Town of Winthrop : Record of Deaths 1943, Part 100

Author: Winthrop (Mass.)
Publication date: 1943
Publisher:
Number of Pages: 594


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 100


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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 hren 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 nece+ sary information which can he obtained as to the deceased, or as to the manner of canse 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 luto the commonwealth until he has re- ceived a permit so to do from the hoard 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 hody 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. 46. G. L., (Tercentenary Edition).


Medical examiners shall make examination upon the view of the dead hodies of only such persons ss are supposed to have died lry violence. If a medical examiner hss 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, Suc. 6.


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the following rulea of practice :


(1) Attending physicians will certify to such deatha 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 physiolana will certify to such deaths only aa those of persons who, though disabled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose phyof- cian ia ahsent from home when the certificate of death is needed.


(3) Medloal Examiners will investigate and certify to all deatha sup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from diseass resulting from injury or Infection related to ccoupation, the audden deaths of persons not disablad hy recognized disease, and those of persons found dead,


Statement of Cause of Death .- Cause of deathi meana the disease, or complication which causes death, not the moile of ilying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important compliestion of the principal cause.


Statement of Occupation .- Precise statement of occupation la very im- portant, so that the relative healthfulness of various pursuits can he 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 husinesa, report the usual occupation prior to retirement. Children not gainfully employed may he returned an at school or at horne. 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, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


Calificata


with per


of medical Em


A


1


Suffolk ' (County) (City or Town) PLACE OF DEATH winthrox BOSTON NOTIFIED 1/10 /A


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.


Registrar's No.


285


No. Winthrop Community Hospital


St.


§ (If death occurred in a hospital or institution,


{ give its NAME instead of street and number)


PHYSICIAN-IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR).


(a) Residence. No.


219 Maverick St.


St.


East Boston


(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


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


Male


4 COLOR OR RACE


White


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Single


18 DATE OF


DEATH


30, 1943


(Month)


(Day)


(Year)


IO I/HEREBY CERTIFY,


That I attended deccascd from


24. 30


19


43.


19


to


I last saw h


alive on


19


death is said to


have occurred on the date stated above,


12:20 a. M.


Immediate cause of death Willborn


Duc to


Due to


11 Social Security No.


12 BIRTIIPLACE (City)


(State or country)


Winthrop


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 to occupation of deceased ? If so, specify. (Signed) (Address)


/M. D.


288Maveux DSB 12/31/43


Boston


Place of Burial, Cremation or Removak


DATE OF BURIAL ...


Jan


(City or Town X.


)9 43


Malino


Received and filed.


19


A


(Registrar)


50m-(e)-3-43-11574


was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactorstandard certificate of death Wine D. Children. (Signature of Agent of Board of Healy of Cher) Healte officer 113/44


(Official Designation) (Date of Issue of Permit)


21 St. Michael


Emilio De Nietolis fatiaif any


17 Informant (Address) 219 Maverick St. East Boston


14 BIRTHPLACE OF


FATIIER (City)


(State or country)


East Boston


15 MAIDEN NAME


OF MOTHER


Edith Lazzari


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Boston


Duration


IMPORTANT


6 Age of husband or wife if alive.


years


7 IF STILLBORN, enter that fact herStillborn


-


If less than 1 day


Hours ...


Minutes


8


AGE


Years.


Months.


Days


Usual


9 Occupation :


Industry


10 or Business:


(Husband's name in full)


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


(Give maiden name of wife in full)


If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. PARENTS


13 NAME OF


FATHER


Emilio De Nietolis


22 NAME OF


FUNERAL INRECTOR.


ADDRESS


9 Chelsea Street Last/Boston


2 FULL NAME


Baby Boy De Nietolis


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


(Usual place of abode)


.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital incdical 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 certificatc of deatlı, 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 re- quired by section one, where same was contracted, the duration of his last illness, when last scen alive by the physician or officer and the date of his deatb ... Gen. Laws, Chap. 46, Scc. 9.


A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one bundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United 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 in such certificate both the primary and the secondary or immediate cause of death as ncarly as he can state the same. For neglect to comply with any provision of this section, sucb physician or officer sball forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippinc insurrection, which sball, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen bundred and seventeen. G. L. Cbap. 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 bas 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 sball 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 bave been delivered to such board, agent or clerk, as the case may be, a satisfactory 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 physi- cian who is a member of the board of healthi, 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 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 bereundcr. 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 perinit. The board of bealth, 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 neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which tbe 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 asbes thercof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue sucb 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).


Medical examiners sball make examination upon the view of the dead bodics 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, be shall forthwith go to the place where the body lies and take charge of the same; ... - Gencral Laws, Chap. 38, Sec. 6.


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of tbe following rules of practice :


(1) Attending physicians will certify to such deatbs 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 sucb deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent 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 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 by recognized disease, and those of persons found dead.


Statement of Cause of Death .- Cause of death mcans the disease, or complication which causes death, not tbe mode of dying, e. g., beart failure, asphyxia, astbenia, etc. As principal cause name the disease causing death. As related causes, name 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 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, how- ever, 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 |


(County)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD


286


(City or town making return)


- RUS


(City or


DEPARTMENT OF HEALTH. BORD' { I }= ERONX


Certificate of Death


Certificale No.


10640


IT.D


343 OCT 27 PM 1 55


1


\AMI. O1. DECEASED


Frank First Name


William Middle Name


NAY


None


Social Security Number


MEDICAL CERTIFICATE OF DEATH ( To be filed 10 b the Physician)


16 PLACE OF DEATH:


Areo-Dist.


