Town of Winthrop : Record of Deaths 1941, Part 30

Author: Winthrop (Mass.)
Publication date: 1941
Publisher:
Number of Pages: 546


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 30


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :


(1) Altending physicians will certify to sueh 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 deatbs only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died witbout recent medical attendance or whose physician is absent from bome 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 deatbs from disease resulting from injury or infection related to occupa- tion, tbe sndden deaths of persons not disabied 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 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 Ocenpation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursults 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 busl- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a womani whose only occupation was that of home bousework, write housework. For a person engaged in domestic service for wages, however, designate tbe occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


1 R-301 A


PLACE OF DEATH No


Suffolp.


(County)


(City or Town)


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. 89


Registered No.


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


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


St. Jehoa OGlafama


(If nonresident, give city or town and state)


months days.


In this community yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE Male Mente


5 SINGLE (waits the word) MARRIED WIDOWED OF DIVORCED Barca


5a If married, widowed & diyorced HUSBAND of Jaciar (Give maiden name of wife in full)


Le


29. ..... years


7 IF STILLBORN, enter that fact here.


8 AGE 5 Years -Months. 3 Days


If less than 1 day Hours. Minutes


Race Track


11 Social Security No ..........


12 BIRTHPLACE (City)


(State or country)


aplaten


13 NAME OF


FATHER


William Freeman


14 BIRTHPLACE OF


FATHER (City) .....


(State or country)


Georgia.


15 MAIDEN NAME


OF MOTHER


Melinda Muerta


16 BIRTHPLACE OF MOTHER (City) ... (State or country)


Dallas Texas.


Relation, if any


17 Informare altra (Address) 4.46 Plesawork 8.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: William S. Childrens (Signature of Agent of Board of Health or other)


agent may 19/4/


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


19


41


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY. , 19 .. 41g


That I attended deceased from


u Quy (9, 19 41


I last saw hill alive on May 13, 941, death is said to .. m. have occurred on the date stated above, at 7,5019. Duration ....... IMPORTANT Immediate Cause of death .. at uluno - a Embolus


mi


3


Due to. Phlebitis flea


7


Other conditions


(Include pregnancy within 3 months of death)


IMPORTANT


PHYSICIAN


Major findings: Of operations


Date of.


Of autopsy


What test confirmed diagnosis?


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


20 Was disease or injury in any way related le occupation of deceased ?. If so, epecify ... (Signed) 9 Centiet St Date Les 19 1941 Hanedadeux .... M. D. Haialook Lowell was Fidea Only Place of Burial, Cremationor Removal. (City or Town)


DATE OF BURIAL.


May 24


22 NAME OF


FUNERAL DIRECTOR


ADDRESS 90 Throughing


Dacace le


.19


Received and filed


MAY .... 2.8 1941


(Registrar) X


-


(Specify whether)


St.


Halda T. Freeman


2 FULL NAME


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


(a) Residence. No 1336 de Wheeling (Usual place of abode) Length of stay: In hospital or institution.


years


1 (or) WIFE of Industry 10 or Business :.... PARENTS 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 Usual 9 Occupation ....


100m-2-'40-D-729-a


(Husband's name in full)


6 Age of husband or wife if alive.


Due to.


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 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 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 heen buried, 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 body 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 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 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 hy law, or In lieu thereof a certificate as herelnafter 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 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 by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously Interred, from one town to 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 ohtained 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 shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit It to the clerk of the town for registration. The person to whom the permit Is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary Information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L .. (Tercentenary Edition).


No undertaker or other person shall hury 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 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 wlil 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 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 supposably due to Injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy 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 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 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-302


PLACE OF DEATH


Surl (County)


The Commonfocalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Che 1.400 (City or town making return)


295


90


No. .... Soldiers Home Hospital


St.


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


2 FULL NAME


Efthimeons ..... Plakias


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


(a) Residence. No.


(Usual place of abode)


28 Trident Avo.


St.


(If nonresident, give city or down and State)


Length of stay: In hospital or Institution.


