USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 45
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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 pernut 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 heu thereof a certificate as hereinafter provided, If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained carly 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. 1, 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 Herk of the town where the body is to be buried or the funeral is to bephetd, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114, Seç. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillinent 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 respHing, septicemia), and by the action of chemical (drugs or poison) thermal or chetrical agents, and deaths following abortion, but also deaths from chiscase 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
PLACE OF DEATH
Suffolk (County)
winthrop (City or Town) Maldans F.5-5 !!
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.
No. Winthrop Comunity Hospital
2 FULL NAME Jacob Epstein
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 23 Newbury St. Malden
St
(If nonresident, give city or town and State)
Length of stay: In place of death
years.
1 months 2 days. In place of residenceO years .... .. months days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIEDarries
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of Gertrude Silvrstein
(Give maiden name of wife in full)
(or) WIFE of (Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE67
5
If under 24 hours
Hours ...... Minutes
13 Usual
Occupation :
Photographer
(Kind of work done during most of working life)
14 Industry
or Business :
(Retired)
15 Social Security Nº 10-07-2651
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER Abraham Epstein
18 BIRTHPLACE OF
FATHER (City)
Vilna
(State or country) Russia
19 MAIDEN NAME OF MOTHER Bessie (Unknown)
20 BIRTHPLACE OF
MOTHER (City)
Vilna
(State or country)
Russia
21 Bernard Epstein
Informant
(Address) 7 Beach Road, Winthrop
7 NAME OF
FUNERAL DIRECTORMurray Goldman
ADDRESS
174 Ferry St. Malden
Received and filed JUL 11 1957 19
(Registrar)
PARENTS
(Signed)
H.B. Green field
(Address)
, M. D.
447 Shirley Sty
Winthrop Mass Date 7-10
1957
Lebanon Lodge Cem. 6
Place of Burial or Cremation
DATE OF BURIAL
July 11, 1957
19
Peabody City or Town)
SOM-5-34-917573
1
01A
INS
FICATE
DEATH ter one ach ad
ot mean dying, failure, t means compli- caused
any, ise to (a), under- last.
contrib- but not terminal n given
OTHER SIGNIFICANT Colostomy for carcinoma CONDITIONS of infestive ( 5 years ago)
Was autopsy performed?
What test confirmed diagnosis? Ecq.
5 Was disease or injury in any way related to occupation of deceased? NO If so, specify
32 days
Due To (c)
INTERVAL BETWEEN ONSET AND DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Coronary Occlusion
(a)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
July
10
1957
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
June 8
57,
July 10
1957
I last saw hi walive on
July 10
, 19 57, death is said to
have occurred on the date stated above, at
2:32 P. m.
(Usual place of abode)
Registered No. 133
f(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)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Thalia terranno (Signature of Agent of Board of Health of other)
Mattie Miche
7/11 /57
(Official Designation), (Date of Issue of Permit)
Vilna
Years
Months
Days
Due To (b)
NO
ter 137, requires print or use or ath on tes.
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.
: 1
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1 1 ( 1 1
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A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another. or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician. if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. ... .- General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to 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 1
SERVICE NUMBER
JUL 121957
١٠
7OF
YSCEIVED
1 S I T C T ( S a T
1
1
€
C
( 1
I t I 1 1
-
-
X
01A
1
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.
134
[ (If death occurred in a hospital or institution,
St. [give its NAME instead of street and number)
No.
Florence ( Munroe ) Shepherd
(If deceased is a married, widowed or divorced woman, give also maiden name.)
I60 Court Rd.
St.
(If nonresident, give city or town and State)
43.
days. In place of residence
years.
months.
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F.
9 COLOR
W.
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Joseph Shepherd.
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 85
Years.I.O.Months.2.I Days
If under 24 hours
Hours ...._ Minutes
13 Usual
Housework own home housewife
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
Own Home
15 Social Security No.
16 BIRTHPLACE (City)
Auburn, Maine
(State or country)
17 NAME OF
FATHER
Noble Munroe
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Auburn, Maine
19 MAIDEN NAME
Marie Washburn.
OF MOTHER
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Portland, Maine
Mt Auburn Cemetery Auburn, Maine 6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
July 15
57
19
7 NAME OF
Harry A. Dillingham
FUNERAL DIRECTOR
Auburn, Maine
ADDRESS
JUL 1/ 1957
Received and filed 19
(Registrar)
PARENT'S
Informant
21
Mr. Noble Hartley
(Address)10 Edgecomb Rd. Binghamton, N. Y
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me/BEFORE the burial or transit permit was issued: tacku (. ) ircanal
(Signature of Agent of Board of Health or other)
1 (Official Designation) (Date of Issue of Permit)
NS
FICATE
EATH er one ach d (c)
t mean dying. failure, : means compli- caused
any, se to (a), under- last.
-
Due To GENERALIZED ARTERIO - (b) SCLEROSIS
5YRS.
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
BRONCHOPNEUMONIA
BENICH NEPHROSCLEROSIS
IXR.
5dapr.
Was autopsy performed?
NO
What test confirmed diagnosis? CLINICAL ELA BORATORY
5 Was disease or injury in any way related to occupation of deceased? NO If so, speflfy ......
(Signed).
De Transportin die
M. D.
567 SHIRLEY ST. WINTHER
MAX Date Vilyic 19.3
(Address)
JULY
12
195%
(Year)
(Month) 1 (Day)
4 I HEREBY CERTIFY, That I attended deceased from
JUNE 10, 1957,
to July 12
57
I last saw heß alive on
July
1957, death is said to
have occurred on the date stated above, at
7:30Pm.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
ARTERIOSCLEROTIC + HYPER-
TENSIVE HEART DISEASE
INTERVAL BETWEEN ONSET AND DEATH 2YRS
SOM- 5-56-917573
ontrib. but not terminal given
ter 137, equires print or Or
use ath on tes.
PLACE OF DEATH
2 FULL NAME
WinthropyCommunity Hospital
Registered No.
PHYSICIAN -- IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence.
No.
(Usual place of abode)
Length of stay: In place of death.
....__... years
1
months
1
3 DATE OF
DEATH
-
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, See. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen, G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medieal 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, See. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
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