USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 39
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(Registrar of city or town where death occurred)
DATE FILED
7/3/40
19
months
days.
years
No. .....
(Specify type of place)
TO !!
CO
6
JUL -S1940 AM
R-302
1
(County) PLACE OF DEATH Bristol Fall River (City for Town) Rose Hawthorne Home No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Full Diver (City or town making return)
Registered No. (If death occurred in a hospital or institution,
give its NAME instead of street and number)
Frederick a. norton
(If deccased is a married, widowed or divorced woman, give also maiden name.)
194 Mashington are
St.
Winthrop Mass
(a) Residence. No.
(Usual place of abode)
Hosp.0
Length of stay: In hospital or institution .
years
months
3
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
m
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED/
(write the word)
18 DATE OF
DEATH.
april
12
1940
(Month)
(Day)
(Ycar)
5a If married, widowed, or divorced
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. Years
7 IF STILLBORN, enter that fact here.
8
AGE 75 Years
Months
22
If less than I day
Hours
Minutes
Usual
9 Occupation:
Cook
Industry 10 or Business:
II Social Security No.
12 BIRTHPLACE (City)
Woodering
(State or country)
y, Com
13 NAME OF
FATHER
Homer norton
14 BIRTHPLACE OF
FATHER (City)
...
Watertown ..
(State or country)
Comm
15 MAIDEN NAME OF MOTHER Margaret Huard
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Com
(Address)
A TRUE COPY?
ATTEST:
Cik & Bergeron
(Registrar of city or town where death occurred)
DATE FILED april 29
19
40
MEDICAL CERTIFICATE OF DEATH
That I attended deceased from
19 I HEREBY CERTIFY,
Cipi 9
140, to.
Cipar 12
19.40
I last saw hemmalive on
apr. 12
19:40
death is said
to have occurred on the date stated above, at ...
m.
Immediate cause of death
Carcinomaaf urinary
bladder
Duration
...
1938
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Carcinoma
Date of.
Of autopsy
What test confirmed diagnos
microscopic
no
20 Was disease or Injury In any way related to occopatioo of deceased ?
(Signed)
1675 20 Main St. Date 9/12 1940
21 PLACE OF BURIAL,
TION OR R
ova treat Hills-Boston
DATE OF BURIAL
Maril 15
(City or Town)
1940
22 NAME OF
Oseph S. Waterman
FUNERAL DIRECTOR
ADDRESS
405 Dank ave. Boston maso
Received and filed. 19
(Registrar of City or Town where deceased resided)
www 4 why tuy atetastu Itsluca ju another city of town at the time
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. (See Chap. 46, Sec. 12, G. L.)
50m-10-'39. No. 8427-f
17 Saus Beature L. Hamilton daughter)
Relation, if any CREM
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
If so, specify.
Greenh & norman,
., M. D.
PARENTS
(If U. S. War Veteran, specify WAR)
(If nonresident, give city or town and state)
(Specify whether)
St.
2 FULL NAME
TOWii
OF
?
6
MASS
JUL-31940 PM
R-301 A
Vital statistics with
PLACE OF DEATH
County) Wünschenp
(City or Town) 115 Butnar No ..
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. St. [ give its NAME instead of street and number)
Giovanni Lampasana
(If deceased is a married, widowed or divorced woman, give also maiden name.)
115 Putnam
St
Withup mass
(If nonresident, give city or town and state)
In this community 30 yrs. mos. days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
Rent EREBY CERTIFY.
19 40, to Fana
2
19.
That I attended deceased from
I last saw her alive on.
4Kg 2
19.5.0, death is said to
have occurred on the date stated above, at.
2.45 9. m.
Duration IMPORTANT
Immediate cause of death .... auteur televis Hemiplegia
3 days ...
Due to.
1 carrad Ofy
Combine Hemorrhage
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify.
Rose 7 Jannini
(Signed).
M. D.
(Address) 219 Biyenem ST (Bastante aug 2 19 40)
21 Winthrop Cemetery
Place of Burial, Cremation or Removal.
guez
DATE OF BURIAL .
.....
5-ty or Town)
19:10
22 NAME OF FUNERAL DIRECTOR. ADDRESS 2215 VulST Carsten nem
Received and filed 19
(Registrar)
cause y hemiplegia internacional y ,
is very important.
100m-2-40-D-029-2 01. La
1
3 SEX
M
7(or) WIFE of
Usual
9 Occupation :
See instructions and extracts from the laws on back of certificate.