PERSONAL F


4 COLOR


Sa If married, widowed, o) HUSBAND of


(


Ciriz. Dec.


March


27


1875


6 ADE


Hf LESS than 1 day,


68


6


29


hrs. c


min.


Neliv. Methe A Fra now, of particular


Clerk


work dhur. A spioner. sawyer, bookkeeper, etc.


+ 1 a Inch Dairy Products to k hay dumr a silk mill, Distributing Co. sowmili, bonk, own beslekis, ofc.


Carcinoma, prostate, with


BIRTHPLACE


OF DECEDENTI (+) State er


Massachusetts


C.


"Cambridge


9 OF WHAT COUNTRY WAS DECE DENT A CITIZEN AT TIME OF DEATHT


United States


Operation


1I Social Security No.


12 BIRTHPLACE (City) (State or country)


Type Auch.


12 RIS THPLACE


OF FATHER


Massachusetts


US MAIDEN NAME


OF MOTHER


O. T. Accld.


OF DECEDENT


14 CISTHPLACE


OF MOTHER


Massachusetts


IS SIGNATURS OF INFORMAN! Information RELATIONSHIP TO DECEASED


obtained from records of deceased. 22 PLACE OF BURIAL Boston, masta OR CREMATION


DATE OF BURIAL OS CREMATION


17. 27 743


Com.


23 FUNERAL


DIRECTOR


BUREAU OF VITAL RECORDS AND STATISTICS


DEPARTMENT OF HEALTH


CITY OF NEW YORK


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


(Signature of Agent of Board of Health or other)


(Official Designation) (Date of Issue of Permit)


21 Place of Burial. Cremation or Removal. (City or Town)


DATE OF BURIAL


19


22 NAME OF FUNERAL DIRECTOR


ADDRESS


Received and filed.


19


...


2 FULL NAME


(a) Residence. (Usual place of a ength of stay : In hospital


[


Massachusetts (c) City. Town of · V'illage Winthrop.


(+) NEW YORK CITY. (b) Borough The Bronx


(c) Name of Hospital Veterans Administration or Jastitution


(If not in hospital or institution, gier street and number.).


If in Turel arra, gite ioratten)


non-resident


N aufk immrchat y pormr to death


3 SINGLE, MARRIED, WIDOWED, OS DIVORCED (awrite the word)


Married


DEATH


October 26


1943 16:50 M.


18 SEX Vale


19 COLOS OB RACI


20 Approximate Age


HUSBAND


Mae Nay


68 years


5 DATE OF BIRTH OF DECEDENT


Month)


(Day)


( \'car)


21. I HEREBY CERTIFY that (DOODODDJUDGE). (a staff physician of this institution attended the deceased)* from September 2 19 43, toOctober 26_ 1943 and last saw Him. .. alive a6 : 50x October 26 1943 Statement of cause of death is based on (wody) focodie) DATROP ONSET (laboratory test (clinical findings) . (Crossent terms that do not apply) Principal cause of death


urinary obstruction and with


metastases to skeletal system. Contribuitory causes and other conditions


Unknown


10 WAS DECEASED WAS VETERAN? IF SO, NAME WAR


Spanish American war


11 NAME OF FATHER OF DECEDENT


Frank Nay


Autopsy Date of


None


Operation Date of None


If none, Mo rate)


Condition for


which performed


Signat ver


M. D.


JOHN R, BOSWELL ,M. D. ,Chief Medical Officer3 Mrest 130 W.Kingsbridge ad. Date Oct.27 ADDRESS


AM.Astop.


15 MAIDEN NAME OF MOTHER


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


THIS CERTIFICATE NOT VALID UNLESS FILED IN THE HEALTH DEPARTMENT DO NOT WRITE IN THIS SPACE. MARGIN RESERVED FOR CODING AND BINDING


Occupation


Luirhyth of the not Tala lo Chy of


(d) Length of stay at place of death immediately prior to death


9-2-43 to 10-26-43


17 DATE AND HOUR OF


1 Month) (Day)


(Year)


(Hour) P


Natlv. Dec.


(H


6 Age of husband or wife i 7 IF STILLBORN, enter that


CooLe ?


7 Occupation


Countr


A


Cause 2


PARENTS OF DECLASED


14 BIRTHPLACE OF FATHER (City)


I No. PLACE OF DEATH 3 SEX (or) WIFE of 8 AGE Yeara. Usun! 9 Occupation: Industry 10 or Business: 13 NAME OF FATHER PARENTS 17 Informant (Address) 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 is very important. See instructions and extracts from the laws on back of certificate. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK- THIS IS A PERMANENT RECORD. Every item of (State or country) 200m-10-'39. No. 8427-d


Boro-Deoth


destitution


Print er T fourites


loro Resid,


PERSONAL PARTICULARS ( To be flhd in b Foneval Director)


2 USUAL RESIDENCE: a Siate


td No


556 Shirley Street


Last Name


A TRUE COPY ATTEST: (Registrar)


PERMIT NUMBER


ADDRESS


HAK


Ella Otis


White


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 belicf 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 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 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 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 heen 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 he 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 cnough 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 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 a 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 hody 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, sneh 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 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 hury a human body or the ashes thereof which have heen 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 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. 46, G. L., (Tercentenary Edition. )


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the ohserv- 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 disahled hy recognized disease un- related 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 septice- mia). and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deathis 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 causc 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.




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