USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 56
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Chap. 114, Sec.46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons whet 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.
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 (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. 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 Statement of Cause of Death .- Physicians: see explanatory instructions ''on'face side of standard certificate of death. 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 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 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. 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 whose only occupation was that of home housework, write housework. For a 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
AUG-2
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
X
1 R-302 1
PLACE OF DEATH
(County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
... (City or town making return) . ..
Registered No. ... 168
No.
J(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)
2 FULL NAME
MARY GREIG .... BROWNING (If deceased is a married, widowed or divorced woman, give also maiden name.)
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
PERSONAL AND STATISTICAL PARTICULARS
.3 DATE OF DEATH
March
14.
1954
8 SEX
9 COLOR OR RACE
10 SINGLE (write the word)
(Mo
CERTIFICATE OF DEATH FLORIDA
STATE FILE NO.
BIAT
1
I. PLACE OF DEATH &. COUNTY
CODE NO. 62-10
a. STATE
b. COUNTY
I last saw h ...
aliv
ctr outside corporate 'Hasits, write 30 AL.
c. CITY
(If wielde surporate limita, write RURAL}
have occurred on the da
TOWN
St. Petersburg
TOWN
Winthrop
d. FULL NAME OF (tt net in hospital er institution, give stront address os location)
d. STREET
LIT rural, give location)
HOSPITAL OR INSTITUTION
701 Park St., No.
18 - 20 36 Grand View Ave.
J. NAME OF DECEASED (Type or Print)
L (First) MARY
1. (Middle)
& (Last)
4. DATE OF
(Month)
(Day) (Yeur)
GREIG
BROWNING
DEATH March 14 195+
5. SEX
2
4. COLOR OR RACE
1. DATE OF BIRTH
1. AGE (Is FORTY Se UNDER I TGAR len birthlar) Days Hours
Female
White
7. MARRIED, NEVER MARRIED, WIDOWED, DIVORCED (Nyerity) Married
June 3, 1867 86
ANTE CEDENT CAUSES
Due To (b)
Own home 100. USUAL OCCUPATION(Gire Mind of wurk 10b. KIND OF BUSINESS OR IN- gę during tatt of working He, even if rotird) Housewife
DUSTRY
50 Scotland
13. FATHER'S NAME
14. MOTHER'S MAIDEN NAME
Alexander Greig
Margaret Dewar
Due To (c)
IS. WAS DECEASED EVER IN U. S. ARMED FORCES? (Yes. no, or valchiro) | (If yes, give war ce dates of service)
16. SOCIAL SECURITY none NO.
ADDRESS
St. Petersburg Fla.
INTERVAL BETWEEN
Enter only one cansell. DISEASE OR CONDITION
DIRECTLY LEADING TO DEATH" (a)
arterio - Sclerosis
yEuro,
"This does not mean
Morbid conditions, if any, giving
such as heart failure, Plas to the above squee (a) stat-
asthenia, ata. It means ing the underlying cover last.
the disease, injury, or
complication w & i . A II. OTHER SIGNIFICANT CONDITIONS
ouwood desth.
Conditions contributing to the death but not
4201-26
Date of operation
19a. DATE OF OPERA- 19b. MAJOR FINDINGS OF OPERATION
20. AUTOPSY?
What test confirmed diagn
YES
NO
(Probably)
(Specify)
215. PLACE OF INJURY (e.g., in or abeat bosse, fari, factory, street, de BILE, d& )
21c. (CITY OR TOWN
(COUNTY)
{STATE)
2ta. ACCIDENT
SUICIDE
HOMICIDE
21d. TIME
(Month) (Das) (Tar)
Zla. INJURY OCCURRED
2 . WOW DID INJULY OCCURY
INJURY
WHILE AT WORK
AT WORK
6
Place of Burial or Cre
Dyson uz Olle}
23c. DATE SIGNED
DATE OF-BURIAL.