PARENTS
17
Informant
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
Industry
10 or Business :..
4 COLOR OR RACE
W.
5 SINGLE
(write the word)!
MARRIED
WIDOWED
or DIVORCED
mo
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of exife in full)
.
Francesca M. Stange
(Husband's name in full)
6 Age of husband or wife if alive.
60 years
7 IF STILLBORN, enter that fact here.
8 60 Years. Months. Days
If less than 1 day Hours Minutes
Pottery Maker
Il Social Security No 028-03-0840
12 BIRTHPLACE (City) Salame Prov. Imapa
(State or country)
13 NAME OF
FATHER
Fingre Lampasana
14 BIRTHPLACE OF Salami Gru. Trapani
FATHER (City) ..
(State or country)
15 MAIDEN NAME
OF MOTHER
anna Di Vita
16 BIRTHPLACE OF Salame Gur. Japans
MOTHER (City)
(State or country)
Relation, if any Francescam Lang Wife (Address) 115 Putnam ST. Winding
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Nau. S. Children. {Signature of Agent of Board of Health or other) Health officer 7/3/40
....... (Official Designation) (Date of Issue of Permit)
Major findings: Of operations
Date of
Of autopsy.
What test confirmed diagnosis?
(If U. S. War Veteran, specify WÄR) .....
Length of stay: In hospital or institution
(Specify whether)
years
months
days.
2 FULL NAME.
(a) Residence. No.
(Usual place of abode)
2
1940
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shail forthwith, after the death of a person whom he has attended during his last iliness. at the request of an undertaker or other authorized person or of any member of time famliy of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and beiief the name of the deceased, his supposed age, the disease of which he dled, defined as required hy section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the datc of his death . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shaii hury or otherwise dispose of a human hody in a town, or remove therefrom a human body which has not been hurled, 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 dicd; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- Ing tomb to another in the same cemetery, untii he has received a permit from the board of health or its agent aforesald 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 hy law to be returned and recorded, which shaii be accompanied. in case of an original Interment, by a satisfactory certificate of the attending physician, if any, as required hy 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 la In- sufficient, a physician who Is a member of the board of health, or em- ploycd hy It or hy the seiectmen for the purpose, shali upon application make the certificate required of the attending physician. If death Is caused by vloience, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and In the possession of the undertaker dealring to make such removal shall constitute a permit for such removai; provided, that such body shail he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval of such hody 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 recltal shali appear upon the permit. The board of heaith, or its agent, upon receipt of such statement and certificate, shail forthwith countersign It and transmit it to the cierk of the town for registration. The person to whom the permit Is so given and the physician certifying the cause of death shali thereafter furnish for registration any other necessary Information which can be ohtained 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 hrought 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 cierk of the town where the body Is to be buried or the funeral Is to be heid, or from a person appointed to have the carc 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 iaws calis for the observance of the following rules of practice:
(1) Attending physicians wiil certify to such deaths oniy as those of persons to whom they have given bedside care during a iast illness from disease unrelated to any form of injury.
(2) Board of Health physicians wiii certify to such deaths oniy as those of persons who, though disabled hy 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 supposahly due to injury. These include not only deaths caused directly or indirectly by traumatism (including resuiting septicemla), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths foliowing abortion, hut 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 .- Cause of death means the disease, or compiicatlon 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 eariier morbid conditions, if any, related to the principal cause and any Important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very 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 lilness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, 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-301 A
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
No 63 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 ..
alexander a. Mac Cormack
(If deceased is a married, widowed or divorced woman, give also maiden name.)
63 Shirley
St
winthrop mars.
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community 20
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Luidowed
Sa If married, wido wed? or divorged
HUSBAND of ........
Elizabeth Curry
Give maiden name of wife in fully
(or) WIFE of.
(Husband's name in full)
6 Age of husband or wife if alive ..
years
7 IF STILLBORN, enter that fact here.
8 AGE 82 Years
Months.
.. Dayal.
If less than 1 day Hours .Minutes
9 Occupation :
Betired
Industry
10 or Business :.
Supt. of Construction
11 Social Security No .. none
12 BIRTHPLACE (City)
(State or country)
P.C. I. Canada
PARENTS
14 BIRTHPLACE OF
FATHER (City)
P. C. J.
(State or country)
Canada
15 MAIDEN NAME
F MC
Christina Mac Donald
16 BIRTHPLACE OF
MOTHER (City) ......
........