(Before death)


(Specify whether)


"hospital


years


months


days.


In this community


yrs.


mos.


days.


26


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


4 COLOR OR RACE


5 SINGLE


(write the word)


malo white


MARRIED


WIDOWED


or DIVORCED


single


5a If married, widowed, or divoroed


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. 5.3 .. Years ... 3 Months Day's


If less than 1 day Hours Minutes


Usual


9 Occupation :


Restaurant .... proprietor


Industry 10 or Business :


11 Social Security No ..


025.05.7569


12 BIRTHPLACE (City)


(State or country)


Greece


13 NAME OF


FATHER


Dimitris


PARENTS


14 BIRTHPLACE OF


FATHER (City)


·Grcoco


(State or country)


15 MAIDEN NAME


Katherine Trasteles


OF MOTHER


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Greece


17 Hospital Records Relation, if any


Informant.


(Address)


A TRUE COPY.


ATTEST :


(Registrar of city or town where death occurred)


19


22 NAME OF


FUNERAL DIRECTOR


Arthur C. Masiotes


ADDRESS


1624WashingtonSt.,Boston


Received and filed. 19


(Registrar of City or Town where deceased resided)


2


Due to.


Other conditions


(Include pregnancy within 3 months of death)


Physician


Underline the cause to which death


Carcinoma of Bolle Euro "Livebould be


Of autopsy


mesentery and Kidneys charged sta-


What test confirmed diagnosis ?. 20 Was disease or dubousyy and toledohoboded sol .... xa If so, specify. no


(Signed)


(Address)


Isadore Kaplan


M. D.


21 PLACE OF BURIAL,


old, Home


Date 5/1019


41


... Boston,


CREMATION OR REMOVAL ........ ono.s.t ......... 1.1.1.9.


(Cemetery)


DATE OF BURIAL


May 22, 1941


(City or Tog s . 19


DATE FILED


of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R.802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased


50m (e)-1-41-4667


18 DATE OF


DEATH


May 19, 1941


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY


Apr.


19 .....


to


.41


That I attended deceased from,


41


I last saw h.


Lanve on ..


......


have occurred on the date stated above, at. 3.254 ... m.


Duration


Immediate cause of death.


Carcinoma of the Lungs wthh


General Abdominal metastases ? mos


Due to


Major findings :


Of operations


tistically.


1


Registered No.


1


(If U. S.


War Veteran,


specify WAR)


World


19


19


Lenth Is sald to


JUNA C1941 AM


M R-302


Butfolk


(County)


Bouton (City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


BOSTON (City or town making return) Registered No. 4914


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


2 FULL NAME


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


58 Bellevue Ave


St.


(If U. S.


War Veteran,


specify WAR)


Winthrop Mass


(If nonresident, give city or town and state)


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX fem


4 COLOR OR RACE 5 SINGLE


MARRIED


WIDOWED


or DIVORCED


single


(write the word)


white


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.


7 IF STILLBORN, enter that fact here.


8


ÅGE


Years


Months


4


If less than 1 day


Hours ...


.. Minutes


Usual


9 Occupation:


Industry 10 or Business:


11 Social Security No ..


12 BIRTHPLACE (City)


(State or country)


Boston Mass


13 NAME OF


FATHER


Floyd Backeberg


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Lanhan Neb


15 MAIDEN NAME


OF MOTHER


Doris Hyatt


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Wisconsin


Relation, if any


17


Informant.


(Address)


Hospital records


A TRUE COPY.


ATTEST:


(Registrar of city or town where death occurred) 5/26/41


DATE FILED 19


18 DATE OF


DEATH.


May 22 1941


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY.


5/8/47


19


That I attended deceased from


.....


to ...


5/22/41


19.


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


5/2.2. 4.1 .... , 19 ........ ,


death is said


to have occurred on the date stated above, at ....


6/40A.


Duration


Immediate cause of death ...


.congenital .... stenosi.s ....


... mitral ... and ... aortic .... valves


since


idiopathic ... congenital .... cardiac


Due to


hypertrophy.


