USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 35
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SPACE FOR ADDITIONAL INFORMATION
R-301 A Suffolk (County)
1
Sinthrop
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
To be filed for burial permit with Board of Health or its Agent.
112
Registered No
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Elisabeth L Dreano
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ...
116 CrestAvenue
...............
St.
Revere.
(If nonresident, give city or town and state)
(Usual place of abode)
Length of stay: In hospital or institution ....
Hospital
years
months1
days.
In this community40 yrs.
mos.
days.
(Specify thether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
18 DATE OF
DEATH
Kune
7
1940
(Month)
(Day)
(Year)
Female
White
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Constant Dreano
(Husband's name in full)
years
6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here.
If less than I day
Hours
Minutes
Usual
9 Occupation:
Housewife
Industry
10 or Business:
At home
II Social Security No.
12 BIRTHPLACE (City)
Cambridge
(State or country) Mass.
13 NAME OF FATHER Patrick Coakley
Major findings :
Of operations
PHYSICIAN Underline the cause to
which death
Of autopsy
What test confirmed diagnosis ?
should be charged sta- tistically.
28 Was disease er Injury In any Way related ta occupation ef deceased?
If so, specify,
John F Collins
(Signed)
M. D.
(Address) Cerere mass Date
6/9
1980
Brookline
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR michael J. Cancella
ADDRESS10 No(Benett St., Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or /transit permit was issued: Www. D . Childrens (Signature of Agent of Board of Health or other) Health Offices 6/8/40
(Official Designation)
(Date of Issue of Permit)
19 I HEREBY CERTIFY, That I attended deceased from
19.3
June 7
19
40
I last saw be alive on ..
Chame 7
19." .... death is said
to have occurred on the date stated above, at.
33 Am
Immediate cause of death .. Cerebral Hemorrhage
Duration IMPORTANT 6 - 6 -40
00 1938
Due to
Other conditions
(Include pregnancy within 3 months of death)
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Jane Murphy
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Relation, if any
17 Edward Dreano ( .... Son
(Address) 56 Floyd Street , Winthrop
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.
V
PLACE OF DEATH
(City or TOR SEVERE NOTIFIED
No ..... Winthrop Community Hospital
CERTIFICATE OF DEATH
St. {
(If U. S.
War Veteran,
specify WAR)
MARRIED
WIDOWED
or DIVORCEDTidow
MEDICAL CERTIFICATE OF DEATH
8
AGE 68
Years
Months.
Days
Due to
Hypertension
Date of.
21
Holy Hood
Place of Burial, Creination moto 1940
(City or Town)
19
Received and filed JUN 13 1540 19 ....
(Registrar)
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 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 hcreunder. 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 fur- nish for registration any other necessary information which can be obtained as to the deccased, 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 burlal 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 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 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 andden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Canse of Death. Cause of death means the disease, or complication which causes death. not the mode of dying, e. g., heart failure, asphyxia, asthenia, ctc. 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
R-302
of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible after the close of the month in which the death occurred. (Sce Chap. 46, Sec. 12, G. L.)
50m-10-'39. No. 8427-f
PLACE OF DEATH
SUFFOLK (County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return)
Registered No ....
5240
(If death occurred in a hospital or institution, -
St. l give its NAME instead of street and number)'
2 FULL NAME
Israel: Abraham ... Levine
(If deceased is a married, widowed or divorced woman, give also maiden name.)
264 River Rd
.....
.....
.St.
Winthrop
(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
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE 5 SINGLE
white
(write the word)
18 DATE OF
DEATH
(Month)
(Day)
(Year)
5a If married, widowed, or divorcedLena Berger
HUSBAND of
(Give maiden name of wife in full)
I last saw h ... 1 m.alive on
6/8/40
19.
.......
death is said
(or) WIFE of
(Husband's name in full)
.years
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
50
AGE
Years.
Months.
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
general rut
Industry
10 or Business:
11 Social Security No.
023-03-2530
12 BIRTHPLACE (City)
(State or country)
Boston Mass
13 NAME OF
FATHER
Jacob Levine
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Jennie -
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Stanley Levine son
Relation, if any
Informant
(Address)
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
6/11/40
... 19.
Received and filed.
19
(Registrar of City or Town where deceased resided)
PHYSICIAN
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.....
autopsy
20 Was disease or Injury la any way related to occupation of deceased ?
If so, specify.
(Signed)
WBOsgood
M. D.
(Address).
Boston
Dato ..
6/8/40
21 PLACE OF BURIAL,
David Vicur Choulim
CREMATION OR REMOVAL.
(Cemetery)
Boston
19
DATE OF BURIAL.
6/9/40
22 NAME OF
FUNERAL DIRECTOR
B F Solomon
ADDRESS
Brookline
Underline the cause to which death should be charged sta- tistically.
PARENTS
Due tochronicglomerular nephritis vr
Due to
to have occurred on the date stated above, at.
Immediate cause of death
uremia
4/25Pm.
Duration
...... 6/1/40
-
6/3/40
X CERTIFY.
19
to
67g /Lended deceased from
19
...
we
June 8 1940
MARRIED
WIDOWED
or DIVORCED
married
(If U. S.
