USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 66
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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 be 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 hody 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 Ileaith 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 tbc 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 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, designatc 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
RM R-301 !!
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every itom of 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
200m-10-'39. No. 8427-d
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial ot transit permit was issued: Waw 0 - Childress
(Signature of Agent of Board of Health or other)
10/21/42 (Official Designation) / (Date of Issue of/Permity
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. That I attended deceased from
Das 20
19.42
.. , to ..
601
,191
I last saw h ............ alive on.
.......
19 ........ , death is said
to have occurred on the date stated above, at ..... ..
........ m.
Duration
Immediate cause of death.
Due to
Due to
Other conditions
.....
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of ..
PHYSICIAN Underline the cause to which death should be
Of autopsy
What test confirmed diagnosis ? Clinical frider
... charged sta- tistically.
20 Was disease or Injury in any way related to occupation of deceased,? .
If so, specify.
(Signed) 23+ Mareuil By
....... M. D.
(Address)
Date 10/20/88
21 ST. Muchas.
Bastino
(City or Town)
22 NAME OF FUNERAL DIRECTOR
ADDRESS 9 Chelsea SA Ecostore
19
2 FULL NAME
....
(If deceased is a married, widowed or divorced woman, give also maiden name )?
(a) Residence. No .. 347 Maverick St.
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
muele Mite
4 COLOR OR RACE
(write the word)
Single
5a If marrled, 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. Stillborn
If less than 1 day
3 AGE Years Months Day
Hours .... .Minutes
Usual 9 Occupation:
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
John Rizzo
PARENTS
14 BIRTHPLACE OF FATHER (City) .....
(State or country) Boston. mars
15 MAIDEN NAME
OF MOTHER
Edith Campagna
16 BIRTHPLACE OF MOTHER (City) (State of country)
El Sortow
17 Foku Rizzo Relation, if any
Informant (Address) 347 marines El Sport
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
(If death occurred in a hospital or institution,
give its NAME instead of street and number) -
Baby Boy Pinto
(If U. S. War Veteran. specity WAR)
aBoston
(If nonresident, give city or town and state)
(Usual place of abode)
i ength of stay : In hospital or institution
(Specify whether)
BOSTON NOTIFIED
11/9/42
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) Winthrop Community Utorprotilst. No.
Place of Burial, Cremation or Removal. DATE OF BURIAL. 2 Papíro 2
Received and filed
A TRUE COPY ATTEST: (Registrar)
20 1942
5 SINGLE
MARRIED
WIDOWED
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 wbom 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 deccased, 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 therc is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application inake tbe 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 a removal shall constitute a permit for such removal ; provided, that such body sball 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, sueh recital shall appear upon the permit. The board of bealtb, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the elerk 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 tbereof 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 funcral 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, Scc. 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 discase unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupa- tion, the 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 failure, asphyxia, asthenia, etc. As principal cause name tbe 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 deatb, report the usual occupation prior to illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 .
1
C PLACE OF DEATH
Suffolk (County) Winthrop (City or Towr) 107 Bowdoin No.
The Commonmoralth 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. .25
Registered No.
S ( If death occurred in a hospital or institution, St.
( give its NAME instead of street and number)
Bessie Frances Kemp
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
107 Bowdoin
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ..
(Before death)
(Specify whether)
years
months
days.
In this community /5 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEJ
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
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 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 AGE 56
Years
3
Months
29 Days
If less than 1 day
Hours ..........
Minutes
Usual
9 Occupation :
Clerk
Industry
: Federal Reserve Bank
11 Social Security No
12 BIRTHPLACE (City)
(State or country)
Bellows Falls Vermont.
13 NAME OF
FATHER
William Oscar
| PARENTS -!
14 BIRTHPLACE OF
FATHER (City)
Bellows Falls.
.. (State or country)
Vermont
15 MAIDEN NAME
OF MOTHER Mary L. Hammond
16 BIRTHPLACE OF *
Bridgewater
(State or country)
Vermont.
