USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 54
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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 heen engaged. sucb recital shall appear upon the permit. The board of health, or ils agent. upon receipt of such stalenient and certificate, shall forthwith countersign it and transnrit 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+ eary information which can be obtained as to the deceased, or aa to tbe manter ot canse of the deatb, which the clerk or registrar uray require .- Cbap. 114. Sec. 45. G. L., ( Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent apjailuted 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 fromn a person appointed to hove tbe care of the cemetery or burial ground in which ibe interment is made. ... Cbap. 114. Sec. 46. C. L., (Tercentenary Editiou).
Medical examinere shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within lils county the body of such a person, he shall forthwith go to the place where the luxdly lies aud take charge of the same; ... - General Laws, Cbap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calle for the observance of the following rules 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 physlolans will certify to such deaths only aa those of persons who, though disabled by recognized disease unrelated to any form of injury. have died without receut medical attendance or whose phyaf- cian ie ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to all dlcatha sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemla), and by the actlon of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from diseasa resulting from Injury or Infection related to occupation, the sudden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statemant of Cause of Death .- Cause of death meana the dleease, or complication which causes death. not the mode of dying, e. g., heart fallure, asphyxia, aothenia, etc. Aa principal cause name tbe disease caualng 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 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 bad 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 wbose only occupatiou waa that of honre bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, an bousekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
03-A Suffolk. (County) Winthrop 8/9/45 (City or Town) Meavant Prak Yacht Club No.
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
161
St. § ( If death occurred in a hospital or institution, {give its NAME instead of street and uumber)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
713
(Usual place of abode)
Length of stay: In hospital or Institution ...
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
1
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
arhite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Juanned
Sa If married, widowed, er divorcedla IM bieri
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Ilusband's name in full)
6 Age of husband or wife If alive 33
years
7 IF STILLBORN, enter that fact here.
AGE ..
8 34 Years. Months. Days
If less than 1 day
Hours .........
.. Minutes
Usual
9 Occupation :
Stock black
10 or Business :
Eart Braten
11 Social Security No ....
011-18-3915
12 BIRTHPLACE (City)
(State or country)
-mass,
atom
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy.
15 MAIDEN NAME
OF MOTHER
Domenica Vinci
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 angela M Spinale Relationille any
Informant.
( tillPp(N )
I HEREBY CERTIFY that a satisfactory standard certificate of death wes filed with me BEFORE the burial or transit permit was Issued: 8/2/2
(Signature of Agent of Board of Health or other) 20
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
ES
30
1943
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury, was involved, state fully,) Acute Congestive Heart Failure +Contusion
of Brain, Possibly following Exposure to 1
Actricecurrent. Investigation pending!
20 Accident, sulolde, or homiolde (specify) ...
accident
Date of ooourrenoe. July 30
19%
Where did
Winthrop
(City or town and State)
Did Injury ooour In or about home, on farm, In Industrial place, or In publlo
place?
yacht Club
Manner of
Injury
Nature of
Injury
While at work?
410
Was there an autopsy?
4.00
21 Was disease or Injury In any way related to ocoupatlon of deceased ?
If so, specify
28 76 Wallers
(Signed)
M. D.
.,
(Address)
Date
19 4.2
22
Holy Cross Malden Mass
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Cinq 3
43
19.
23 NAME OF
A Ci umane
FUNERAL DIRECTOR ..
ADDRESS
516Buraduray Green
Received and filed.
........
"AU9-3 -1049-
.19
(Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effeot
50m (g)-1-41-4667
2
PLACE OF DEATH
1059/4 MShinoPE
St.
Ercell
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
mais
(If nonresideut, give city or town and State)
( Month)
(Day)
Industry
General ship & Engine Woche
Injury oocur ?
