USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 18
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If death is used by violence, the medical examiner shall make such certificate. If such a rmit for the removal of a human body, not previously interred, from one town another within the commonwealth cannot be obtained early enough for the irpose, the certificate of death made as above provided and in the possession of e undertaker desiring to make such removal shall constitute a permit for such moval; provided, that such body shall he returned to the town from which it was moved within thirty-six hours after such removal, unless a permit in the usual rm 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 front disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia). and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
PACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE.
ANK, RATING
ORGANIZATION AND OUTFIT
ERVICE NUMBER
M R-302 1
PLACE OF DEATH
SUFFOLK BOSTON panty)
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
LOSTON
(City or town making return)
56
Registered No ...
1951
Veterans Administration Hospital xxxl(If death occurred in a hospital or institution. No.
give its NAME instead of street and number)
MAURICE N RUSKIN
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.) 56 Sagamore Ave.
(Was deceased a
U. S. War Veteran,
if so specify WAR)
I
(a) Residence. No. (Usual place of abode)
1
30
Length of stay: In place of death
......
.. years.
......
months.
days. In place of residence.
.. years.
months.
.days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
carrie
MARRIED
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
Bloom
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
AGE .... 65Years.
5.Months .. 1 .. Days
If under 24 hours
Hours ......
Minutes
13 Usual
Occupation:
(Kind of work done during most of working life)
14 Industry
or Business:
insurance
15 Social Security No ..
050-01-1913
16 BIRTHPLACE (City).
(State or country)
raw York,
17 NAME OF
FATHER
Frank Ruskin
18 BIRTHPLACE OF FATHER (City). (State or country)
19 MAIDEN NAME OF MOTHER Fannie Rosenberg
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21 Informant (Address)
Hospital Records
A TRUE COPYartes H. mackie .......
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
19
54
VAI.
25M-10-53-910621
6
sharon som Fark
onuron,
Place of Burial or Cremation (City or Town) 5
DATE OF BURIAL
19
7 NAME OF
FUNERAL DIRECTOR
Levine Chapel
ADDRESS Brookline, Wass.
Received and filed.
march 15 19:54
(Registrar of City or Town where deceased resided)
yrs.
Date of operation
electrocardiogram
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify ........ volbort. (Signed). VAR
M. D.
(Address)
Date ... 3/3 19 .... ">4
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,
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Day},
(Month)
4 I HEREBY CERTIFY,
That, I
3/3
372
19
to
Plast saw h .............. alive on.
have occurred on the date stated above, at
CEDENT (b)
CAUSES
coronary arteries
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Was autopsy performed ?.
What test confirmed diagnosis?
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
ANTE
Due Toarteriosclerosis of
March
3
1954
(Year)
attended deceased from
54
19
- .. , death is said to
4:20a.
.m.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADINGcardial infarction TO DEATH (a).
-days
Salesman
PARENTS
xxxx
winthrop, Mass
(If nonresident, give city or town and State)
DATE OF ENTERING MILITARY SERVICE - 6/19/17 11 DISCHARGE
1/24/19
RANK, RATING
Pvt
ORGANIZATION & OUTFIT
U S Army 26th Div
SERVICE NUMBER
3571
TO
6
MAR15 TH
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.
5.2.
No. .. Winthrop Convalscent .... Home ..... St. Į give its NAME instead of street and number)
2 FULL NAME. May Josephine French
(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)
NO.
(a) Residence. No. 183 .... WinthropStreet St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death 1 .years ... .months. days. In place of residence. years months .days.
70
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIED Widowed
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
Orra French
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE. 83 Years
6Months 29 Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
retired housewife
(Kind of work done during most of working life)
14 Industry or Business: own home
15 Social Security No ..
none
16 BIRTHPLACE (City)
(State or country)
Jaimaica Plain
Mass.
OTHER
Fracture femur right, 951
3 yrs
Major findings:
Of operations more
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. If so, specify .....