Za. BURTAL, CREMA- 24h. DATE
24c. NAME OF CEMETERY OR CREMATORY
24d. LOCATION (City, town, or county) tate)
HON REMOVAL (apeltn) Removal
3-16-54
Winthrop,
Mass.
DATE REC'D JY LOCAL REGISTRAR'S SIGNATURE
25. PUES RAL DIRECTOR'S SIGNATURE
cel Pe Baxgod"s, Fla ..
ATTEST:
· (Registrar of City or Town where death occurred)
Received and filed.
6.1.8.1954
........... .... 19
(Registrar of City or Town where deceased resided)
DATE FILED
........ 19
...
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.)
50m-(e)-10-48-24658
MARRIED
VIDOWED
r DIVORCED
4 I HEREBY CE
NON RESIDENT
2. USUAL RESIDENCE (Wwws domuel Hval L' fortitution: rostorace before
Mass.
Suffolk
me of wife in full)
name in full)
If under 24 hours Hours Minutes
IT. BIRTHPLACE (Mais er foreign muntey)
12. CITIZEN OF WHAT COUNTRY? USA
uring most of working life)
18. CAUSE OF DEATH
MEDICAL CERTIFICATION Cormary Occlusion
ONSET AND DEATH
per line for (a), (1), and (c)
Storial
OTHER SIGNIFICANT CONDITIONS
ANTECEDENT CAUSES
the mode of dying.
Major findings: Of operations
related to the disease or condition onusing death.
TION
5 Was disease or injury in If so, specify (Signed). (Address)
attended the deceased from Mar, 14, 54, Mar 14.54
on ViaA 1,1954, and that death occurred at 4:20Am, from the causes and on the date stated above.
GNATURE
23b. ADDRESS 7346 Central QUE StPo 3-15-53
7 NAME OF FUNERAL DIRECTO ADDRESS
3/15/54 Emily B. Knew
If riral, state RURAL)
OF
NOT WHILE
17. INFORMANT'S SIGNATURE Mente Ch
DISEASE OR CONDIT DIRECTLY LEADING TO DEATH (a).
b. CITY OR
Pinellas
c. LENGTH OF STAY (Ls pata ylene) 6 Weeks
REGISTRAR'S NO.
8521
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. (Usual place of abode)
..
DUE TO (c)
4
1
AUGAL
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.)
PLACE OF DEATH
Essex (County) Danvers
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS ! COPY OF : CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No.
169
(If death occurred in a hospital or institution.
St. [ give its NAME instead of street and number)
2 FULL NAME.
Freeman DeCaust
(If deceased is a married, widowed or divorced woman, give also maiden name.) 10 Billow
Winthrobif so specify WAR)
St.
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death 11 years 2 months 0
days. In place of residence ............ years.
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
July
2,
1954
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased, from
Apr. 26,
1950
July 2,
54
to
death is said to
(or) WIRE of
2. Cannot be learned
have occurred on the date stated above, at 1:15 P.
.. m.
INTERVAL BE-
(Husband's name in full)
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Arteriosclerotic heart disease
TWEEN ONSET AND DEATH yrs
11 IF STILLBORN, enter that fact here.
12 91
AGE
Years.
Months.
......... Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
Unable to work
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
P.E. I. Canada
3-1 wks
Major findings: Of operations.
Date of operation.
. Was autopsy performed?
Yos
What test confirmed diagnosis ?........ u.t.op.sy
5 Was disease or injury in any way related to occupation of deceased? If so, specify.
(Signed) Androu Nichols 349 MI D
(Address) ..
Hathorne, Dass Date?/7/
11
Winthrop Cemetery
a
Winthrop
Place of Burial or Cremation (City or Town)
DATE OF BURIAL. July 6.
1954
7 NAME OF
FUNERAL DIRECTOR
Alfred B. Marsh
ADDRESS inthrop. Mass.
Received and filed.
AUG 1 2 1954
19
(Registrar of City of Town where deceased resided)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
19 MAIDEN NAME
OF MOTHER
Cannot be learned
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
21
Informant.