(Specify type of place)
13 NAME OF
FATHER
Domenica Spinale
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, furnisb for registration a standard certificate of death, stating to the best of bis knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where samc was contracted, tbe 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 tbe preceding section or by section forty-five of chapter one hundred and four- teen, shall, if tbe 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 tbat effect, speci- fying the war, and shall also certify in such certificate botb the primary and the secondary or immediate cause of death as nearly as be can state the same. For neglect to comply with any provision of this section, sucb physician or officer shall forfeit ten dollars. For the purposes of tbis sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" sball include tbe China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteentb, eigbteen bundred and ninety-eight and July fourth, nineteen bundred and two, and the Mexi- can border service of nineteen hundred and sixteen and nineteen hundred 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 buman body wbich 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 wbere the person died; and no undertaker or otber person shall exhume a human body and remove it from a town, from one cemetery to anotber, or from one grave or tomb otber than tbe receiving tomb to another in the same cemetery, until be bas 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 sball be issued until tbere shall have been delivered to sucb board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, wbicb shall be accompanied, in case of an original interment, by a satisfactory certificate of tbe 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 selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence. tbe medical examiner shall make such certificate. If such a permit for tbe removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for tbe purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such removal sball constitute a permit for such removal; provided, tbat such body shall be returned to tbe town from which it was removed within thirty-six bours after such re- moval, unless a permit in the usual form for the removal of such body bag 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 wbicb
it has been engaged, such recital shall appear upon the permit. The board w health, or its agent, upon receipt of such statement and certificate, sball forthwith countersign it and transmit it to the clerk of the town for regis- tration. The person to whom the permit is so given and tbe physician cer- tifying the cause of death shall thereafter furnish for registration any otber 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 re- quire .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person sball bury a human body or the ashes thereof which have been brought into the commonwealth until be bas re- ceived 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 tbe clerk of the town where the body is to be buried or the funeral is to be held, or from a per- son appointed to have the care of the cemetery or burial ground in which the interment is made .... Cbap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
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 bas notice that there is witbin his county the body of such a person, he shall fortbwith go to the place where the body lies and take charge of the same; ...- General Laws, Chap. 38, Sec. 6.
... He shall in all cases certify to the town clerk or registrar in tbe place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of tbe following rules of practice :
(1) Attending physicians will certify to sucb 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 physiclans will certify to such deatbs only as those of persons who, tbougb disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or wbose physi- cian is absent from home wben the certificate of death is needed.
'3) Medical Examiners will investigate and certify to all deaths sup- posably dus to Injury. These include not only deatbs caused directly or in- directly by traumatism (including resulting septicemia), and by tbe action of chemical (drugs or poisons), thermal, or electrical agents, and deatbs following abortion, but also deaths from dissass resulting from Injury or Infection related to occupation, ths sudden deaths of persons not disabled by recognized disease, and those of persons found dsad.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, tbe nature of an injury and of its consequences; and (2) under manner, tbe mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol sbot wound of the chest with asso- ciated bemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation sbows tbe deatb to have been due to disease, specify : (1) Under cause its known or presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example: "Hemorrhage spon- taneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
03A
PLACE OF DEATH
(County) Wintherfs
(City or Town)
Pleasant Park Jacht Club No .....
The Cammonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No ......
§ (If death occurred in a hospital or institution, St. {give its NAME instead of street and number)
2 FULL NAME.
Josefin Spinale
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
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 Years
........ Months Days
If less than 1 day Hours ........ Minutes
Usual 9 Occupation :.
Industry 10 or Business :.
1I Social Security No.
12 BIRTHPLACE (City) (State or country)
13 NAME OF
FATHER
14 BIRTHPLACE OF FATHER (City) (State or country)
15 MAIDEN NAME OF MOTHER
16 BIRTHPLACE OF MOTHER (City) (State or country)
Relatlon, If any
17 Informant. (Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or trensit permit was issued :
(Signature of Agent of Board of Health or other)
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July 30
(M,nth)
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are
as follows: (If an injury was involved, state fully.) Deute Congestive Heart Failure and
Contusion of Brain following exportER to spectik curent
20 Accident, suicide or homicide (specify).
Date of occurrence.
July 30
19 49
Where did
Injury occur?
Wintrash
(City or Town and State)
Did injury occur in or about home, on farm, in industrial place, in public place?
Club house
(Specify type of place)
Manner of Injury.
"Nature of
Injury.
While at work ?.
410
Was there an autopsy ?.
400
21
Was disease or injury in any way related to occupation of deceased ?.
If so, specify ..
(Signed)
W H Watters
M. D.
(Address)
Date Oct 2
19.45
22
Place of Burlal, Cremation or Removal.
(City or Town)
DATE OF BURIAL
.19
23 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed
19
(Reglatrar)
25m-2-'40-D-729-b
1
of Death. See reverse side for extracts from the laws relative to the return of certificates of death. PARENTS
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
years
months
days.
In this community
yTs.
(If U. S.
War Veteran.
specify WAR)
1993
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 registration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required hy 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.
No undertaker or other person shall bury or otherwise dispose of a human hody in a town, or remove therefrom a human body which has not heen buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing 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 hody is buried. No such permit shall he issued until there shall have been delivered to such hoard, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall he accompanied. in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy 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 in- sufficient, a physician who is a member of the board of health. or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot he 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 re- moval of such body has been sooner ohtained 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 heen engaged, such recital shall appear upon the permit. The hoard 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 necessary information which can he ohtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be huried 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 hodies 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 hody of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; . . . - General Laws. Chap. 38, Sec. 6.
. . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the 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 hedside 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 disahled hy recognized disease unrelated 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 supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disahled hy recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas hacillus) caused hy a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation hy suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with asso- ciated internal injury sustained under circumstances unknown."
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