Town of Winthrop : Record of Deaths 1943, Part 44

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 44


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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 four- teen, shall, if the deceased, 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 s recital to that effect, speci- fying the wsr. and shall also certify in such certificate both the primary and the secondary or immeiliate cause of death as nearly as he can state the same. For neglect to comply with suy provision of this aection, auch physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one bunilred and 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 and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen bundred and seventeen. G. L. Chap. 46, Sec. 10.


No undertaker or other person shall bury or otherwise dispose of a buman body in s town, or remove therefrom a human body which has not been buried, until he haa received a permit from the board of health, or ita agent appointed to issue such permita, or if there is no such board, from the clerk of the town where the person died; and no undertaker or otber person shall exhume a human body and remove it from a town. from one cemetery to another, or from one grave or tomb other thau tbe recelving tomb to another In the same cemetery, until be haa received a permit from the board of health or ita agent aforesaid or from the clerk of the town where the boily is buried. No such permit shall be Issued until there shall bave been delivered to sucb board, agent or clerk, as the case may be, & satisfactory written statement containing the facta 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, aa required by law, or in lieu thereof a certificate as hereinafter provided. If there ia no attending physician, or If, for sufficlent reasons, hla certificate cannot be obtained early enough for the purpose, or ia insufficient, a pbysi- cian who ia a member of the board 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 la caused by violence, the medl- 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 counnonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession ot tbe undertaker desiring to make such removal sliall constitute a permit for such removal; provided, that auch 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, aa 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. sucb recital shall appear upon the permit. The bosrd 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 la 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 matter or canse of the death, which the clerk or registrar way require .- Cbap. 114. Sec. 45. G. L., ( Tercentenary Edition).


No undertaker or other person shall bury s human body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agem appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the boily 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 ia made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).


Medical examinera shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the hody 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 sucb deaths only as those of persona 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 deatha only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbyaf- clan ia 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 deaths caused directly or in- directly by traumatiam (including resulting septicemia), and by the action of chienrical (druga or poisons), thermal, or electrical agents, aml deaibs following abortion, but also deaths from diseass 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 meana the disease, or complication which causea death. not the moile of dylng, e. g., heart fallure, asphyxia, astbenla, etc. As principal cause name the disease caualng death. As related causea, 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 la very 1m- portant, so that the relative bealthfulness 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 death, report the usual occupation prior to illness. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at boine. For a woman wbose only occupatiou was that of bone housework. write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, aa bousekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


>


-301 A


1


Winthrop


P. J. holipid


The Commontoralth 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. 127


[ { If deeth occurred in a hospital or institution, St. [ give its NAME instead of street and number)


2 FULL NAME


CHARLES C. MANSOLILLO


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


PHYSICIAN - IMPORTANT


(Was deceased a wrong


U. S. War Veteran,


if so specify WAR)


$2


(a) Residence. No.


137 Hanover Street


St.


Providence,


R. I.


(If nonresident, give city or town and State)


Length of stay: In hospital or Institution


( Before death )


(Specify whether)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


( Month)


(Day)


(Year)


19 | HEREBY CERTIFY,


That I attended deceased from


April 18


1943


to


June 16


1943


I last saw h.J.m.


..... alive on


June


16, 19.43, death Is seld to


have occurred on the date stated above, at.


10:00


Pm.


Immediate cause of death. Peritonitis gener alized, with multiple abscesses and


extensive adhesions


Due to.


Perforation of the intestine


Due to.


Volvulus


Other conditions.


Extreme emaciation


(Include pregnancy within 3 months of death)


Major findIngs :


Of operations.


Peritonitis


Date of.Apr.18/13


Of autopsy


See Above


Whet test confirmed dlagnosis?


20 Was disease or inisty Wwrelated to oooupation of deceased ?. No.


If so, specify


M. D.


(Sigred) ................ BEASER, Captain ...... M. C ...


(Address) Fort Banks, Mass.


Date June17 19 1 3.


21


Providence


Rhode Island


l'lece of Burial, Cremation or Removal.


(City or Town)


DATE OF BURIAL


June 20


19.4.3


22 NAME OF


FUNERAL DIRECTOR


ـيس


ADDRESS


254


19


Received and filed .1.11 2 1 1943


( Registrar)


1 mo.


29 .days


IMPORTANT


Physician


l'uderline the cause to which death -Iwould be charged sta- listically.


14 BIRTHPLACE OF


FATHER (City)


Panni


(State or country)


Italy


15 MAIDEN NAME


OF MOTHER


Grazia Grasso


16 BIRTHPLACE OF


MOTHER (City)


Panni


(State or country)


Italy


17 U. S. Army


Informent ( Addrese)


Reletlon, if any


Station Hospital, Ft Banks, Mass.


I HEREBY CERTIFY that a satisfactory stendard certificate of death was filed with me BEFORE the burial or transit permit was Issued : m. D. Childress


(Signature of agent of Death of Health or other)


6/17/43


Health officer (Official Designation ( Date of Issue/of Pefmit)


5 SINGLE


( write the wurd)


DEATH


June


16,


1943


MARRIED


WIDOWED


or DIVORCED


Single


5a If married, widowed, or divoroed


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


( flushand's neme in full)


6 Age of husband or wife if elive


yeers


7 IF STILLBORN. enter that fact here.


8


AGE


21


Years


2


Months


20


Days


If less than 1 day


-


Hours


Minutes


Usual


9 Occupation :


Soldier


Industry


U. S. Army


10 or Business:


11 Social Security No.


Unknown


Providence


12 BIRTHPLACE (City)


( State or country )


Rhode Island


13 NAME OF


FATHER


Giovanni Mansolillo


extracts from the laws on back of certificate. 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 (d)-1-41-4667


PLACE OF DEATH


Suffolk (County)


7/9/43


(City or Town) Station Hospital, Fort Banks, Mass.


