USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1949 > Part 1
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Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70
J. L. FAIRBANKS DIV. Thomas Groom & Co. Stationers 105 State St., Boston
To duplicate this book order No. 2008 -2 O.U.7
PLACE OF DEATH
Auffach. (County)
Nintendo (City or Towy)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or ita Agent.
1
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)
(If deteased is a married, widowed or divorced woman, give also maiden name.) 79 Woodside alve
St. .
(If nonresident, give city or town and State)
... year .years, 3.
months .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
(Day)
1449 (Year)
8 SEX
9 COLOR OR BACE
While
ì
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
10a If married, widowed, or divorced HUSBAND of
(or) WIFE of.
(Giyt maiden name of wife in full wilfred grundel
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 22
Years
... . Months
.. Days
If under 24 hours
Hours .. . Minutes
13 Usual
Occupation:
Thore
(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 Thomas Lister
18 BIRTHPLACE OF FATHER (City) (State or country)
England.
19 MAIDEN NAME OF MOTHER
Para Gardner
20 BIRTHPLACE OF MOTHER (City) (State or country)
England
21 Informant
Pay Francel
. I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter f. Maker 2. (Signature of Agefit of Board of Health or other) Health Milice . 11/3
(Date of Issue of Permit)
JAN 3 - 1949
149
100M-(D)-10-46-24658
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify. 1 (Signed) IM Bol Tre M. D. 19
(Address)
7 Date
Place of Burial or Cremation (City of Town)
DATE OF BURIAL. 1949
Lan, 3
7 NAME OF FUNERAL DIRECTOR Aaby Kolay
ADDRESS
Received and filed
19
1/3/1
(Registrar)
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION apte
DIRECTLY LEADING Meetthe
TO DEATH (a)
Due To
ANTE CEDENT (b) CAUSES
Due To b. a. wound (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation.
.Was autopsy performed?
What test confirmed diagnosis ?.
M R-301A 1
No.
79 Noreside Que Annie (Lister ) Greenall
2 FULL NAME.
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death .... .... years. months.
days. In place of residence
PERSONAL AND STATISTICAL PARTICULARS
4 I HEREBY CERTIFY,
That I attended deceased from
19
...
to
19
I last saw h
alive on
19
death is said to
have occurred on the date stated above, at
I.A
m.
TRUCTIONS FOR L CERTIFICATE
giving : OF DEATH not enter e than one e for each (b) and (c)
s does not mean of dying, such failure, asthenia, eans the disease, lications which ath.
bid conditions, iving rise to the use (a) stating erlying cause
ditions contrib- he death but not the disease or causing death.
PARENTS
England
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 shallexhume 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).
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 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.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
,
SERVICE NUMBER
FORM R-305 1
Boston
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
161
2
J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
236 Lincoln St
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years.
months
.days. In place of residence.
28.years
months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Jan. 4/49
(Month)
(Day)
(Year)
4I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Coronary occlusion
11a
If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE.
Years
53
Months.
Days
If under 24 hours
.Hours ..
Minutes
14 Usual
Occupation1.
Cook
(Kind of work done during most of working life)
15 Industry
or Business:
Restaurant
16 Social Security NoCannot ... be obtainable
17 BIRTHPLACE (Greece (State or country)
18 NAME OF
FATHER
Nicholas Flessas
19 BIRTHPLACE OF
FATHER (City) ...
(State or country)
Greece
20 MAIDEN NAME
OF MOTHER
Asimo Rodepoulos
21 BIRTHPLACE OF
MOTHER (City)reece
(State or country)
22
Informant
(Address)
James Flessas
Son
DATE OF BURIAL.
Jan. 7/49
19
8 NAME OF
FUNERAL DIRECTOR
A C Hasiotis
ADDRESS Boston Mass.
Received and filed. FED 5 1949
19
(Registrar of City or Town where deceased resided)
9 SEX
M
10 COLOR OR RACE
W
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
5 Accident, suicide, or homicide (specify)
Date and hour of injury.
19
Where did Injury occur? (City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
(Specify type of place)
Manner of
(How did injury occur?)
Nature of
While at work?
.Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
(Signed)
Richard Ford
M. D.
(Address)
Date 1-5
.19 ..
Winthrop Cem-Winthrop Mass.
7 Place of Burial, or Cremation. (City or Town)
A TRUE COPY.
