/12
19
8/13
53
I last saw h
.alive on
19
., death is said to
.m.
INTERVAL BE-
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEAMINertensive cardio-
TO DEATH (a).
vascular disease
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
56
12
AGE
Years
Months.
.Days
If under 24 hours
Hours.
Minutes
ANTE
Due Toessential hypertension
CEDENT (b)
CAUSES
5mos.
13 Usual
Occupation:
Contractor - Builder
14 Industry
or Business:
Building Constructim
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
Ben jamin Ginsberg
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
-cannot be learned-
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21
Informant
(Address)
A TRUE COPY
of Inackie
ATTEST
A ((Registrar of City or Town where death occurred)
DATE FILED
Aug 17
19,53.
(Registrar of City or Town where deceased resided)
PARENTS
5 Was disease or injury in any way related to occupation of deceased? If so, specify ... L" Neumann
M. D.
(Address)
MGH
Date.
8/13
1953.
6 Liberty Progressive
Everett
Place of Burial or Cremation (City or Town) 153
DATE OF BURIAL
Aug 14
7 NAME OF
FUNERAL DIRECTOR
Chelsea .. . Mass ..
H Torf
ADDRESS
Received and filed.
NIG 2 1 1953
19
MIS
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
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 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-302 to the clerk of the city or town in which the deceased resided as soon as possible,
25M-3-53-909098
arteriosclerotic
Due To
(c) ..... heart disease
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation.
Was autopsy performed?
no
What test confirmed diagnosis ?.
6mos.
8 SEX
M
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDarried
(write the word)
10a If married, widowed, or divorced
(or) WIFE of
(Give maiden name of wife in full)
have occurred on the date stated above, a
6:45a.
That
I
attended deceased
.from
HUSBAND of.
Ldna Copans
8/13
53
...
omos.
(Kind of work done during most of working life)
(Signed).
B Ginsberg
- .
M R-302 1
(Was deceased a
U. S. War Veteran,
if so specify WAR)
SCEIPL
TO:
1
AUG2 4
I R-301A 1
PLACE OF DEATH
X Juffolk (County) Winthrop (City or Town) 265 Games
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD
CERTIFICATE OF DEATH
Registered No.
137
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. . 265 Ruin Rd.
(Usual place of abode)
Length of stay: In place of death 5 .years .. months .days. In place of residence.
5
.years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
3 DATE OF
DEATH
(Month)
(Day)
13
1953
(Year)
4 I HEREBY CERTIFY.
That I attended deceased from
19
to
19
I 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 LEADING
TO DEATH
) Natural Causes
frecumably Cerebral Hemorrhage
ANTE
Due To
CEDENT CAUSES
(b)
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
no
Date of operation.
Was autopsy performed? no
What test confirmed diagnosis ?.
Clinical
5 Was disease or injury in any way related to occupation of deceased? No.
(Signed). M. D. WagerEt wep Board of Carbonate /13 19.53 MX. Lebaron Ind Priced Boston- W, Mix Muy Place of Burial or Cremation
DATE OF BURIAL. 1923
7 NAME OF
FUNERAL, DIRECTOR
Caron Solov
ADDRESS OWaslium Rochester
Received and filed. AUX 1 1953 19
(Registrar)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
codicelow
10a If married, widowed, of divorced HUSBAND of Sección Cohen
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
76 Years
.Months
Days
If under 24 hours
Hours
. ... Minutes
13 Usual
Occupation:
Variety
(Kind of work done during most of working life)
14 Industry
Ketivedl
or Business :.
15 Social Security No.
16 BIRTHPLACE (City). (State or country) Letturaria
17 NAME OF FATHER Dease Matelemalos
18 BIRTHPLACE OF FATHER (City) (State or country) Fatturania
19 MAIDEN NAME OF MOTHER immig be learned
20 BIRTHPLACE OF MOTHER (City) (State or country) Delhuanca
21
Informant.
Sadie mansky
(Address) 965Rowerffel.With.om I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter S. Jaklicy
Heallnature og (Signature of Agent of Board of Health or other)
8.14.53
(Official Designation)
(Date of Issue of Permit)
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure, asthenia, ns the disease, cations which th.
d conditions. ing rise to the e (a) stating lying cause
ions contrib- death but not he disease or ausing death.
50M-5-52-907046
No. Abraham
Watchmaker
J(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)
Wirthmay
St.
(If nonresident, give city or town and State)
To be filed for burial ·permit with Board of Health or its Agent.
PARENTS
(City or Town) 1X
/ her.
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 imine- 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 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 derk 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 in jury, 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.
P
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
AUG1 %
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 ...
X
PLACE OF DEATH
1 SUFFOLK BOSTON
(City of Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return 178
Registered No.
7285.
enroute to Mass. General Hospitalxx. give its NAME instead of street and number) [(If death occurred in a hospital or institution, No.
WALTER ROWE
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Coral Ave.
(Was deceased a
U. S. War Veteran,
if so specify WAR).
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death
.......... years.
.. months.
days.
In place of residence.
........... years.
months.
... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
M
10 COLOR OR RACE
11 SINGLE
MARRIED
WIDOWED
of DIVORCED
(write the word)
DEATH
(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.)
11a If married, wi
HUSBAND of
virginfa M Visconte
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
43
AGE
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:
029-10-4294
16 Social Security No.
17 BIRTHPLACE (City)
(State or country)
winthropMass
Charles Rowe
18 NAME OF
FATHER
19 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
20 MAIDEN NAMEarion Powers OF MOTHER
21 BIRTHPLACE OF
MOTHER (City)
(State or country}
Vancouver
Rowe
22
Informant
(Address)
A TRUE COPY.
ATTEST:
Charles
& mackie
(Registrar of City or Town where death occurred)
DATE FILED
Aug 20
19
53
m.S
(Registrar of City or Town where deceased resided)
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-305 to the clerk of the city of 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.)
25M.5.52-907046
(Address) Boston
Date.
8/1719 53
Winthrop
7 Winthrop
Place of Burial, or Cremation. (City or Town)
53
DATE OF BURIAL
19
8 NAME OF
FUNERAL DIRECTOR
J O' Maloy
ADDRESS.
Winthrop Mass.
Received and filed.
AUG 2 1 195
19
6 Was disease or injury in any way related to occupation of deceased ?. .....
If so, specify
(Signed)
M
Luongo
M. D.
place?
(Specify type of place)
Manner of
Injury
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