USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 88
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death certificate contains a recital, as requiredl by section ten of chanter 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 only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . General Laws, Chap. 38, Sec. 6.
No undertaker or other 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, nr 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).
RECEIVED RULES OF PRACTICE
The fulfillment of the purpose these laws dalts for the observance of the follow- ing rules of practice:
(1) Attending physicians will certify. to auch deaths only as those of persons to whom they have given bedside care di ring a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certity 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 jugestigate and certify to all deaths supposably due to injury. These include bot afly deaths coused directly or indirectly by traumatism (including resulting septicemia) and. by the action of chemical (drugs or poisons) thermal, or electi and deaths following abortion, but also deaths from disease resulting from orinfection related to occupation, the sudden deaths of persons not disabledtb y recognized disease, and those of persons found dead.
Statement of Cause of De Pricians: on face side of standard certificate of death.
Seg lexplanatory instructions
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 1
PLACE OF DEATH Suffolk (County) Winthrop (City or Town) Bay View Nursing Home 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.
262
Ethel Hirschberg 2 FULL NAME ...
(If deceased is a married, widowed or divorced woman, give also maiden name.) 7 Lea Foam Que. St.
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death. 0 years 0 months. 2 days. In place of residence. years.
14
0
0
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
DEATH
3 DATE OF
Recenter 18
1954
(Yeaf)
(Month)
(Day)
1954
I last saw her alive on
Dec 18, 1964, death is said to
have occurred on the date stated above, at 8:40 Am.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a) Carcinoma of cecum
U Carum
ANTE
Due To
CEDENT (b)
CAUSES
Due To . (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings: Carcinoum of Cecum nutritario Of operations ..
Date of operation
lyst. 1954 Was autopsy performed?
200
What test confirmed diagnosis? Clinical, Patteological
5 Was disease or injury in any way related to occupation of deceased? 200
If so, sp
(Signed)
(Address) Wirthmay
M. D.
Date 12/18/
1954
Danvers
oChesed Shel Emelt
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL.
dec 19
1954
7 NAME OF
FUNERAL DIRECTOR ...
Hyman J. Joy
ADDRES
5/ Washington Que Cheluc
Received and filed DEC .20 1954 ..... 19
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Ruscia
19 MAIDEN NAME
OF MOTHER
Fanny Barr
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ruasia
21
Informant
(Address)
Idea tram Que Werehog
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter A- Makers
(Signature of Agent of Board of Health or other)
Milable Office
12/18/54
(Official Designation)
(Date of Issue of Permit)
marit
MARRIED
WIDOWED
of DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
france
1954
to ..
Dec. 18
...
10a If married, widowed, or divorced
HUSBAND of.
(or) WIFE of
abraham Hirschberg
(Husband's name in fully
11 IF STILLBORN, enter that fact here.
12
AGE 50 Years.
0
Months.
0
Days
If under 24 hours
Hours ...
Minutes
13 Usual
Saleslady
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
Retail General Merchandise
15 Social Security No. 032-01-7526
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
morris Shapiro
100M-10-53-910621
CTIONS ERTIFICATE
iving F DEATH enter han one or each ) and (c)
es not mean dying, such re, asthenia. s the disease, tions which .
conditions. g rise ta the (a) stating ing cause
ons contrib- eath but not disease or using death.
Registered No.
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)
no
(If nonresident, give city or town and State)
10 SINOLE
(write the word)
8 SEX
Female
9 COLOR OR RACE
White
(Give maiden name of wife in full)
INTERVAL BE- TWEEN ONSET AND DEATH 6 mos
abraham Hirschberg
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, defincd 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 n 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 erson died; and no undertaker or other person shall exhume a human body and emove 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 aw, 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 be heldRol ffoff 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).
