USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 83
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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 he 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 huried 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 person's, 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 (frags or poisons) thermal, or electrical agents, and deaths following abortion, but also- Maths 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
X
PLACE OF DEATH
Suffolk
(County) Bostan
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Bosta
(City or town making return)
Registered No. 1091269
[(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)
2 FULL NAME
Hyman B .Horovitz
(If deceased is « married, widowed or divorced woman, give also maiden name.)
U. S. War Veteran,
if so specify WAR).
(a) Residence. No. 252.Shore ... Drive (Usual place of abode)
St.
.Winthrop
(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
8 SEX
M
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDarri ed
4 I HEREBY CERTIFY,
That I attended deceased from
Dec ...... 1.
1953 ...
to.
Deo.10
19.5.3
I last saw h ......... alive on
Dec.10
.,
1953
.. , death is said to
(or) WIFE of.
have occurred on the date stated above, at.
6:25A
.m.
INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGi.
55
Years
Months.
Days
If under 24 hours
Hours
Minutes
13 Ús· al
Occupation :
(Kind biavarerne during most of working life)
14 Industry or Business:
15 Social Security No ..
16 BIRTHPLACE (City).
(State or country)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation.
.Was autopsy performedres
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
E-Neumann
M. D.
(Address).
Date
6 Boston Mass Place of Bundberematinm . Park Pharm- 888
DATE OF BURIAL ..
Dec. 11/53
19
7 NAME OF
FUNERAL DIRECTOR.
.H.J ... Torf
ADDRESS
Chelsea Muss
Received and filed.
19
PARENTS
Isaac Horovitz
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
Wife
21
Informant
(Address)
Doris Herovits
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
Dec/14/53
DATE FILED
19
(Registrar of City or Town where deceased resided)
10a If married, widowed, or divorced
HUSBAND of
Doris Williams
tein full)
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Myocardial infarction
extensive
13 Days
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
25M-3-53-909098
M.S.
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, Sec 12, G. L.)
M R-302 1
No.
.Mass. General ...!! os.pt ..
(Was deceased a
w W #1
3 DATE OF
DEATH
(Month)
(Dayy
Dec .10/53
(write the word)
17 NAME OF FATHER
6
DEC2 9-1
Entered Service April 17,1917 Discharged 2-8-1919 Private 55th C.A.C. Service No Unknown
R-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 52 Brookfield Road No.
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.
270
Registered No.
J (If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME ..
Mary E. Shaw
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR)
(a) Residence. No.
(Usual place of abode)
50
Length of stay: In place of death
years
months
days. In place of residence
.years
.. months
.days.
St. .
(If nonresident, give city or town and State)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
December 14, 1953
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
nov. 12
19
53
Dec. 14
to. ..
19
I last saw her alive on
Dac.
14
.. 1953. death is said to
have occurred on the date stated above, at
10a If married, widowed, or divorced
(or) WIFE of
HUSBAND of ..
(Give maiden name of wife in full)
Hugh J. Shaw
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a)
acute Coronary thrombois
ANTE
Due To arteriosclerosis and
CEDENT (b) CAUSES hypertensive Realdicen
1 year
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Hypertrophic arthritic
2 years
Major findings:
Of operations
Date of operation
. Was autopsy performed?
Clinical + Laboratory
Ko
What test confirmed diagnost
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed) MauriceT
TrouvePain
(Address) 5625 Bily St. Winthrop Madate Dec.14
M. D.
Winthrop
Winthrop
December 16: 1953 DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR ..
ADDRESS
Slew J. Otraley.
Winthrop Mass
Received and filed 1
DEC 15.1953
19
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWEDu.
or DIVORCED dowed
(write the word)
13 Usual
Occupation :
Clerk
(Kind of work done during most of working life)
14 Industry
or Business:
Real Estate
15 Social Security No.
021-28-2846
Everett
16 BIRTHPLACE (City).
(State or country)
Mass
17 NAME OF FATHER Augustus Arnaud
18 BIRTHPLACE OF
FATHER (City)
Paris
(State or country)
France
19 MAIDEN NAME
OF MOTHER
Mary E. LeBlanc
20 BIRTHPLACE OF
MOTHER (City)
Cape Breton
(State or country)
Nova Scotia
21 Paul Shaw
Informant (Address) 52 Brookfield Road Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other) platte Crecer 12-15.53
(Official Designation) (Date of Issue of Permit)
UCTIONS OR CERTIFICATE
iving OF DEATH t enter han one for each b) and (c)
oes not mean f dying, such ure. asthenia, is the disease. ations which h.
conditions. ng rise to the (a) stating ying cause
ons contrib -- death but not e disease or using death,
5
/50M (B)-12-49.900722
6
Place of Burial or Cremation
20
PARENTS
(Registrar)
52 Brookfield Road
That I attended deceased1 from
8:10A.