(State or country)
Caucida
Informant
Christina Gilles (Daughter)
(Address) 63 Shirley St. Luciethrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
Childrens
(Signature of Agent of Board of flesh or other) Health Gefecht 7/6/40
(Official Designation)/ (Date of Issue of Permit)'
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
July
1440
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY
That I attended deceased from
1940
to
U
19 40
I last saw h ... Lamalive on 19 40 death is said to have occurred on the date stated above, at.( .... 2 m. P
Immediate cause of death ..
Duration IMPORTANT 10
Due to.
Due to.
attimo slan
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings:
Of operations ...
Underline the cause to which death
Of autopsy.
What test confirmed diagnosis ?...
should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed).
....... (
M. D.
"(Address) Constington in Date 7/5 1946.
21 Holy Cross Centroturis Malden mars.
Place of Burial, Cremation or Removal.
DATE OF BURIAL ..
July
1940
8
(City or Town)
........
22 NAME OF
FUNERAL DIRECTOR.
R. C. Kirby
ADDRESS
17 Bennington St. E. Boston
Received and filed 19
(Registrar)
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.
100m-2-'40-D-729-m
17
Relation, if any
St.
(If U. S.
War Veteran,
specify WAR)
none
(a) Residence. No.
(Usual place of abode)
1
Usual
13 NAME OF
FATHER
alexander m. Mac Cormack
.Date of.
....
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. definded as required hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death . . . Gen. Laws, 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 hody which has not been huried, until he has received a permit from the hoard 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 hody and remove it froin a town, from one cemetery to another, or from one grave or tomh other than the receiv- ing 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 huried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall he accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy 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 in- sufficient, a physician who is a member of the hoard of health, or em- ployed by it or hy the selectinen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as ahove 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 he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval of such hody has heen sooner ohtained hereunder. If the death certificate contains a recital, as required hy 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 heen 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 he 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 hrought into the commonwealth until he has received a permit so to do from the hoard 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 hody Is to he huried or the funeral Is to be held, or from a person appointed to have the care of the cemetery or hurial ground in which the interment is made. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent 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 septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from Injury or infection related to occupation, the sudden deaths of persons not disabled hy recognized dlsease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morhid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very 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 husiness, 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 hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
f
R-301 A
Suff-1k
(County)
1
Winthrop
(City or Town)
No. 507 Pleasant 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 Agerit.
Registered No
§ (If death occurred in a hospital or institution, St. {give its NAME instead of street and number)
2 FULL NAME.
Joseph Hayward
(If deceased is a married, widowed or divorced woman, give also maiden name.)
2I Grovers ave
St.
(If nonresident, give city or town and state)
....
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
Thite
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDingle
5a If married, widowed, or divorced
HUSBAND of .......
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
7 IF STILLBORN. enter that fact here.
8
AGE 7
Years
.Montha.
Days
Ifless than 1 day Hours Minutes Due to ..
9 Occupation:
Retired
Industry
10 or Business:
Civil Engarneer
11 Social Security No ....
12 BIRTHPLACE (City)
(State or country)
Char stown
Mass
PARENTS
14 BIRTHPLACE OF
Charlestown
FATHER (City)
(State or country)
Mass
15 MAIDEN NAME
OF MOTHER
Mary Mc Closkey
16 BIRTHPLACE OF
Boston
MOTHER (City) .......
(State or country)
Mass
17
Relatlon, if any
Informant:d ...
William Clark (Sister)
(Address) 21 Grovers Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: William Childress (Signature of Agent of Board of Health or other)
agent July 6/40
(Official Resignation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH ..
July
(Monch)
(Day)
(Year)
19 | HEREBY CERTIFY. That I attended deceased from
may 16
1938 to July 6
19.40
I last saw him alive on may 26
19.4/.9 death is said to
have occurred on the date stated above, at 5 a. m.
Immediate cause of death
Chessie myocarditis
angina Pectoris
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT PHYSICIAN
Underlire 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 Bele wrichiestay
Winthrop Man Date 7/6 19.6.6.0
21 ... Forest Hills Place of Burial, Cremation of Ren DATE OF BURIAL.
Boston
22 NAME OF
FUNERAL DIRECTOR
ADDRESS.
Removal. FazitCity of Town) John Fi@Maley
Winthrop
Received and filed ..........
19
........
(Registrar)
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.
100m-2-'40-D-729-a
13 NAME OF
FATHER
Henry Hayw ard
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