USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 32
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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- livercd to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal ; provided, that such body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall 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) 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 Examinere 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 undden 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 failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to Illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
A R-302
Suffolk
PLACE OF DEATH
(County)
Boston
(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 ...
51.31 ....
(If death occurred in a hospital or institution, give its NAME instead of street and numher)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 538 Shirley
St.
Winthrop Mass
(a) Residence. No.
(Usual place of ahode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community3 2yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
May 30 1941
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
5/21/41
19.
That I attended deceased from
5/30/41
19 ....
...
I last saw h ..... j. m.alive on ...
5/30/41, 19.
death is said
to have occurred on the date stated above, at ... g ..... ], P.m. Immediate cause of death. coronary .... occlusion
5 ... min
Due tohypertensive .... heart .... dis.
2 ... yrs
Due to
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 ?
(Signed)
If so, specify
W T S Thorndike
M. D.
(Address)
Boston
Dates/31/19 41
21 PLACE OF BURIAL.
CREMATION OR REMOVAL
St Michael's Boston
(Cemetery)
(City or Town)
DATE OF BURIAL
June 2 1947
.19
22 NAME OF
FUNERAL DIRECTOR
PRapino
ADDRESS
Boston
Received and filed
19
(Registrar of City or Town where deceased resided)
-
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorced
HUSBAND of
Nelie Ingingneri
(Hushand's name in full)
6 Age of husband or wife if alive. years
If less than 1 day
Hours.
.Minutes
Giacomo Arena
15 MAIDEN NAME
OF MOTHER
Maria Ranieri
I.t.a.l.y .···············....
Relation, if any
A TRUE COPY.
ATTEST:
Francis
(Registrar of city of town where death occurred)
cured)
DATE FILED
6/2/41
19
. St. 1
No. Mass .... General .... Hospital.
Arena
(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
to ...
Daration
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
2 FULL NAME
Frank
3 SEX
male
white
(or) WIFE of
48
7 IF STILLBORN, enter that fact here.
8
AGE 53 Years
Months.
.. Days
Usual
9 Occupation:
barber
Industry
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Italy
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
17
Informant ..
wife
(Address)
(. oples of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time
(State or country)
Italy
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
50m-10-'39. No. 8427-f
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
JUN111941 M
A R-303
1
2 FULL NAME
3 SEX
Female
(or) WIFE of
9 Occupation:
10 or Business:
PARENTS
DEATH in plain terms, so that it may be properly classified under the International Classification of Causes
of Death. See reverse side for extracts from the laws relative to the return of certificates of death.
FATHER (City)
(State of country)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE| 5 SINGLE
White
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widow
5a If married, widowed, or divorced HUSBAND of
(Give, maiden name of wife in full)
Charles
frederic Johnson
(Husband's name in full)
.years
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
AGE .. 7.1
8
Years
Months ...
8
.Days
If less than 1 day
Hours.
Minutes
Usual
Housewife
Industry
Own Home
Il Social Security No ...
Bristol
12 BIRTHPLACE (City)
(State or country)
New Hampshire
13 NAME OF
FATHER
William Towne
14 BIRTHPLACE OF
Unknown
15 MAIDEN NAME
OF MOTHER
Julliet ?
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Unknown
17 Frederic Johnson
Relation, if any
Informant.
(Address)
9 Audubon Rd Lexington I
I HEREBY CERTIFY that a satisfactory standard certificale of death was tiled with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
Health officer
6/2/41
(Official Designation)
(Date of Issue of Permity
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
Man-31-1941
DEATH
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows : (If an injury was involved«state fully.) neoplasm die abdomen Prenumer, Carcinoma
20 Accident, suicide, or homicide (specify)
Date of occurrence ..
......
Where did
Injury occur?
(City or town and State),
Did injury occur in or about home, on farm, in industrial place, in public place?
(Specify type of place)
Manner of
die without medical atten-
Injury
Nature of
Injury
dance
While at work ?
Was there an autopsy ?..
100
21 Was disease or lojury lo any way related to occupation of deceased ?
uno
If so, specify
(Signed)
(Address)
But
Date -3/1941
22
West Lawn
Place of Burial, Cremation or Removal.
Littleton Mass
......
(City or Town)
DATE OF BURIAL
June
2nd
23 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop mars.
Recoived and filed 19
JUN 4 1941
A TRUE COPY ATTEST:
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
50m-10-'39. No. 8427-h
PLACE OF DEATH Sall1k (Connty)
uswithus . (City of Town) 52 Washig ton are Guttural No ...
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
WINTHROP (City or town making (return)
Registered No
§ (If death occurred in s hospital or institution, St. ¿ give its NAME instead of street and number) - (II U. S. War Veteran, specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 52 Washington are Mutterop St.
(Usual place of abode)
Length of stay: In hospital or institution
years
months
(Specify whether)
(If nonresident, give_city or town and state)
days. In this community2
yrs.
mos.
days.
.
.
19.
