USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1933 > Part 69
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give its NAME instead of street and number)
2 FULL NAME
Catherine .... Riley.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S. War Veteran, specify WAR) -
(a)
Residence. No.
94 Faun Bar Ave.
.St., ............
Ward,
Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
ул.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divorced
HUSBAND of
19 I HEREBY CERTIFY, That I attended deceased from
July 24
19
33 to Aug.
1
19 .. 3.3
I last saw h ... e.I. alive on
July 31
19.3.3., death is said
to have occurred on the date stated above, at-
The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
Arteriosclerosis
sev.yrs .?
Contributory causes of importance not related to principal cause:
Name of operation
None
Date of
What test confirmed diagnosis?
Was there an autopsy? No
20 Was disease or injury in any way related to occupation of deceased?
NO
If so, specify
(Signed)
C .. R.Draper
(Address) 37 Forest St. Med. Date 8/1
19.3.3
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Old Dorchester ....... Rox ....
(Cemetery)
(City or town)
DATE OF BURIAL
August 4
19
33
22 NAME OF
Jos. L.Burke
UNDERTAKER
ADDRESS
75 Chambers St Boston
Received and filed
SEP 1/ 100-
19
(Registrar of City or Town where deceased resided)
-
7
AGE
59
Years
2
Months
.Days
If less than 1 day Hours Minutes
8 Trade, profession, or particular
OCCUPATION
sawyer, bookkeeper, etc.
Housekeeper
9 Industry or business in which
work was done, as silk mill,
saw mill, bank, etc.
At ..... home
10 Date deceased last worked at
11 Total time (years)
this occupation
(month and
spent in this
occupation.
25
year)
June 1933
12 BIRTHPLACE (City)
(State or country)
England
13 NAME OF
FATHER
Thomas Regan
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Catherine Rock
16 BIRTHPLACE OF MOTHER (City) (State or country) England
17 Henry C.McKenna
Informant
(Address)
94 Faun Bar Ave.
A TRUE COPY. CharlesA Kinslow
ATTEST:
(Registrar of city or town where death CityreCtork
DATE FILED
August 5
19.
33
18 DATE OF
DEATH
August 1, 1933
(Month)
(Day)
(Year)
(or) WIFE of
(Give maiden name
John Albert Riley
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
important.
50m-2-'30. No. 7997-đ
PLACE OF DEATH
Middlesex (County)
St.,
Ward
(Usual place of abode)
(write the word)
10A. .m.
M. D.
RM R-302
SUFFOLK
(County)
BOSTON
(City or Town)
No Mass General Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
175
(City or town making return)
Registered No.
7335
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Jane L
Harvey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
(Usual place of abode)
97 Locust St Winthrop St,
Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days.
How long in U. S., if of foreign birth?
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of
George A Harvey
(Husband's name in fully
6 IF STILLBORN, enter that fact here.
7 AGE 58. Years 11 Months Days
If less than 1 day Hours. Minutes
OCCUPATION|
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
at home
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
10 Date deceased last worked at this occupation (month and year) .. Aug 17 1933
11 Total time (years)
spent in this
occupation.
38 hrs
12 BIRTHPLACE (City)
(State or country)
Nova Scotia
13 NAME OF
FATHER
William Hammond
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Sarah Smith
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nova Scotia
17
Informant
Harold P. Harvey
Winthrop
A TRUE COPY.
ATTEST:
James J. Mulvey
(Registrar of city down where death occurredy
DATE FILED
Aug.
31
19.33
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Au g 29 1933
(Month)
(Day)
(Year)
Aug
29
.19.33
19 I HEREBY CERTIFY, That I attended deceased from
Aug
.. 1.9.
193.3 .. , to
I last saw h ... er ... alive on
Aug
29
19.33 .. , death is said
to have occurred on the date stated above, at. 4.28A.m. The principal cause of death and related causes of importance in order of Dateofonset onset were as follows: broncho pneumonia
acute bronchitis
2 wks ?
Name of operation
Date of
What test confirmed diagnosis? anatomical Was there an autopsy? yes
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
L.V. Ragsdale
(Address)
Boston
Date 8/29/19 33.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthrop
(Cemetery)
(City or town)
DATE OF BURIAL
Aug
31
19
33
22 NAME OF
UNDERTAKER
C. R. Bennison
ADDRESS
Winthrop
Received and filed
SEP 18 1933
19
(Registrar of City or Town where deceased resided)
1
:
important.
50m-2-'30. No. 7997-đ
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
1
PLACE OF DEATH
St.,
Ward
(L U. S.
War Veteran,
specify WAR)
MARCIN KEORKYED TON DINEING
PARENTS
(Address)
Contributory causes of importance not related to principal cause:
M. D.
RM R-303 B
7 OCCUPATION of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS 5m-2-'30. No. 7997-c
PLACE OF DEATH
(County)
(City or Town)
- Habitat No .........
