Town of Winthrop : Record of Deaths 1940, Part 14

Author: Winthrop (Mass.)
Publication date: 1940
Publisher:
Number of Pages: 494


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 14


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Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mnode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.


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 usual occupation prior to illness. If the deceased had retired from busi- ness, 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, 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


2-303 B


PLACE OF DEATH No.


Suffolk. (County)


(City or Tom) 6) Beacons. -2


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. 42


Edward facultar


(If deceased is a married, widowed or divorced woman, give also maiden name.)


25 Shore atrive


(a) Residence. No ... (Usual place of abode) Length of stay: In hospital or institution (Specify whether)


years


months


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE| 5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Single


(Give maiden name of wife in full)


(Husband's name in full)


6 Age of husband or wife if alive. Years


lf less than 1 day


Hours.


Minutes


Industry


apartment vonal


11 Social Security No ....


016-18-0292


EBación


13 NAME OF


amaziah Hamilton


15 MAIDEN NAME


OF MOTHER


nellie & murray


Italifan


(State or country)


nova scotia


5m-10.'39. No. 8427-j


1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www.D. Childress (Signature of Agent of Board of Health of other) Health Spaces, 2/27/40 (Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


Liebe 25, 1940


(Month)


(Day)


(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.)


Gente Endian Factual


I have teallafeed creddeuly


Was there an autopsy?


(See reverse side for description for unknown person)


20 Where did


injury occur ?.


(City or town and State)


21 Was disease or Injury In any way related to occupation of deceased?


If so, specify ...


M. D.


(Signed)


avrillugo


Date 2006 1940


Place of Burial, Cromatico er Removal.


(City or Town)


DATE OF BURIAL


xii- 25


1940


23 NAME OF


FUNERAL DIRECTOR


ADDRESS


EBéton


Received and filed 19


(Registrar)


17


Muro Vielen in Cartland


Relation, If any


22


Holy Cross


Malden


(Inter (Address) 35 anfield Rd Winthrop


2 FULL NAME 3 SEX male White 5a If married, widowed, or divorced HUSBAND of (or) WIFE of 7 IF STILLBORN, enter that fact here. 8 56 AGE Years. Months Days Usual Janitor 9 Occupation: 10 or Business: 12 BIRTHPLACE (City) (State or country) maso FATHER 14 BIRTHPLACE OF FATHER (City) IS BIRTHPLACE OF PARENTS MOTHER (City) Informant. information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER 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 N. D .- WRIL PLAINLY, WAR ONFADING DLACA INA -TITIS DA LLAMANLITT ALVOAV. AGY 4 OF (State or country) maine


§ (If death occurred in a hospital or institution, Gt. { give its NAME instead of street and number)


(If U. S. War Veteran, specify WAR)


St.


(If nonresident, give city or town and state)


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 regis- tration a standard certificate of death, stating to the best of his knowledge and belief the na:ne 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. Laus, Chap. 16. 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 icceived 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 de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 registration. The person to whom the permit is so given and the physician certifying the cause of death shall thercafter 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, See. 45, G. L., as amended.


No undertaker or other person shall bury a human body or the ashes thercof 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 burled or the funeral is to be held, or from a person appointed to have the cure 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 vlew 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 ; otherwise a description as full as may be, with the cause and man- ner 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 fulfillment of the purpose of these laws calls for the observ- ance 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 ill- ness 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 un- related 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 supposabiy due to Injury. These include not only deaths caused directly or Indirectly by traumatism (including resulting septice- mia), 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 relaled lo occupa. tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


STATEMENT OF CAUSE OF DEATHI


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 ac- cident." "Pistol shot wound of the chest with associated hemor- rhage, homicidal." "Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."


If disease or injury was related to occupation, specify. If Inves- tigation shows the death to have been due to discase, specify : (1) Under cause, its known or presumable nature; and (2) under man- ner, indicate the circumstances leading to medico-legal inquiry. For cxample: "Hemorrhage 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


R-301 A


PLACE OF DEATH!


Suffolk (County) winthrop (City or Town)


No. 39 Growers avenue


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. Registered No .......... 13


(If death occurred in a hospital or institution, give its NAME instead of street and number)


(If U. S. War Veteran, specify WAR)


(If deceased is a married, widowed or divorced woman, give also maiden name.)


29 Shirley Street


.... St.


years


months


days.


(Specify whether)


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


.Vid owed


5a If married, widowed, or digred ja Mazzella HUSBAND of


(Give maiden name of wife in full)


(Husband's name in full)


Years


If less than 1 day


Hours.


Minutes


1I Social Security No.


027-07-4577


Unable to obtain Deminico


14 BIRTHPLACE OF


Unable to obtain


15 MAIDEN NAME


OF MOTHER


Unable to obtain


Unable to obt in


17 Informant. RobertH.DeMinico ( ....... son (Address) 21 Avon St Cambridge Lass


Relation, if any


100m-10-'39. No. 8427-e


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the huhial or transit permit was issued: Man. S. Nul dress & (Signature of Agent of Board of Health or other) Health officer 2/27/40


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


February


26


1940


(Month)


(Day)


(Year)


That I attended deceased from


Feliway 5 19.70 t


n.