No.


(Usual piece of abode)


0


years


7


months


29


days.


In this community


0


yrs.


0


mos.


O dayı.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Male


4 COLOR OR RACE!


White


Registered No.


Duration IMPORTANT


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical officer shall forthiwith. after the death of a person whom he has attemled during his last illness, at the request of an undertaker or other anthorized 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 behof the name of the decrasel, bis supposed age, the di case of which he dio. 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, 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 humlred and four- teen, shall, if the decrasel, 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 ail the secondary or immediate cause of death as nearly as he can state the same. For negleet 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 sabl chapter one humired and fourteen, the worl "war" shall include the China relief ex- peilition aml 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 border service of nineteen hundrol 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, fromn the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or 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 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 he 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, of 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 selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence. the meli- 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 carly 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 forin 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 I'nited 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 atut certificate, shall forthwith counter-ign 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 the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).


No umulertaker or other person shall bury a human hody or the ashes thereof which have been hronght into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issne such joumits, 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 hekl, ar from a persou 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 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 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, thengh disabled by recognized disease unrelatol 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 inchide not only deaths caused directly of in- directly by traumatism (including resulting septicemia), and by the action of elo mical ( drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths fromn 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 discase 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 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 discase 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


X


301 A


1


PLACE OF DEATH


Suffalle (County) Nichole (City or dyn) .... 45 Travers que Menchol No. Francke a Buhne


The Commontoralth 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 .; 128


Registered No.


§ ( If death occurred in a hospital or institution, St. { give ite NAME instead of street aud nuniber)


PHYSICIAN - IMPORTANT


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


(a) Residence. No. .


93 Grover que.


St.


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In'Incoltal or Institution.


( Before death)


(Specify whether)


years


months days.


In this community 2 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Mace


4 COLOR ØR RACE


Hlute


5 SINGLE


( write the word )


MARRIED


WIDOWED


or DIVORCED


Sa If married, widowte or divorced Becariale


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


( Husband's nome in fuli)


6 Age of husband or wife if alive 55 years


> IF STILLBORN. enter that fact here.


8


AGE 54 Years


Months


Days


If less than 1 day


Hours


Minutes


Usual


9 Dccupation :


accountant.


Industry


10 or Business :


11 Social Security No.


·2 BIRTHPLACE (City)


( State or country)


Burton


mark


13 NAME OF


FATHER


Joseph Jahre


14 BIRTHPLACE DE Celenci Lorraine


.FATHER


(State or country)


15 MAIDEN NAME


OF MOTHER


Maria I Vollmer


16 BIRTHPLACE OF


MDTHER (City)


(State or country)


Jeumami


17 Informent ( Address ) 43 France que


Relation, thuny ( wife


I HEREBY CERTIFY that a satisfactory standerd certificata of death wos filed with me BEFORE the Dudlal or trapsit permit was Issued ? Wi. D. Childrens


...


(Signature of Agent of Board nf Lenth # other) Health Officer 6/18/43


... (DMciel Deelgnationy ( Date of Issue of Permit)


18 DATE OF


DEATH


(Jfonth)


17


(Day)


1943


(Year)


19 I HEREBY CERTIFY,


That ! attended deosased from


19:47


to Arme 17, 1943


last saw him


allve on.


. 19 ... 3., death Is cald to


have occurred on the date stated above, at 5.3 0A m.


Immedlate cause of death. Cormay infant


Due to


Due to


Other conditions.


( Include pregnancy within 3 months of death)


Major findings :


Df operations


Date of.


Of outopsy


What test confirmed dlegnosis?


IMPORTANT Physician


Uuilerlino 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, spoolfy.


. M. D.


(Signed)


(Address) With M Date 617- 1943


21 Cedar hore besin


l'lace of Burial, Creniation or Removal.


(City or Town)


DATE OF BURIAL.


1943


22 NAME DF


FUNERAL DIRECTOR.


R. Jury Mas


ADDRESS


Reoalved and Aled


JUN 2 1 1943


19


( Registrar)


Duration IMPORTANT


6 dias


If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physiolans to Insert a recital to that offoot. PARENTS


100M-4 -2-42-8855


2 FULL NAME


(Was deceased a


U. S. Wer Veteran,


if so epeolfy WAR)


MEDICAL CERTIFICATE OF DEATH


Amal 16


Boston Mash


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medloal officer shall forthwith, after the death of a person whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of ans meniber of the family of the deceased, furnish for registration a standard certificate of desth, 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 wss contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of hia death ... Gen. Laws, Chap. 46, Src. 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 four- teen, shall, if the decessed, to the best of his knowledge and 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, and shall also certify in such certificate both the primary and the secondary or immeiliste cause of death as nearly as he can state the ssine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall inchule the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deemcd to have taken place hetwcen February fourteenth, eighteen hundred and ninety- eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chsp. 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 lesue 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 fromn 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 inay 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. o1 in lieu thereof a certificate as hereinafter provided. If there is no sttending physician, or if, for sufficient reasons, his certificate cammot be 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 aelectmen for the purpose, shall upon application niske the certificate re- quired of the attending physician. If death is csused by violence, the medl- cal examiner ahall make such certificate. If such a permit for the removal of a humsu 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, unlesa 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




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