R
OP PRACTICE
7
The fulfillment of the purpose thesenews caKs for the observance of the follow- ing rules of practice: ( (1) Attending physicianswill certify fo such deaths only as those of persons to whom they have given bedside care during Elast illness from 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 bot Uattendance or whose physician is absent
from home when the certificate ( death is heeded:
(3) Medical Examiners investic Inte tand, certify to all deaths supposably due to injury. These inchide not e deaths caused directly or indirectly by traumatism (including resulting adputemin), 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 res persons found dead. DEC2O fygnized disease, and those of
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
M R-301 1
PLACE OF DEATH
Suffolk (County)
Winthrop
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
263
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) No.
2 FULL NAME .. Helen Verdi Nee O'Reilly (If deceased is a married, widowed or divorced woman, give also maiden name.)
91 Freemount St.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. ..... .. years. .. months.
4 days. In place of residence. 30
.years.
.months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
12
18
195 4
(Year)
8 SEX Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDMarried
(write the word)
4 I HEREBY CERTIFY,
Acc 14
That I attended deceased from
to ..
Dec 18
14
I last saw her alive on
Dec :7
1927, death is said to
(or) WIFE ofAndrew Verdi
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) Coronary
occlusion
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGETO
Years
11
Months.
18
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
At Home
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Prov
R.I.
OTHER
SIGNIFICANT
arteriosclerosis
CONDITIONS
generalized
Major findings:
Of operations.
Date of operation.
.Was autopsy performed?
What test confirmed diagnosis?
E.ILG.
5 Was disease or injury in any way related to'occupation of deceased?
no
If so, specify ....
(Signed) .....
(Address) Mulicalea
2/2 Date 12-18 1924
6 Winthrop Place of Burial of Cremation
Winthrop (City or Town)
DATE OF BURIAL Dec ..... 21
19.54
21 Informam
Andrew Verdi 91 Freemount St. Winthrop
..
7 NAME OF
FUNERAL DIRECTOR
Ernest P Caggiano
ADDRESS47 Winthrop St Winthrop
Received and filed.
DEG-20-1954
.19
(Registrar)
A TRUE COPY ATTEST:
PARENTS
18 BIRTHPLACE OF
..
FATHER (City) (State or country) Ireland
19 MAIDEN NAME
OF MOTHER
Margaret Mc Dermott
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
I HEREBY CERTIFY that e satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wolter At Baker (Signature of Agent of Board of Health or others
Thealite Officer
12/20/54
(Official Designation) (Date of Issue of Permit)
..
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
have occurred on the date stated above, at 9:06 Am.
INTERVAL BE-
min
ANTE
Due To
Coronary occlusion
CEDENT (b)
CAUSES
- healing
5 day
Due To Coronary artery (c)
disease
SOM (A)-1-51 903586
UCTIONS FOR CERTIFICATE
giving OF DEATH t enter than one for each b) and (c)
does not mean f dying, such ure, asthenia, ns the disease, ations which h.
conditions, ng rise to the : (a) stating ying
ions contrib- death but not e disease or using death.
(City or Town)
Winthrop Community Hospital
Registered No.
(Was deceased a U. S. War Veteran, { if so specify WAR)
(a) Residence. No. (Usual place of abode)
.......
M. D.
17 NAME OF FATHMathew O'Reilly
..
(Month)
(Day)
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 sertion 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 only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . General Laws, Chap. 38, Sec. 6.
No undertaker or other 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).
RECEIVED
RULES OF PRACTICE -
E The fulfillment of the purpes o TOW law siçaHs for the observance of the follow- ing rules of practice: (1) Attending physicians vil 12 such deaths only as those of persons
to whom they have given-beffi ng last illness from disease unrelated to any form of injury.[.
sicjat will fertily_to such deaths only as those of
(2) Board of Health persons who, though,disabled by gnized sease unrelated to any form of injury, have died without recent me attendance or whose physician is absent from home when the 'certisa of death is beeded. '! vestita and certify to all deaths supposably
(3) Medical Examthe ow due to injury. These ine traumatism (including deaths caused directly or indirectly by and by the action of chemical (drugs or poisons) thermal Sand deaths following abortion, but also deaths from disease resaki nitry or infection related to occupation, the sudden deaths of persons ed by recognized disease, and those of persons found dead.
Statement of Cause
DEG20 -Physician 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.
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