USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1939 > Part 2
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St.,. Ward ( give its NAME instead of street and number)
2 FULL NAME
John Maddolini
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
117 Locust
(Usual place of abode)
Length of residence in city or town where death occurred
months
days.
How long in U.S., if of foreign birth?
years
mouths days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
Dec. 20
1937, to Jau
2
19.39.
I last saw h.w.i ..... allve on.
Jam.
2,
19 39, death is said
to have occurred on the date stated above, at.
4 a.m.
The principal cause of death and related causes of Importance in order of onset were as follows:
Date of Onset IMPORTANT
Chronic myocarditis
1934
generalized arteriosclerosis
1934
replus @clerosis
1936
Hypertension
1936
Contribatory causes of Importance not related to principal cause: Heyportatic pneumonia
Jan 4, 1939
Name of oparation
none
Date of.
What test confirmed diagnosis? Clinical
.Was there an autopsy ?........
20 Was disease or Injury in any way related to occupation of deceased?
no
(Signed)
Ggidie 1, piclinton
M. D.
(Address) Winthrop, Muss
Date Jau 8 1939.
21 ..
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
January 9
39
22 NAME OF
UNDERTAKER
Charles R. Bennison
ADDRESS
Winthrop Mass
Received and filed.
......
19
(Registrar)
100m 11.36. No. 9080.F
-
1
3 SEX
4 COLOR OR RACE
White
Male
6 IF STILLBORN, antar that fact here.
7
AGE ...
5.9
9 Industry or business In which
work was done, as silk mill,
saw mill, bank, etc ....
this occupation (month and
OCCUPATION
12 BIRTHPLACE (City)
(State or country)
Italy
14 BIRTHPLACE OF
FATHER (City)
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
Italy
tion should be carefully supplied. Age should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH
important. See instructions and extracts from the laws on back of certificate.
in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very
(State or country)
Italy
5 SINGLE
(write the word)
MARRIED
WIDOWED
Or DIVORCED
Married
5a If married, widowed, or divorced
HUSBAND of
Angelina Divita
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
Years. Months .. Days
If less than 1 day Hours ............ Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc .... Builder
1O Date deceased last worked at
11 Total time (years)
1933
spent in this
occupation ..
25
year).
13 NAME OF
FATHER
Pasquale Maddolini
15 MAIDEN NAME Angelina Grasso OF MOTHER
Relation, if any
17 Mrs Angelina Maddolini wife) Informant .. (Address) 117 Locust St Winthrop Mass
I HEREBY CERTIFY that a satisfactory standard certificata of daath was fHed with ma BEFORE the burial of transit permit was issued:
(Signature of Agent of Board of Health or other)
" (Official Designation) (Date of Issue of Permit)" 1/9/39 health Afferer
St.,
Ward
(If nonresident, giye/city or town and state)
1939.
(If U. S. War Veteran specify WAR)
JAN-9 -....
1000
Registered No.
Statement of occupation. Precise statement of occupation is very important, so that the relative healthfulness of various pur- suits can be known. Make some entry in this section for everv 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 bus- iness, report the occupation prior to retirement. Children not gainfully employed may be returned as AT SCHOOL OF 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 whatever 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 deccased last worked at the occupation.
11. The number of years the deccased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "cimployee," "worker," "operative," etc. Find out the partic- ular kind of work done and return that, as SPINNER, WEAVER, etc. .
In stating the industry or husincss, avoid the use of such gen- cral terms as "store," "factory." "mill." etc. State the particular kind of store, factory, mill, etc., as GROCERY STORE, SOAP FACTORY, COTTON MILL. ctc.
-
Distinguish carefully the different kinds of engineers by stating the full descriptive titles. as ctvtt ENGINEER, MECHANICAL ENGIN- EER, MINING ENGINEER, STATIONARY ENGINEER, etc. Avoid the term "laborer" when a more precise statement of the occupation 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 dcath, NOT the mode of dying, E. G., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. . As related causes, name carlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. U'nder 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:
Date of Onset
Arteriosclerosis ...
1915
Chronic interstitial nephritis
1921
...
Carebral hemorrhage
July 5. 1927
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.
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, alter 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 sup- posed 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 scen 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 issuc 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 nave been delivered to such board, agent or clerk, as the case may be. a satisfactory written statement con- taining 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 re- quired by law, or in licu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot be obtained early enough for the pur- pose, 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 attend- ing 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 an- other 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 a removal shall constitute a permit for such removal: provided, that such body shall be returned to the town from which it was re- moved within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has heen 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 ap- pear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith counter- sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician cer- tifying 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. (TER- CENTENARY 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. .- GEN. 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; otherwise a description as full as may be, with the cause and manner of death .-- GEN. LAWS, CHAP. 38, SEC. 7.