Mary E. Shochan
.....
(Address)
A TRUE COPY
Arthur W Say
ATTEST:
(Registrar of City or Town where death occurred) 0
DATE FILED
July
12
.19
54
X
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED: idowed
or DIVORCED
(write the word)
10a If married, widowed; or divorced ot Steele
HUSBAND of
(Give maiden name of wife in full)
I last saw Em ........ alive onfully ..... 2.,
ANTE Due To CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT Urinary Tract .... Infection CONDITIONS
17 NAME OF
FATHER
Cannot be 1 arned
25M-3-53-909098
M R-302 1
Danvers State Hospital, Hathorne No.
(Was deceased a
U. S. War Veteran,
X
PLACE OF DEATH
1 SUFFOLK
(City or Town) New England Center Hosp No.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return)
Registered No.
6757
170
[(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME
Martha L. Eveleth
(If deceased is a married, widowed or divorced woman, give also maiden name.)
38 Edgehill Rd., Winthrop,Mass.
(a) Residence.
No.
(Usual place of abode)
20
60
(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
Aug 5, 1954
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
7-16-54
8-5-54
19
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
Renal failure
TO DEATH (a)
TWEEN ONSET AND DEATH 8 day's
11 IF STILLBORN. enter that fact here.
12 84
5
Months
Days
If under 24 hours
Hours.
Minutes
ANTE
CEDENT (b)
Due To
Hepatic failure
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Sclerosing cholangitis
Of operations
Date of operation
7-21-54
.Was autopsy performed?
What test confirmed diagnosis ?.
15 days
13 Usual
Occupation:
Retirei School teacher
(Kind of work done during most of working life)
14 Industry
or Business:
Winthrop School Dept.
15 Social Security No.
nme
16 BIRTHPLACE (City).
Durham,Me ..
(State or country)
17 NAME OF
FATHER
James H. Eveleth
PARENTS
19 MAIDEN NAME
OF MOTHER
Mary L. Roak
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Me.
6 .Winthrop
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
Aug 9, 1954
19
7 NAME OF
FUNERAL DIRECTOR
A. B. Margh
ADDRESS
Winthrop, mass
Received and filed.
AUG 30 1954
19
(Registrar of City of Town where deceased resided)
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
8-9-54
DATE FILED .19
.5.
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.)
.... 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, CAUSES
A R-302 1
5 Was disease or injury in any way related to occupation of deceased ?.
If so, specify .....
A. Bowens
(Signed)
Date :- 5-54
19
M. D.
(Address )LECH
18 BIRTHPLACE OF
FATHER (City)
(State or country)
.........
21
Miss HelenB. Baker, Winthrop, Mas
Informant.
(Address)
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED Single
or DIVORCED
(write the word)
I last saw h
er
8-5-54
alive on
19
death is said to
2,05PM
have occurred on the date stated above, at
m.
INTERVAL BE-
8 SEX
Fem
St.
(Was deceased a
U. S. War Veteran.
if so specify WAR)
no
That I
attended deceased from
19
t
Winthrop Mass.
Yes
AGE
Years
9
AUGOO
-
1
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.)
25M-3-53-909098
PLACE OF DEATH
SUFFOLK BOSTON (County)
(City or Town)
VA Hosp
No.
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.
6824
171
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Martin J. Bell
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
7 Orchard St., Revere, Maas.
(Was deceased a
U. S. War VeteranSpan-Amu-
if so specify WAR)
(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 .. 3.
days. In place of residence 5
... years
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Auf: 6, 1993
(Month)
(Day)
(Year)
8 SEX
le
9 COLOR OR RACE
(write the word)
4 I HEREBY CERTIFY.
That I attended deceased from
8-3-54
19.
to
19.
I last saw h
alive on
19
death is said to
8:45PM
10a If married, widowed, or divorced
HUSBAND of.
Path. Smith
(Give maiden name of wife in full)
have occurred on the date stated above, at
m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
1274
AGE
Years
,20
Months
Days
If under 24 hours
Hours ..