17 Informant ouriet A. Kemp
Sistep. any (Address) Toy Bow dar
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was Issued : Www.D- Childrens.
(Signature of Agent of Board of IIealth or, other)
10/23/42
( Official Designation) (Date of Issue of Permit)'
18 DATE OF
DEATH
Och.
22
1942 (Year)
19 | HEREBY CERTIFY,
That I attended deceased from
.....
...
1939, to Cock 22
1942
I last saw her
.. alive on
, 19 .... ", death Is sald to
have occurred on the date stated above, at.
11:20 0
m.
Immediate cause of death
Carcinoma liña.
Due
bund-speed way-1959 for
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
Expecting Sept 8-1942
Curcuma formal
Date of.
9/5/42
Of autopsy.
What test confirmed diagn
dena lab
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
M. D.
20 Was disease or injury in any way related to occupation of deceased ?......
If so, specify
('Signed)
At. La Leyton
(Address) Offent mellone
10/23
19.4 4
2. 3 K Hill Cemetery BellowsFalls Vermont.
Place of Burial, Crepiation or Removal.
(City or Town)
DATE OF BURI
October 25.
1942
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Clientes & Bennecon
Received and filed
19
(Registrar)
100m (d)-1-41-4667
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recitai to that effect. extracts from the laws on back of certificate.
PHYSICIAN - IMPORTANT
2 FULL NAME
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
(write the word)
(Month)
(Day)
Duration
IMPORTANT
> -- MOTHER (City>
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 whoin he has atteinled during his last illness, at the request of an mmlertaker or other authorized person or of any member of the family of the deceased, furoish for registration a standard certificate of death. stating to the hest of his knowledge and belief the name of the decrawl. his supposed age, the disease of which he died. defined as re- quired 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 hia death ... Cen. l.aws, Chap. 46, Sec. 9.
A physiciao or officer furnishing a certificate of death as required by the preceding scetion or by section forty-five of chapter one hundred and four- teen, shall. if the deceased, to the best of his koowledge and helief, served in the army. navy or marine corps of the I'nited States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, and shall also certify io such certificate hoth the primary and the secondary or immediate cause of death as nearly as he can state the sanoe. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-sjx and forty-seven of said chapter one humlred and fourteen, the word "war" shall inchule the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes. he deemed to have taken place between February fourteenth, eighteen hundred and ninety eight and July fourth. nineteen hundred and two, and the Mexi- can horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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 huried. No such permit shall he 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 by law to he 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 suthicient reasons, his certificate catinot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence. the medi- cal examiner shall make such certificate. If such a permit for the removal of a Imman 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 l'nited States in aoy 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 counter-ign it and transmit it to the clerk of the town for registration. The person to whom the peronit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces sary 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 hudy or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or it> 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 buried or the funeral is to he 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. 16. G. L., (Tercentenary Edition).
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 lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attendiog 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 physi- cian is ali-ent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or in- directly by traumatism ( including resulting septicemia), and by the actlon of chemical (drugs or poisons ), thermal, or electrical agents, anil deatha following ahortion, but also deaths froin 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 .- Canse 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, naine earlier 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 im- portant, so that the relative healthfulness of various pursuits can be knowu. 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 discase causing death. leport 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 by the appropriate terma, as housekeeper-private family. cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
RM R-301 ||
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 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
200m-10-'39. No. 8427-d
REVERE NOTIFIED
11/9/42
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
-
(If death occurred in a hospital or institution,
.St. \ give its NAME instead of street and number)
2 FULL NAME
(If deceased is a marfied, widowed or divorced woman, give also maiden name.)
48 Pearl Avenue
St. ... Revere
(a) Residence. No. (Usual place of abode)
: ength of stay : In hospital or institution
Hospital
(Specify whether)
years
months
3 days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
(puhospital)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
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