USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 42
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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 heen given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he 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
M R-301 All
Suffolk Winthrop (City or Town)
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.
CERTIFICATE OF DEATH Que
St.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S.
War Veteran,
specify WAR)
Winthrop
(If nonresident. give city or town And state)
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
3 SEX Firmele white
5 SINGLE
MARRIED
WIDOWVED
or DIVORCED
(write the word)
Enlearned
5a If married. widowed, og divorced HUSBAND of
Ziegler
(Give maiden name of wife in full)
(Husband's name in full)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July.
18
(Month)
(Day)
That I attended deceased from
19 I HEREBY CERTIFY 10
1990
.,
jul 18 19
40
I last saw h. Q alive on ... Jul 18) 1950 death is said to have occurred on the date stated above, at 1850 m.
Duration IMPORTANT
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
If less than 1 day
AGE 7º Years Months. Days
Hours
Minutes
9 Occupation:
Housewife
Industry 10 or Business: of Home
12 BIRTHPLACE (City)
(State or country)
Ruana
13 NAME OF
FATHER
Sammel Palais
teamed
Giamine-Cannotbe
Pu
17 Blufammizi
Relation, if any
120-
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Children (Signature of Agent of Board of Health or other) Health Officer 7/19/40
(Official Designation)
(Date of Issue of Permit)
Due to sugrandit
1/1/40
1/1/kg
Other conditions
(Include pregnancy within 3 months of death)
Major findings : Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?..
20 Was disease or Injury In any way related to occupation of deceased?
If so, specify.
(Signed)
/08 menalias
21
A Date 7/18 940) (City of Torny werde Leurs um everett Place of Burial, Cremation of Removal. DATE OF BURIAL Manuel Stanitaly
19.40
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
10-West.
Received and filed.
19
(Registrar)
1 2 FULL NAME (or) WIFE of 8 Usual 11 Social Security No. 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME OF MOTHER PARENTS 16 BIRTHPLACE OF MOTHER (City) (State or country) Informant. (Address) is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 100m-10-'39. No. 8427-e N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country)
PLACE OF DEATH No. 20-
Coral
nellie Ziegler
(If deceased is a married, idowed , divorced woman, give also maiden name.)
(a) Residence. No ...
(Usual place of abode)
20 Coral Du.St.
1940
(Year)
8% years Immediate cause of death
Due
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
Registered No .......
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall fortbwith, 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 tbe 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 sball 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 ease 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 wbo 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 tbe death certificate contains a recital, as required by seetion 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 reeital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, sball 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 ean be obtained as to the deceased, or as to the manner or eause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Teroentenary Edition.)
No undertaker ør 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) 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 eaused 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, er complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, ete. As principal cause name the disease causing death. As related eauses, name earlier morbid con- ditions, if any, related to the principal eause and any important complication of the principal eause.
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 pr 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 whowe 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
I R-301 A
Suffolk
(County) Winthrop (City or Town
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
8/13/20
To be filed for burial permit with Board of Health or its Agent.
37
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Stillborn ) capa
(If deceased is a married, widowed or divorced woman, give also maiden name.)
164 A Chelsea
St
East Boston Max
(If nonresident, give city or town and state)
Hospites
years
months
---- days.
-
In this community.
yrs.
mos.
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Sa If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive.
.years
7 IF STILLBORN, enter that fact here.
8
AGE X
Years
Y
Months.
7 Days
If less than 1 day .. Hours. .Minutes
Usual 9 Occupation :..
11 Social Security No.
Winthrop Hayat
12 BIRTHPLACE (City).
(State or country)
Raffaele Scopa
13 NAME OF
FATHER
14 BIRTHPLACE OF FATHER (City) .... (State or country)
15 MAIDEN NAME
OF MOTHER
Elisabetta Jeiarap
16 BIRTHPLACE OF MOTHER (City) ..... (State or country)
Barton Man
17 Relation, Many Holdacte Leone (Faller)
Informant (Address) 1164 A
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burist or transit permit was issued: Www. D. Chil dress & (Signature of Agent of Board of Health or other) Health Office 7/22/40
(Official Designation) (Date of Issue of Permity
18 DATE OF
DEATH.
July
18
1940
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. July 4/0, 1940 to
I last saw RN cali on
19. death is said to have occurred on the date stated above, at m. Immediate cause of death
Duration IMPORTANT
Due to
Stillban
Due to.
