USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 37
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Statement of Cause of Death .- Cause of death meana the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name tbe 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 ia very im- portant, so that the relative bealthfulness 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 desth, report the usual occupation prior to illness. If the deceased bsd retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at hoine. For a woman whose only occupatiou was that of honie bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terma, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
If deceased was a U. S. War Veteran, G. L. Chap. 46. Seotion 10, requires physicians to Insert a reoltal to that effect. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
per. P. Rapino
PARENTS
100ml (d) -1-41-4667
Suffolk
medford notified
6/4/43
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permi with Board of Health or its Agent.
Registered No.
105
....... { (If death occurred in a hospital or institution, St. [ give its NAME instead of street and numher)
PHYSICIAN - IMPORTANT
2 FULL NAME
Josephine Mazzarella
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
167 Park St
St.
Medford
( If nonresident, give city or town and State)
Length of stay : In hospital or institution.
(Before death)
(Specify whether)
years
months
17
łays.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE!
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divoroed
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Frank ... Mazzarella
(Husband's name in full)
6 Age of husband or wife if alive ..... 56
years
7 IF STILLBORN, enter that fact here.
8
AGE 54 ..
.. Years
- Months.
-
Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
House .... work
Industry
10 or Business :
at ... home
11 Social Security No ....... nono
12 BIRTHPLACE (City)
(State or country )
Italy
13 NAME OF
FATHER
Paolo Boncoraggio
14 BIRTHPLACE OF
FATHER (City)
Italy
(State or country)
15 MAIDEN NAME Pasqualina
OF MOTHER
Pasquery Bonaiuto
16 BIRTHPLACE OF
MOTHER (City)
(State or country )
Italy
(Address)
7 Central 59. 20 Date 5/17 1943
21
Holy Cross
Malden
Place of Burial, Crepration or Removal
DATE OF BURIAL ..
(City or Town)
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) Health officer 5/18/43
Received and filed.
MAY 1-3 -1943
19
(Officiat Designation) ( Date of Issue of Permit) /
18 DATE OF
DEATH
may
16
( Jfonth)
(Day)
(Year)
19 | HEREBY CERTIFY.
apr 29
That I attended deceased from
19 43 to. may 16 19 43
1 last saw h.
alive on.
16 , 19 43 death is said to
have occurred on the date stated above, at.
9 05p
n.
immediate cause of death ..........
IMPORTANT
Belang / 2tomy & Ccedoras
Due Uo. Reft Pycnophone
R Rt Pyelonesliter
1.
Due to
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations ....
Left Kidney
Date of 5/3/43.
Of autopsy
What test confirmed diagnosis ?
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or Injury in any way related to oooupation of deceased ? If so, specify
(Signed)
D . B.
Potito-
. M. D.
17 Frank Mazzarella
Informant
(Arbresx) 167 Park St. Medford
Relation, if any ( husband
Datas Napino
22 NAME OF
FUNERAL DIRECTOR ....
ADDRESS
9 Chelsea Street East(Boston
M R-301 A 10
.... ... VU LANVILI. POISICIANS should state CAUSE OF DEATH in plain
1 1
PLACE OF DEATH
(County)
Winthrop
(City or Town)
No. Winthrop ... Cammunity .Hospital
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
(Usual place of abode)
27
1943
Female
White
MEDICAL CERTIFICATE OF DEATH
Duration
4 200 1 whe. 1 yen
Pronephrovis ¿ Stres
( Registrar)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physiolan 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 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 his death ... Gen. Laws, Chap. 46, Scc. 9.
A physician or officer furnishing a certificate of death aa required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the ariny, 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 nearly as he can state the same. 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-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place hetween Fehruary fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border 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 perinit 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 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 health, or employed by it or by the selectinen 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 cominonwealth 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 aection 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 atatement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit ia 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 body or the ashes thereof which have been brought into the commonwealth until he haa re- ceived a permit so to do from the board of health or ita agent appointed to issue such permits, or if there ia 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 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 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 physicians will certify to such deathis 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 physi- cian 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 in- directly 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 means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause naine 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 .- l'recise 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, 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
301 A
1
Winthrop
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.
106
No.
(City or Town)
Winthrop Community Hospital
St.
{ { If death occurred in a hospital or Institution,
( give its NAME instead of street and nuniber)
PHYSICIAN - IMPORTANT
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
19 Revere St
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
months 2
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEĮ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
Louis A
.Racca
( Husband's name in full)
6 Age of husband or wife if alive years
> IF STILLBORN. enter that fact here.
8
80
AGE Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
Own Home
11 Social Security No.
12 BIRTHPLACE (City)
( Stato or country)
Italy
13 NAME OF
FATHER
Cannot be learned
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE DF
MOTHER (City)
(State or country)
Italy
17 Informant ( Address) Sandy Racca 19 Revere St Winthrop
RelayHoff any
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with me BEFORE the burial of transit permit was Issued:
(Signature of Agept hBoard of Health or other)
al may 20/40.