I last saw h .!......... alive on ...


February 1719 40, death is said


to have occurred on the date stated above, at 3:209;


Duration


INFORSA


Immediate cause of death ....


acute Coronary Thrombosis


2 hours


...


-


3 mos. .............


Due to


Other conditions


(Include pregnancy within 3 months of death)


Major findings :


Of operations


none


Date of.


Of autopsy


What test confirmed diagnosis? Clinicalx


laboratory no


20 Was disease or lajury lo any way related to occopation of deceased? If so, specify


(Signed)


Jacob.


abramo


7.8


...


3) 562 Hurley ST


Date.


2/26 940.


21


Winthrop


Worthcop. mars vinthr


Place of Burial, Crematigmo


pr Removal 28 (City or Town)


DATE OF BURIAL


19.40


22 NAME OF


FUNERAL DIRECTOR


Charles R. Bennison


ADDRESS


inthrop Mass


Received and filed


19 ......


(Registrar)


muformation should be carefully supplied.


- 3 SEX [ale 8 AGE AGE should be stated EXACTLY. PHYSICIANS should state (or) WIFE of


(a) Residence. No.


(Usual place of abode)


Length of stay: In hospital or institution.


4 COLOR OR RACE


Thite


6 Age of husband or wife if alive


7 IF STILLBORN, enter that fact here.


60


Years.


11


Months ..


30 Days


Usual


9 Occupation:


Inventor


10 or Business:


12 BIRTHPLACE (City)


(State or country)


Italy


13 NAME OF


FATHER


FATHER (City)


(State or country)


PARENTS


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION


Industry


Shoe Machinery


is very important. See instructions and extracts from the laws on back of certificate.


St.


2 FULL NAMECharles Attlie


De minico


(If nonresident, give city or town and state)


In this community 20yrs.


mos.


days.


9 I HEREBY CERTIFY muay 26 ..... to ... r


19 20


Due to


Auquia Pectoris


PHYSICIAN Underline the cause to which death should be charged sta- tistically.


M. D.


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 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 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 tbc person died ; and no undertaker or other person sball 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 de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 tbe 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 registration. The person to whom the permit is so given and the physiclan certifying the cause of death shall thereafter fur- nish 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, Sco. 45, G. L., (Tercentenary Edition.)


No undertaker or other person shall bury a human body or the asbes 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 bave the eare 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 observ- ance 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 ill- ness 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 un- related to any form of injury, have died without recent medieal 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 septice- mia), 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 occupa- tion, the sudden deaths of persons not disabled by 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 mnode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As reiated causes, name earlier inorbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.


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 usual occupation prior to Illness. If the deceased had retired from busi- ness, 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 domestle service for wages. however, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, ete. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


R-301 All


PLACE OF DEATH


Suffolk (County)


Winthrop


(City or Town)


No.


915 Shirley St


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.


Registered No (If death occurred in a hospital or institution, give its NAME instead of street and number)


2 FULL NAME


PatrickM ....... G.1.1.1.001y.


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(If U. S.


War Veteran,


specify WAR)


915 Shirley St


.....


.St.


(If nonresident, give city or town and state)


years


months


days.


In this community 30yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Male


4 COLOR OR RACE


Thite


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Widowed


Sa If married, widowed, on divorced noghue HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here.


8 76


AGE


Years


Months


Days


Hours


Minutes


Usual


9 Occupation:


Plumber


Industry


Retired


10 or Business:


1I Social Security No.


12 BIRTHPLACE (City)


(State or country)


Scotland


13 NAME OF


FATHER


Michael


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


15 MAIDEN NAME


OF MOTHER


Bridget Moque


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


......


........


17


Informant


Mrs Samuel Baker


Relation, if any daughter


(Address) 915 Shirley St


Pintaron


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


Childrens


(Signature of Agent of Board of Health of other


Whatthe Officer 2/27/40


(Official Designation)


18 DATE OF


DEATH


(Month)


(Day)


1940 (Year)


I last saw h .. Cnalive on


tuk 2.6


19 .. 0 death is said


Duration IMPORTANT 2


3


Due to


Due to


Other conditions


(Include pregnancy within 3 months of death)


Major findings : Of operations


Of autopsy


What test confirmed diagnosis ?


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?


If so, specify


(Signed)


4 Umarm Date 2017 19.


M. D ..


(Address)


21


St


Joseph's


Boston


....


Place of Burial, Cremation or Removal (City of Town)


DATE OF BURIAL


os John F. OMaley


FUNERAL DIRECTOR


22 NAME OF


ADDRESS


Winthrop Massachusetts


Recoived and filed.


19


(Registrar) 1


100m-10-'39. No. 8427-e


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.


PARENTS


If less than I day


years


MEDICAL CERTIFICATE OF DEATH


26


That I attended deceased, from


19 I HEREBY CERTIFY. 70-1 19.70, to tv 26 19 40 m. to have occurred on the date stated above, at 1.150 Immediate cause of death ...............


Date of ..


.......


19


40


1


(a) Residence. No.


(Usual place of abode)


Length of stay: In hospital or institution ...


(Specify whether)


St. 1


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 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 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.




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