War Veteran,
spocify WAR)
(If nonresident, give city or town and state)
No. Peter Bent Brigham Hospital
Other conditions
...
cardiac hypertrophy
(Include pregnancy within 3 months of death)
--
0
JUL-91940 MI
R-305
No.
female
Usual
9 Occupation:
Industry
10 or Business:
13 NAME OF
FATHER
PARENTS
25m-10-39. No. 8427-8 as per phone call the City Requation 7/11/x.
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
(State or country)
3 SEX
1
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
(write the word)
widowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
John Ryan
(Husband's name in full)
6 Ago of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
AGE
77
Years
Months.
Days
If less than 1 day
Hours
Minutes
housewife
11 Social Security No.
12 BIRTHPLACE (City)
Boston Mass
William Orpin
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Sullivan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 John Ryan. ........
Relation, if any
·so.n .....
A TRUE COPY.
ATTEST:
James Q. Burke
(Registrar of city or town where death occurred)
6/13/40
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June 10 1940
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named und that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) broncho pneumonia arteriosclerosis
-
20 Accident, suicide, or homicide (specify) ....... accident
Date of occurrence.
May 30 1940
19
Where did
workshop
Injury occur?
(City or town and Statc)
Did injury occur in or about the home, on farm, in industrial place, or in
public place ?
house
(Specify type of place)
Manner of
Injury
fall to floor.
Nature of
fracture of hip
Injury
While at work?
Was there an autopsy?
21 Was disease er lajury Is acy way related to occupation cf deceased ?.
If so, specify.
(Signed)
W H Watters
(Address)
Boston
Date .. ..
19
22 holyhood
Brookline
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
June ..... 13 .... 1940
19
23 NAME OF
FUNERAL DIRECTOR
J F O'Maley
ADDRESS.
Recoivod and filed.
19
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATH
(County)
Bos
(City or Town)
^Carney Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
(City or town making return)
Registered No
5315
(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Elizabeth
Ryan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
200 Lincoln
........................ St.
Winthrop
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
(If U. S.
War Veteran,
specify WAR)
(2) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
PERSONAL AND STATISTICAL PARTICULARS
Years
own home
Futbolla
Informant
(Address)
Winthrop Mass
M. D.
15
6
PROP.
JUL-31940 AM
R-301 AII
Suffolk
POSTON NOTIFIED
The Commonincalth 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.
115
Registered No
(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME Michele Sacco
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
333 Chelsea
St.
East ... Boston
(If nonresident, give city or town and state)
(Usual place of abode)
Length of stay: In hospital or institution
Hospital
years
months
3
days.
In this community
yrs.
mos.
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
100m-10-'39. No. 8427-0
I HEREBY CERTIFY that a satisfactory standard certificate of death was files with me BEFORE the burial of transit permit was issued: Www. D. Children x (Signature of Aztny of Board of Health of other)
Health officer (Official Designation)
10/14/40 (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
(Month)
13
(Day)
(Year)
19 I HEREBY CERTIFY
That I attended deceased from
1940, to See
19
.. , 19 .. 40 I just saw be alive en Gena 19, ....... , death is said to have occurred on the date stated above, at .3. 40
Immediate cause of death.,
IMPORTANT
2012,1940
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
PHYSICIAN Underline the cause to which death
should be
Of autopsy
charged sta- What test confirmed diagnosis? the Exam
tistically.
20 Was disease or Injury In any way related te occupation of deceased?
(Signed)
(Address ) 903
. M. D.
21 Holy Cross
Malden
Place of Burial, Cremation or Removal. June 19 40
15'
.(City or Town)
22 NAME OF
DATE OF BURIAL
Paka Sabino
FUNERAL DIRECTOR
ADDRESS 9Chelsea St. Fast Boston.
Received and filed
19
(Registrar)
(County) 1 Winthrop (City or 3 SEX 4 COLOR OR RACE Male White (or) WIFE of 6 Ago of husband or wife if alive. 7 IF STILLBORN, enter that fact here. 8 Usual 9 Occupation: Industry 10 or Business: 11 Social Security No. 14 BIRTHPLACE OF FATHER (City) (State or country) Italy PARENTS 17 Informant. Donato Sacco 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. information should be calciumy supposed. nous offguia De stated DAHILI. THISICIANS should state 13 NAME OF FATHER Donato Sacco
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
Years
If less than 1 day
AGE 3 Years. Months. .. Days
Hours Minutes
12 BIRTHPLACE (City)
(State or country)
East Boston
15 MAIDEN NAME
OF MOTHER
Iolanda Viola
16 BIRTHPLACE OF MOTHER (City) (State or country) Chelsea Mass,.
Relation, if any father
(Address)
333 Chelsea St. East Boston.
PLACE OF DEATH
No. Winthrop Comunity Hospital
.....
(Jf U. S. War Veteran, specify WAR)
1940
If so, spec
.Date of ..
Daration
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 deccased, 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 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 aforcsaid 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 licu 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 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, 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., (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) Allending 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, thoughi 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 to occupa- lion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Canse 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 con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Sialement 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.
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