.m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
11 IF STILLBORN. enter that fact here.
9 hours
69
.Years
Months
Days
12
AGE
If under 24 hours
Hours ..
Minutes
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 pernt. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall'burry a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the'interment is made.
Chap. 114, Sec. 46. G. L. (Tefcentenary Edition).
'RULES OF. PRACTIGE MINA The fulfillment of the purpose of these lawscalls for the observance of the follow- ing rules of practice:
(1) Attending physicians wil such deaths only as those of persons to whom they have given bedside Zar Mittag a last illness from disease unrelated to any form of injury. 6
(2) Board of Health physicians wil certify to such deaths only as those of persons who, though disabled bay reudenized 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 milhinvestigate and certify to all deaths supposably due to injury. These include hot ouly 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 no.e.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
M R-302 1
PLACE OF DEATH
Suffolk
(County)
Boston
(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.
11083 221
J(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.)
483 Shirley
Winthrop Mass.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ..
......
.. years.
months.
16 ays.
In place of residence 3.5.
.. years.
.. months ..
... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
10a If married, widowed, or divorced
Helen Placco
19
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AG65.
1
Years
26
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
Bar tender
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
010-11-3815
16 BIRTHPLACE (City).
(State or country)
East Boston Mass.
17 NAME OF
FATHER
Herbert Wyke
18 BIRTHPLACE OF
FATHER (City).
(State or country)
England
19 MAIDEN NAME
OF MOTHER
Alice Holt
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
Place of Burial or eferha
winthrop Cem-ninth (City of Town)
DATE OF BURIAL
Dec. 17/53
19
7 NAME OF
FUNERAL DIRECTOR.
J ........ Q1Mia.le.y.
winthrop Mass.
ADDRESS
Received and filed.
19
(Registrar of City or Town where deceased resided)
1-2 Yr
ANTE
Due To
with metastases to pelvic
CEDENT (b)
CAUSES
ncdes ... and .. liver.
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings: Of operations.
Date of operation
Ca of bladder with metastases
AUD/11/53
.Was autopsy performed ?. .... No
What test confirmed diagnosis?
operations
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
NO
(Signed).
Harold APiedy
M. D.
(Address)
VA Hospt Boston
„.Date.
12-14
53
6
25M-3-53-909098
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, 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.)
3 DATE OF
DEATH
Dec. 14/53
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
Nov.28
53
That I attended deceased
Dec.14
from 53
I last saw h ...
em.alive on
to.
Dec/14
53
19
death is said to
have occurred on the date stated above, at
m.
3;PM
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Carcin ra of bladder
INTERVAL BE- TWEEN ONSET AND DEATH
PARENTS
21
Informant
(Address)
V A Hospt Records
Boston Mass.
A TRUE COPY
ATTEST:
P
(Registrar of City or Town where death occurred)
DATE FILED
Dec.18/53
19
V
No.
Veteran's Admi:Hospt Bos ton
William A Wyke
(Was deceased a
U. S. War Veteran,
if so specify WAR)
W W #1
(a) Residence.
No.
(Usual place of abode)
(write the word)
19
M.S.
ALGEIVEE
DEC31 AN
Entered Service 12-19-17 Discharged 2-8-19 Cook U S Army
Service No. 579533
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 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
X
SUFFOLK
BOSTON
(City or Town) 818 Harrison Ave No.
** Corrected Copy **
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 217 2
Registered No.
11092
j(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Stephen D. McCallum
(Was deceased a U. S. War Veteran,
WWII
(If deceased is a married, widowed or divorced woman, give also maiden name.) 817 Shirley
Winthrop
(a) Residence. No.
(Usual place of abode)
St.
(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
3 DATE OF
Dec. 15, 1953
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.) Arteriosclerotic heart disease
11a If married, widowed, or divorceda Thompson
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
56
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:
144-07-4587
16 Social Security No.
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