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
176
(If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
.. Waną,“
ulf nonresident give city or town and state)
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
Iwhite
5 SINGLE
MARRIED
WIDOWED
(write the word) Widow
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's rime in full)
6 IF STILLBORN, enter that fact here.
AGE 60 Years Months Days
If less than 1 day Hours. .Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Housework
9 Industry or business in which work was done, as silk mill,
saw mill, bank, etc .. of Home
10 Date deceased last worked at this occupation month and year)
11 Total time (years) spent in this occupation ..
12 BIRTHPLACE (City)
Russia
(State or country)
18 NAME OF
FATHER
Cannot be learned
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
1
16 BIRTHPLACE OF MOTHER (City) (State or country)
17 Informant (Address) 46 =
pross
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transit permit was issued luce
(Signature of Agent of Board of Health or other)
(Official Designation) 9Th which Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Sujet -
2 -
(Month)
(Day)
1973
(Year)
19 | 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.) + dning Med Fraction4 Riba
Saidthecher etla queto. at Theone Drive Withtop
?
1
(See reverse side for description for unknown person)
20 IN WHAT CITY OR TOWN
WAS INJURY SUSTAINED ?,„
n th
(Signed)
, M. D.
(Address)
13 Um
195
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
new york City n.4 (Cemetery (City or town
DATE OF BURIAL Sept. 44 1983
22 NAME OF
UNDERTAKER
Manuel Stanitalia
ADDRESS 63@roy
Received and filed. 5. 6 1933
19
(Registrar)
-
1
B
2 FULL NAME
Siegel
St.,.
(If deceased is a married, widowed or divorced woman, give also maiden name.) (a) Residence. No. 140 Ta a st. 12, 505, (Usual place of abode) Length of residence in city or town where death occurred yrs. mos.
days. How long in U. S., if of foreign birth? yrs.
or DIVORCED
egel
1
1
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, 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 regis- tration 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 con- tracted, 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.
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 under- taker 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 interment, 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 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 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 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., as amended.
No undertaker or other person 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. as amended
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.
.. He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfilment 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 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident. " "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
RM R-301A
Itatuturn Suffolk (County)
The Commonwealth of
33 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.
Registered No ..
(If death occurred in a hospital or institution,
Ward give its NAME instead of street and number)
2 FULL NAME Stillborn - Antionette Santangelo.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
41 Riverside
St.,
Ward,
Watertown
Mass.
(If nonresident, give city or town and state)
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here. Stillborn
If less than 1 day
Years
.Months
Days
.Hours .Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. 9 Industry or business in which work was done, as silk mill, saw mill, bazk, etc.
10 Date deccased last worked at
this occupation (month and
year)
Winthrop, Mas.
11 Total time (years) spent in this occupation ..
FATHER Joseph Anthony Santangelo
FATHER (City)
Italy
(State or country)
15 MAIDEN NAME
OF MOTHER
Antionette De Simone
16 BIRTHPLACE OF
MOTHER (City)
Atwton Boston
(State or country)
17 Dr. Zullo
Informant (Address) REVEre ST. REVERE
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Nau. D. Childress (Signature of Agent of Board of Health or other)
We the four
9/5/33
(Official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Sepr
5
1933
(Year)
(Month)
(Day)
19
I HEREBY CERTIFY, That I attended deceased from
Lept 5
, 19 23, to.
sept 5
19.3.3
I last saw
alive on
19-
.- death is said
to have occurred on the date stated above, at .................... m. The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
Dead baby in
nitero 0
Contributory causes of importance not related to principal cause:
Name of operation
What test confirmed diagnosis?
Date of
Was there an autopsy ?.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
4. O. zallo
(Signed)
, M. D.
(Address)
353 Rense St. Kr Date
9/5/139
21 PLACE OF BURIAL,
CREMATION OR REMOVAL Woodlawn
(Cemetery)
Chelsea
DATE OF BURIAL
Sept. 5.1933
19
22 NAME OF
Murray + Morrer
UNDERTAKER
ADDRESS
375 Broadway REVEVE.
Received and filed
SEP 6
1933
19
(Registrar)
?
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of residence in city or town where death occurred
YES.
mos.
days.
How long in U. S., if of foreign birth?
Fra.
1 3 SEX (or) WIFE of 7 AGE OCCUPATIONI (State or country) 13 NAME OF 14 BIRTHPLACE OF PARENTS is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 75m-2-'30. No. 7997-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 12 BIRTHPLACE (City)
Winthrop. (City or Town) PLACE OF DEATH No. Winthrop Community HospitalSt,
Revised United States Standard Certificate of Death
Statement of occupation .- Precise statement of occupation is very important, 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 occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the 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 in answer to Question 8 and own home in answer to Question 9. 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 what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative, " etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store," "factory. " 'mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary. engineer, etc .. Avoid the term "laborer" when a more precise statement of the docupatios can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
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, asthenia, 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. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis
Date of onset
1915
Chronic interstitial nephritis
1021
Cerebral hemorrhage
July 5, 1027
Contributory causes of importance not related to principal cause:
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, 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 be ief 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.
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 satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, 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 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 state- ment 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 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., as amended.
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