Other conditions. (Include pregnancy within 3 months of death)
Major findings: Of operations.
Date of.
Of autopsy.
What test confirmed diagnosis ?.
IMPORTANT PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in apy way related to occupation of deceased? 10, specie: Lolullelau
M. D.
(Signed)
(Address).
482 Ware Plan 07/2040
It Michael teen Boylan My Place of Burial, Cremation or Removal. (City or Town) DATE OF BURIAL July 22 19/1.4
22 NAME OF FUNERAL DIRECTOR ... ADDRESS
a. Jagone!
Received and filed.
19
(Registrar)
100m-2-'40-D-729-8
1 3 SEX Male (or) WIFE of .. PARENTS Lucarappa is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information? should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry 10 or Business:
PLACE OF DEATH
Winthrop, Hospital No.
Registered No
(If U. S.
War Veteran,
specify WAR).
......
(a) Residence. No ....
(Usual place of abode)
Length of stay: In hospital or institution ......
MEDICAL CERTIFICATE OF DEATH
That I attended deceased from
July 18, 1940
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 best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined 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 hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been huried, 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 hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiv- Ing tomh 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 satisfactory written statement contalning the facts required hy law to be returned and recorded, which shall be accompanied, In case of an original Interment, hy 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 sufficlent reasons, his certificate cannot be obtained early enough for the purpose, or is In- sufficient, a physician who Is a member of the board of health, or em- ployed hy it or hy the selectmen 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 permult 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 deslring 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 re- moval of such body has been sooner obtained 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 been engaged, such recital shall appear upon the permit. The hoard 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 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 hury 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 clerk of the town where the body Is to he huried 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 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 hy 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 supposahiy due to Injury. These include not only deaths caused directly or Indirectly hy traumatism (including resulting septicemla), and hy the action of chemical (drugs or poisons), thermal. or electrical agents, and deaths following 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 complication which causes death, not the mode of dying, e. g., heart fallure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morhld 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 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 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
M R-301 A
Suffolk
The Commonwealth of Massachusetts (County) Winthrop OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Winthrop Community Hospitals (City or Town) No.
To be filed for burial permit with Board of Health or its Agent.
Registered No ..........
occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
(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
3 SEX
Female
4 COLOR OR RACE
White
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)
(or) WIFE of
(Husband's name in full)
6 Ago of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
If less than 1 day
AGE Years Months.
Days
Hours Minutes!
Usual 9 Occupation: Industry 10 or Business:
11 Social Security No.
Winthrop
12 BIRTHPLACE (City)
(State or country)
mais.
13 NAME OF
FATHER
Gerard B. Newman
14 BIRTHPLACE OF
FATHER (City)
Gloucester
(State or country)
Mass.
15 MAIDEN NAME
OF MOTHER
Constance Roffey
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
mass.
17 Gerard B. Newman. Relation, if any
Informant (Address) 58 Brookfield Rd Quien)
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial ot transit permit was issued: Www. D. Childress (Signature of Agent of Board of Health or other)
7/20/40
(Official Designatich) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
(Month) 19
(Day)
(Year)
19 I HEREBY CERTIFY. That I attended deceased from
19
19
...
I last saw h ............ alive on 13 ........ , death is said
to have occurred on the date stated above, at. .m.
Duration IMPORTANT
Due
Due to
detachedla placenta
Other conditions (Include pregnancy within 3 months of death)
Major findings : Of operations
.Date of ..
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)
(Address)
, M. D.
21 Holy Gross
Malden
(City of Town) 19 40
Place of Burial, Cremation or Remegall 28 DATE OF BURIAL W. L. Kelly
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
11 Meridian Str., 8.13.
Received and filed.
19
(Registrar)
100m-10-'39. No. 8427-e
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
1
PLACE OF DEATH
2 FULL NAME
Female newman
(If deceased is a married, widowed or divorced woman, give also maiden name.) 58 Brookfield Id. St.
(If nonresident, give city or town and state)
1940
to
Stillborn .Years Immediate gause of death
PARENTS
Holyoke
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 secn 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 sanie 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 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 sclectmen 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 hercunder. 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, See. 45, G. L., (Tercentenary Edition.)
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