M. D. (Address) WinthropMan Date 4 March 1954 6 Winthrop Cemetery ..... Winthrop ,Mass Place of Burial or Cremation (City or Town)
DATE OF BURIAL March 6 1954 19
7 NAME OF FUNERAL DIRECTOR. Bulked 19 March
ADDRESS
174 Winthrop St .Winthrop Mass.
13% Received and filed. VEAR 5 19
(Registrar)
PARENTS
17 NAME OF
FATHER
John F. Sawyer
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
19 MAIDEN NAME
OF MOTHER
Frances A. Burrill
20 BIRTHPLACE OF MOTHER (City) (State or country) Maine
21 Informant Harold Eaton .... French (Address) 183 Winthrop St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Watter I Bakery .
(Signature of Agent of Board of Health or other)
Health Officer 3.5.54
(Official Designation) (Date of Issue of Permit)
74
5.
I R-301A 1
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
4, 1954
(Month)
(Day)
1.
(Year)
4 I HEREBY CERTIFY,
June
1951
That I attended
deceased from
to ..
March
1954
Mast saw
h. CA ...... alive on.
March 3, 1954, death is said to
have occurred on the date stated above, at 6:45 Am. INTERVAL BE- TWEEN ONSET AND DEATH years
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a) Cerebral arterio -
sclerosis
Generalized arteno-
ANTE
CEDENT (b)
CAUSES
sclerosia
Due To
(c)
CONDITIONS
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
March
female
white
Registered No.
(If death occurred in a hospital or institution,
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 seventecn. 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 othe: 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 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
R-301A 4
PLACE OF DEATH
Suffolk (County),
Nuestroh (it: 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.
58
J(If death occurred in a hospital or institution, St & give its NAME instead of street and number)
Mary E(MC Cormack) McDonalds
2 FULL NAME.
(If deceased is A married, widowed or divorced woman, give also maiden name.) 67 Bates
St.
(If nonresident, give city or town and State)
.years
.. months .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
& SEX
9 COLOR OR RACE Finale # lute
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Widowed
10a If married, widowed, or divorced HUSBAND of .......... (Give maiden name of wife in full) of Willian To Mac Donald (or) WIFE of
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
12
AGE
D.Z.Years
Months.
.Days
If under 24 hours
Hours ...
. Minutes
13 Usud
Occupation :.
Tome
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City). (State or country)
17 NAME OF FATHER
Cislaustin Mc Cormack
18 BIRTHPLACE OF FATHER (City) (State or country)
Source pel
19 MAIDEN NAME OF MOTHER "Chigabeth Mr Jean
20 BIRTHPLACE OF MOTHER (City) (State or country)
fourie pel
Thelma mac Donald
14
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter . Brakers
(Signature of Agent of Board of Health or other)
Thealite Oficer 3.5,54
(Official Designation)
(Date of Issue of Permit)
50M-5-52-907046
7 NAME OF FUNERAL DIRECTOR.
ADDRESS
3/3.54
19
(Registrar)
INTERVAL BE- TWEEN ONSET AND DEATH 13hr
ANTE CEDENT (b) CAUSES
Due To Hypertension
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation.
Was autopsy performed? he
What test confirmed diagnosis? Chanical
5 Was disease or injury in any way related to occupation of deceased? If so, specify. myronun Kung M. D.
(Signed). (Address) -22 Pleaseist woultimate nur5
1957
0 Pace of Burial of Cremation
(City of Town).
DATE OF BURIAL 19.
Received and filed.
(Day)
5
1954
(Year)
4 I HEREBY CERTIFY.
That I attended deceased from
Dec 1952
to ..
man 5
1957
I last saw h en alive on
man 4, 1954, death is said to
have occurred on the date stated above, at 12 Am.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Cerebral hemorrhage
UCTIONS FOR CERTIFICATE iving OF DEATH t enter han one for each b) and (c)
oes not mean f dying, such ure, asthenia, ns the disease, ations which h.
conditions. ng rise to the : (a) stating ying cause
ions contrib- death but not e disease or using death.
M.S.
Registered No.
Nulamok com. thank. No.
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death .. years. months. .. 2.days. In place of residence
3 DATE OF
DEATH
mar
(Month)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran. if so specify WAR)
Source per
PARENTS
Informant. (Address) 67 Bates ane
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 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
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