M. D.
....
unie Toune Johnson
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 inemher 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 be dicd, 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 bis 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 wbich 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 hoard, 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 receiving tomb to another in the same cemetery, until he has received a permit from the board of bealth 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 hoard, 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, sball 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 witbin 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 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- nisb for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, whieb the clerk or registrar may require .- Chap. 114, Scc. 45, G. L., as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.
No undertaker or other person shall bury a human body or tbe ashes thereof which bave been brought into the commonwealth until bc 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 tbe funeral is to be held, or from a person appointed to bave the care of the cemetery or burial ground in whieb the interment Is made .... Chap. 114. Scc. 46, G. L. as amended.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lics and take charge of the same ; ... - General Laws, Chap. 38, Sec. 6.
... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known ; otherwise a description as full as may be, with the cause and man- ner of death .- General Laws, Chap. 38, Scc 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Altending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last 111- ness from disease unrelated to any form of injury.
(2) Board of Ilealth 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 bomne wben tbe certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized discaso, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under causc, the nature of an injury and of its consequences ; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway ac- cident." "Pistol shot wound of the cbest with associated hemor- rbage, homicidal." "Asphyxiation by suspension. suicidal." "Syn- cope wbile under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If inves- tigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under man- ner, indieatc the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal ganglia) (found dead in bed) ." "Heart disease, presumably coronary sclerosis. (Sudden death)."
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
R-302
BuffoUx
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return) 28
Registered No .....
5150 ........
5
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Conday
(If deceased is a married, widowed or divorced woman, give also maiden name.)
5 Brewster Ave
..... 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
18 DATE OF
DEATH.
May 31 1941
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
5/31/41
19 ..
That I attended deceased from
... , to ..
5/31/41
...... ,
19.
19 ........ ,
I last saw h .... e.) ... alive on ..
5/31/41
......
death is said
to have occurred on the date stated above, at ...
4/42A
.. m.
Duration
Immediate cause of death
aortic & mesenteric embolism
2 d
Due to .rheumatic ...... heart .... disease. mitral .... & ... aortic .... stenosi.s
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to occupation of deceased ? If so, specify
(Signed)
W T & Thorndike
M. D.
Date
(Address)
Boston
5/31/ 41
Camb
DATE OF BURIAL
(Cemetery)
June 3 1941
19
22 NAME OF
FUNERAL DIRECTOR
DF O 'Brien
ADDRESS
Cambridge
Received and filed
19
(Registrar of City or Town where deceased resided)
50m-10-'39. No. 8427-f
2 FULL NAME
3 SEX
fem
white
5a If married, widowed, or divorced
HUSBAND of
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
AGE.5.5
.. Years.
Months.
Days
Usual
9 Occupation:
Il Social Security No 012-07-9401
(State or country)
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
Boston
17
Informant
James Condry
(Address)
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
(State or country)
Boston
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.)
4 COLOR OR RACE, 5 SINGLE
MARRIED
WIDOWED
(write the word)
or DIVORCED
widowed
(Give maiden name of wife in full)
(or) WIFE of
James I Gendry
(Husband's name
years
If less than 1 day
Hours
Minutes
candy worker
Industry
10 or Business:
Fanny ..... Farmer's
12 BIRTHPLACE (City)
.......
Boston Mass
Henry Zilch
Mary Boland
Relation, if any
A TRUE COPY.
ATTEST:
francis
Pray
(Registrar of city of town where death occurred)
DATE FILED 6/3/41
19
1
PLACE OF DEATH
(County)
oston
(City or Town)
No
Mass .... GeneralHospital
Anna G
St. l
(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
1
A
?..... y.r.s
Date of.
should be charged sta- tistically.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL.
Cambridge
(City or Town)
JUN1 11941 A
1 R-301 A
PLACE OF DEATH
Suffolk (County)
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)
2 FULL NAME
Laura Marie (Christophersen) Williams
(If deceased is a married, widowed or divorced woman, give also maiden name.)
54 0tis
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community
48
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
6
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
19.41,
to
That I attended deceased from
6-6
19
41
last saw het alive on
6/5
19 ..... , death is said to
have occurred on the date stated above, at. Immediate cause of death Edema y Lungs
Due to.
Due to. Churria Trezor Canelitas
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.
(Signed) ..
(Address).
M. D.
Date ...
16/5
19 .. 444.
21 Winthrop Cemetery Winthrop Mass Place of Burial, Cremation or Remova (City or Town)
DATE OF BURIAL.
June 6, 1941
19
22 NAME OF
Charles R. Bennison
FUNERAL DIRECTOR
ADDRESS.
Winthrop Mass
Received and filed
June
11.
1941
(Registrar)
100m-2-'40-D-729-a
-
Winthrop
1
(City or Town)
No
54 Otis
(a) Residence. No.
(Usual place of abode)
3 SEX
Female
4 COLOR OR RACE
White
(or) WIFE of
6 Age of husband or wife if alive.
8
75
AGE
Years
3
Months ..
Industry
10 or Business:
11 Social Security No ..
12 BIRTHPLACE (City).
Oslo
(State or country)
Norway
PARENTS
17
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 :
At home
5 SINGLE
(write the word)
Married
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Wiggo C. Williams
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