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. (TERCENTENARY EDITION.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ob- servance 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 discase unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disahled 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 hy traumatism (including resulting septi. cemia), and hy the action of chemical (drugs or poisons), thermal. or electrical agents, and deaths following ahortion, 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.
3
Suffolk
PLACE OF DEATH
(Cusor Towa) Val Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Chelsea
4
(City or town making return)
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number) ~
World
(If deceased is a married, widowed or divorced woman, give also maiden name.)
94 Terrace Ave.
.St.,.
Ward,
Winthrop Mass
(a)
Residence.
No.
(Usual place of abode)
0
3
25
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
угз.
mos.
days.
How long in U. S., if of foreign birth?
JTI.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
Jen.7, 1939
DEATH
(Month)
(Day)
(Year)
5a If married, widowed, or asociaa Mack
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
Years
Months
Days
If less than 1 day
Hours
Minutes
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
Watch Maker
9 Industry or business in which
work was done, as silk mill,
saw mill, bank, etc.
Own Business.
10 Date deceased last worked at
this occupation (mponand 1937
year)
11 Total time (years)
spent in this 18
occupation.
12 BIRTHPLACE (City)
Nyack, New York
Charles C.
14 BIRTHPLACE OF
FATHER (City)
"Boston, Mass.
15 MAIDEN NAME
OF MOTHER
cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
"Brookfield, Mass.
17 Edna M.Brooks
Relatii & any Informat Terrace Ave.Winthrop Mass. ( Address)
(Registrar of city or town where death occurred)
DATE FILED Jan ..... 9, 1939 19
19
SHUREBY
CERTIFY . That attended deceased freue
Im
.39 ..... , 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
"Generalized carcinomatosis unknown
Contributory causes of importance not related to principal cause:
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy? YOS
20 Was disease or injury in any way related to occupation of deceased?
If so, specify,
(Signed)
A. Latham Lieut (MC) USN
M. D.
L
(Address)
U.SN.H.sp.Chelsea Date 1 ....
19
39 .
21
Winthrop, Mass.
Place of Burial, Cremation
(City or Town)
DATE OF BURIAL
pr
"a"" 10,1939
19
22 NAME OF
Richard Kirby
UNDERTAKER
Bennington St., East Boston
ADDRESS
Received and filed
19
M R-302
1 No. 2 FULL NAME 3 SEX M (or) WIFE of 7 46 AGE (State or country) 13 NAME OF FATHER PARENTS (State or country) A TRUE COPY. ATTEST: tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very OCCUPATION important. 50m-11-36. No. 9080-g N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- (State or country)
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
St.,
Ward {
Charles Edgar Brooks
(If U. S.
War Veteran,
specify WAR)
{ last saw h
.alive on
11.48"A
1
i!1
5/ 6
FEB-31033 AM
M R-303 B
PLACE OF DEATH
Suffolk. (County)
(City or Town) No. 164Woodside Que. Maritlisa ford
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. 5
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Drusilla atcharly
(If deceased is a married, widowed or divorced woman, give also maiden name.)
164 Woodside ave
... St.,.
.Ward,.
Withsap
(If nonresident, gife city or town and state)
Length of residence in city or town where death occurred
5
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widow
5a If married, widowed, or divorced
atcherley
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE ...
88
.Years.
7
Months
14
.Days
If less than 1 day
Hours
Minutes
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
at home
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
this occupation (month and
year)
Wolverhampton
(State or country)
England
13 NAME OF
FATHER
Joseph Greatorer
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Martha Black
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
17 Ragland & ackerley (Kri)
Informant
(Address)
Providence Rial !
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
11919
7251
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
Saw. 8, 1939
DEATH
(Month)
(Day)
(Year)
19 I 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.)
Hejportale Aneumonia
Fractured hegyevis-said I have fallen at home. Oce 1/1/39 38
(See reverse side for description for unknown person )
20 IN WHAT CITY QR TOWN
WAS INJURY SUSTAINED ?
theas
M. D.
(Signed)
ex Med Comu Date 1/8/ 1939
(Address) ...
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
North Burial Providence Rol
(Cemetery)
(City or town)
DATE OF BURIAL
Jan. 11, 1939
1999
22 NAME OF
UNDERTAKER ..
ADDRESS
309 Benefit St. Providence Rd
Received and filed
19
LAN 2 ) 1939
1
(Registrar)
1 (a) Residence. No (Usual place of abode) 3 SEX Female 4 COLOR OR RACE White 7 OCCUPATION 12 BIRTHPLACE (City). 14 BIRTHPLACE OF FATHER (City) .. PARENTS information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF 5m-12-'34. No. 2938-g N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 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 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
(If U. S.
War Veteran,
specify WAR)
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 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 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 hoard 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 raused hy 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 common- wealth 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 re- moval; 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 re- quired 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. (Tercentenary Edition.)
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. (Tercenten- ary 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.
... 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, anddeaths 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.) "
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