Due to


Other conditions


(Include pregnancy within 3 months of death)


PHYSICIAN


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)


R Ganz


, M. D.


(Address)


Boston


Date :5/22/1947


21 PLACE OF BURIAL.


CREMATION OR REMOVAL ....! o.o.dlawn


Everett


DATE OF BURIAL


19


22 NAME OF


FUNERAL DIRECTOR


H-S.Reynolds


ADDRESS


Winthrop


19


Received and filed.


(Registrar of City or Town where deceased resided)


X


-


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


50m-10-'39. No. 8427-f


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-302 to the clerk of the city or town in which the deceased resided as soon as possible Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time


PLACE OF DEATH


No .. .....


The Children's Hospital


St. l


Julia G


Backeberg


(a) Residence. No


(Usual place of abode)


Length of stay: In hospital or institution ..


(Specify whether)


years


montbs


days.


In this community


yrs.


MEyet24 1941


(City or Town)


birth


2


years


1


1 R-301 A


PLACE OF DEATH


Suffolk (County)


(City or Town) 64 Mightand No ...


CERTIFICATE OF DEATH ave


St.


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


2 FULL NAME.


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


329 Pleasant


St


(If nonresident, give city or town and state)


years


months


days.


In this community


14 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


1941


(Month)


(Day)


(Year)


5a If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


unable & ablan


(Husband's name in full)


6 Age of husband or wife if alive


years


7 IF STILLBORN, enter that fact here.


8 56 Years X Months ....... Dayal


If less than 1 day Hours. Minutes


9 Occupation :.


Due to


7


Other conditions


(Include pregnancy within 3 months of death)


IMPORTANT 2


PHYSICIAN


Major findings:


Of operations.


none.


Date of


Of autopsy


none


What test confirmed diagnosis?


clinica


20 Was disease or injury in any way related to occupation of deceased ?. NO


If so, specify ................


(Signe


(Address).


Wintudo mass. Date 5/26


M. D.


19.41


21.


Place of Burial, Cremation or Removal.


[City or Town)


DATE OF BURIAL.


6/26 Everett Las


194


22 NAME OF


FUNERAL DIRECTOR ..


ADDRESS.


.


Received and filed MAY-2 8"1941 19


(Registrar) L


100m-2-'40-D-729-3


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued : Www.D. heldress (Signature of Agent of Board of Health or other) Wealth Aplicar 5/26/41


(Official Designation) (Date of Issue of Permit)


19 I HEREBY CERTIFY. That I attended deceased from Jabil, 1941, to May 22, 1941 I last saw h vim alive on May 202, 1941, death is said to have occurred on the date stated above, at 3.65 a.m.


Immediate cause of death Cerebral Hormonal


Duration IMPORTANT 92. 11.41


1936 u


11 Social Security No ...


12 BIRTHPLACE (City).


(State or country)


Chica Miran


13 NAME OF


FATHER


George. W. Eer.il.


14 BIRTHPLACE OF


FATHER (City) ...


(State or country)


Chelsea


15 MAIDEN NAME


OF MOTHER


un the & oblou


16 BIRTHPLACE OF


MOTHER (City).


(State or country)


17 Marian Donaghy


Informant


(Address) Carbura. 11-K-


Relation, if any Dang(in)


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.


Registered No. 92


albert Jerome


(If U. S.


War Veteran,


specify WAR)


(a) Residence. No.


(Usual place of abode)


Length of stay: In hospital or institution ...


(Specify whether)


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


18 DATE OF


DEATH


may


23


1 3 SEX (or) WIFE of AGE. Usual PARENTS 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 :.


1


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


Due to.


arthio 2clemais


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 hody in a town, or remove therefrom a liuman hody 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 toinb other than the receiv- ing tomh 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 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 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 sufficient 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 by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously Interred, from one town to 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-slx hours after such removal, unless a permit in the usual form for the re- moval of such body has heen sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty- slx, that the deceased served in the army, navy or marine corps of the United States In any war in which It has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can 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 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 care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition) .




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