(Dmcfal Designation) ( Date of Issue of Perm/t)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
May
19 1949
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deosased from
I last saw h ............... alive on.
18
195, death Is said to
have occurred on the date stated above, at.
7 50 a.m.
Immedlate oause of death
Due to.
....
quandture nechat fern
Rua, 13/43
Due to
Other conditions
( Include pregnancy within 3 months of death)
Major findings :
Of operations
IMPORTANT Physician
Underline the cause to which death should be charged sta- listically.
20 Was disease or injury in any way related to occupation of deceased 2
If so, spoolfy .........
(Signed) ...
Jong Escuela
, M. D.
(Address)
19Bennybase. 5/20
Malden
Cigy or Town)
DATE OF BURIAL
22 NAME DF
FUNERAL DIRECTOR
Solu T. O Malec
ADDRESS
Winthrop Mass.
Reoelved and Aled ...
MAY 2 X-1943
19
( Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS
100M-6 - 2-42-8855
PLACE OF DEATH
Suffolk (County)
Marie J. Racca ( Simonelli )
(Was deceased a
U. S. War Veteran,
if so apeolfy WAR)
45
19.5 ... >
21
Holy Cross
Place of Burial, Creniation or Removal.
May 21.
1943.
19
Date of
Of autopsy
What test confirmed diagnosis ?.
Duration IMPORTANT my 16/49
4
Give maiden name of wife in full)
19.49
May 19
19
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medioal officer shall forthwith, after the death of s person whoin he has stteiled during his last illness. st the request of an undertsker or other authorized person or of ans meniber of the family of the decessed, furnisb for registration s standard certificate of desth, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disesse of which he died. defined ss re- quired by section one. where ssme wss contracted. the duration of his last illness, when Isst seen slive by the physician or officer and the date of bia death ... Gen. Laws, Chap. 16, Sec. 9.
A' physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and fnur- teen, shall, if the decessed, to the best of his knowledge sud belief, 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. sud shall slso certify in such certificate both the primary and the secondary or immediate cause of death ss nearly as he can state the same. 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-six and forty-seven of said chapter one hundred sud fourteen, the word "war" shall include the Chins relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place hetwcen February fourteenth, eighteen hundred and ninety eight snd July fourth. nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen bundred and seventeen. G. L. Clisp. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman 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 ita agent appointed to lasue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertsker or otber person shall exhume a human body and remove it from a town. from one cenietery 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 sforessid or from the clerk of the town where the body is buried. No such permit shall be Issued until there sball bave been delivered to such board. agent or clerk, as the case inay be, a satisfactory written statement containing the fscta required by law to be returned and recorded, which shall be accompanied, in case of an original Internient, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate as liereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or ia insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application niske the certificate re- quired of the attending physician. If death is caused by violence, the medl- cal examiner shall make such certificate. If such a permit for the removal of a liumisn body, not previously interred, from one town to another within tbe commonwealth cannot be obtained early enough for the purpose, the certificate of desth 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 sny 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 sud 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 be obtained as to the deceased. or as to the msuner nr cause of the desth, which the clerk or registrar may require .- Cbap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No undertaker or other person shall bury s hunian body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a perurit 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 body is to be buried or the funeral is to he held, or from a person appointed to have tbe 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 bodies of only such persons ss sre supposed to have died hy violence. If a medical examiner hss notice that there is within his county the hody of such a person, he shall forthwith go to the place where the body llea 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) Attending physicians will certify to such destha only ss 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 physlolans will certify to such deaths only ss those of persons who, though disshled by recognized disesse unrelated to any form of injury. have died without recent medical sttendance or whose pbyal- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only desths cansed directly or in- directly by traumatism (including resulting septleemla), and by the action of chenrical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, but also deaths from diseass resulting from Injury or Infeotlon 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 deathi 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 conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation ia very 1m- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every persou aged 10 years or over. If the occupation had been given up or changed on account of the discase causing desth, report the usual occupation prior to Illness. If the decessed bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at home. For a woman whose only occupation wss that of honie bousework, write bousework. For a person engaged in domestic service for wages. however, designste the occupation by the appropriate terma, aa housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-301 A
E Suffolk
(County) Wanttwoh Mass
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. 107
Registered No.
(etty o> Town) 7. Woodside Park Nunthere Was { { If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual piace of abode)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE|
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Manuel
18 DATE OF
DEATH
(Month )
(Day)
(Year)
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Eli - De maiden great white in full feer
(Husband's name in full)
6 Age of husband or wife if alive 92
years
7 IF STILLBORN, enter that fact here.
AGE
Years
11
Months.
20
.Days
If less than 1 day
Hours ..
.Minutes
Usual
9 Occupation :
Homenage
Industry 10 or Business:
11 Social Security No.
Poural
12 BIRTHPLACE (City)
( State or country )
13 NAME OF
FATHER
Joseph Richardson
Major findings :
Of operations
IMPORTANT Physician
Underline the cause to which death should be charged sta- iistically.
20 Was disease or injury in any way related to occupation of deceased ?......
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