ISHannig
ATTEST!
(Registrar of City of Town where death occurred)
DATE FILED
19
Injury after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible Injury 25m-(h)-10-48-24658
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
MARGIN RESERVED FOR BINDING
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 place?
+
PLACE OF DEATH
Suffolk (County)
No. 818 Harrison° Ave.
Christ Flessas
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No. (Usual place of abode)
Winthrop
Mass.
(write the word)
PARENTS
M R-301 A
×
PLACE OF DEATH
folk (County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
3
No. Winthrop Memorial Hospital § (If death occurred in a hospital or institution, ( give its NAME instead of street and number) r Are antonette Bonfiglio Jelly.
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
42 Carlson Que. Devere
.
St.
( Usual place of abode)
Length of stay: In hospital or Institution
(Before death)
( Specify whether)
years
2
months
days.
In this community
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
JANUARY
5
1999
( Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That i attended deoeased from
OCTOBER 28, 1948
, to JANUARY 4, 1999
I last saw h.
ER
allve on
JANUARY 4, 1949, death Is said to
have occurred on the date stated above, at
12.20A.m.
Immediate cause of death
IMPORTANT
MYOCARDIAL
.
INSUFFICIENCY
Due to.
RHUEMATIC ENDOCARDITIS
10-25-18 >
Due to
Other conditiona
CHILDBIRTH
10- 8-48
(Include pregnancy within 8 months of death)
Major findings:
Of operations
Of autopsy
What test confirmed diagnosis ?.
ECG - XRAY
IMPORTANT
Physician Underline the cause to which death should be charged sta. tistically.
20 Was disease or injury in any way related to occupation of deceased ? NO
If so, speelfy rolon. Yourgrave
( Signed )
M. D.
630 Benchit Krodue Date JANI 5 1999
21
Lo.Ly .... Cross
walden
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL Jan. 8, 1949
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Revue Durch
...
(Signature of Agent of Board of Health or other) Health Officer
1/5/49
Received and Aled
JAN 11 ....
19
(Official Designation)
( Date of True of Permit)
100m· (g) - 1-45-15510
1 winthrop 2 FULL NAME 3 SEX female| PARENTS If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain 11 Social Security No. no.ne
4 COLOR OR RACE
white
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED rried
5a If married, widowed, or divorced
HUSBAND of
;(Clue maiden name of wife in full )
(or) WIFE of
William J .Kelly
( Husband's name In full)
6 Age of husband or wife if alive 27
years
7 IF STILLBORN, enter that fact here.
8 AGE 27 Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Ocoupation :
housewife
Industry
10 or Business :
at home
12 BIRTHPLACE (City)
( Siate or country)
Boston Mass.
13 NAME OF
FATHER
Santo Bonfiglio
14 BIRTHPLACE DF
FATHER (Clty)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
c/b/1
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 William J.Kelly
Informant
( Address}
42 Carlson Ave Revere
I HEREBY CERTIFY that a satisfactory standard oartifloate of death was filed with me BEFORE the burist or, transit permit was Issued ; Walter A Bakery
Revere 7/2/19
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR) n.Q.
(If nonresident, give city or town and State)
Date of
Duration
( Registrar)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital 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 helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death . . . Gen. Laws, Cbap. 46, Sec. 9.
A physician or officer furnishing a certificate of deatb as required by the preceding section or hy section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, 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, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as be 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 sec- tion 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, he deemed to have taken place hetwecn February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen bundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been huried, 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 hoard, from the clerk of the town where the person died; and 110 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 tomh 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 bave been delivered to such hoard, 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 interment, hy 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 he obtained early enough for the purpose, or is insufficient, a pbysi- cian who is a member of the board of bealth, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, tbe medi- cal examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot he obtained early enough for the purpose, the certificate of deatb made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for sucb 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 hody has been sooner obtained bereunder. If the death certificate contains a recital, as required
by section ten ui 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 registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary 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 hy violence. If a medical examiner has notice that there is within bis county the hody of such a person, he shall fortbwith go to the place where the hody lies and take charge of the same; .. . - General Laws, Cbap. 38, Sec. 6.
No undertaker or other person sball bury a human hody or the ashes thereof which bave heen brought into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the hody is to he 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 following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to sucb deaths only as those of persons who, though disabled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, astbenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healtbfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had heen given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. 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, how- ever, designate the occupation hy the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
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