.Minutes
13 Usual
Occupation:
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No ...
023-07-1605A
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
Martin Bell
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Bonpor Vo.
19 MAIDEN NAME
Winifred Wuldom
OF MOTHER
20 BIRTHPLACE OF
Ireland
MOTHER (City)
(State or country)
21 VA Hosp records, Boston, Mass.
Informant
(Address)
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
(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 en
M. D.
(Signed) ...
VAR ,Boston
Date
8-7-54
19
winthrop 6 Place of Burial or Cremation
winthrop.
Aug 10, 15L
(City or Town)
DATE OF BURIAL. 19
7 NAME OF
FUNERAL DIRECTOR
"inthrop, Mass.
O'Maley Funeral Ho
0
ADDRESS
Received and filed.
7.1954
19
2-3
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Y
Date of operation
.Was autopsy performed?
Autopsy
What test confirmed diagnosis?
pancrons
vr
Locasotivo Engineer
Due To
Carcinom of head of
ANTE
CEDENT (b)
CAUSES
Due ToBiliary cirrhosis with (c) ophageal varices
DISEASE OR CONDITION
DIRECTLY LEADINGIstrointestinal
TO DEATH (a)
Flooding
2days
10 SINGLE
MARRIED
WIDOWED
or DIVORCED,Iria
VA
(or) WIFE of.
(Husband's name in full)
8-11-54
nach
6
A R-302 1
(Address)
entry 6-10-98
Disch.
12-1-98
Rank
PFC
Org.
8th Co. Sig. Corps, US Army
X PLACE OF DEATH
Postow
54 37
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or Town making this return)
Registered No. 172
Mary ATSullivan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death years 2
Hlvistic
St.
Ch
(Was deceased a
U. S. War Veteran,
if so specify WAR)
elas lovon
(If nonresident, give city or town and State)
months.
11 days. In place of residence
.years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
august
11
1954
(Mønth)
(Day)
1
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
-
I last saw h .............. alive on
19 ........ , death is said to
have occurred on the date stated above, at.
10:20 A
.. m.
INTERVAL BE- TWEEN ONSET AND DEATH
TO DEATH (a)
Arteriosclerotic
years
Due To Arteriosclerosis.
(c)
Generalized.
years
OTHER SIGNIFICANT CONDITIONS
None
Major findings:
Of operations.
none
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
arthurc. Murray M. D.
(Signed).
(Address) Mentara Board of Date 11 Lug 1954
Healich Hablinas Martin
(City or Town)
6 Place of Burial or Cremation DATE OF BURIAL ligrest 14 19.5€
7 NAME OF
FUNERAL DIRECTOR
Ancient Del Diade
ADDRESS 109 Marin Ht. Chain Valter &. Pakleg
Received and filed. AUG II 1954 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Jemuli
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full) .
(or) WIFE of
Florence Le Sullivan
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
50
.. Years
6 Months
AGE.
Days
If under 24 hours
Hours .. Minutes
13 Usual
Occupation :
(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
Dennisj. Flanagan
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Corte
19 MAIDEN NAME
OF MOTHER
Hannah Sullivan
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mir Eileen M. Grenaul
21
Informant
(Address)
10 Mystic It Timain
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)
health Price 8/11/54
(Official Designation)
(Date of Issue of Permit)
1
R-301
CTIONS OR ERTIFICATE
ving F DEATH : enter an one or each ) and (c)
es not mean dying, such re, asthenia, s the disease, tions which
conditions, g rise to the (a) stating ing cause
ns contrib- eath but not disease or sing death.
50M-3-53-909098
- (County)
(City or Town) 35 culte que
No.
2 FULL NAME
j(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
7. Lamayan).
PARENTS
A TRUE COPY ATTEST:
- -
ANTE CEDENT (b) CAUSES Heart Disease
DISEASE OR CONDITION
DIRECTLY L
Natural Causes
19
to
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 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
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