USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1943 > Part 69
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A physlelan 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 helief, served in the army, navy or marine corps of the I'nited States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war. sud shall also certify in such certificate both the primary and the secondary or inmediate cause of death as uearly as he can stste the saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of thla sec- tlon and of sections forty-five, forty-six and forty-seven of said chapter one bundred and fourteen, the word "war" shall luchde the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deencd to have taken place hetween February fourteenth, eigliteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen bundred and seveuteen. G. L. Chiap. 46, Sec. 10.
No undertakar 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 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 thau tbe 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 uutil 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. ou in lieu thereof a certifleste as hereinafter provided. If there is no attending physician, or if, for suthicient ressous, his certificate cannot be obtained early enough for the purpose, or is insufficient, a pbysl- 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 medl- cal examluier shall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one towu to another within the commonwealth cannot be obtained esrly 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 any war In which It has heen engaged, sucb recital shall appear upon the permit. The board of health, or its agent. upon receipt of such ststenient aud certificate, shall forthwith countersign it and transniit 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 manner of cause of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 46, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a hunian body or the ashes thereof which have been brought luto the conimonweslh until he has re- ceived a permit so to do from the board of health or its agent appointed to lasue 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 the care of the cemetery or burial ground in which the Intermeut is made .... Cbap. 114. Sec. 16. G. L., (Tercentenary Editiou).
Medical examiners shall mske exsminstion upon the view of the dead bodies of only such persons as sre supposed to have died by violence. If a medical examiner hss notice that there is within lils county the body of such a person, he shall forthwith go to the place where the loudly lles and take charge of the same; ... - General Laws, Chap, 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calls for the observance of the following rules of practice :
(1) Attending phyalcians 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 deaths 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- cian is ahsent from home when the certificate of death is needed.
(3) Medioai Examiners will investigate and certify to all dicatba 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 clientical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from dlasase resulting from injury or Infsotion related to occupation, the sudden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death meana the disease, or complication which causes death, not the mode of ilyhig, e. g., heart failure, asphyxia, astbenia, etc. As principal cause name tbe disease caualig death, As related causes, name earlier morbid conditions, If any, related to the principal cause and any important complication of the principai cause.
Statemant of Ocoupstlon .- Precise statement of occupation la 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 ou account of the disease causing desth, report the usual occupation prior to illuese. If the deceased had 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 whose only occupstiou was that of home housework, write bousework. 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
1 A
10/9/43
PLACE OF DEATH
(County) Winthrop most
(City or Town) Widtop (Community Itespital s) No .. ,
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. 201
Registered No.
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME Baby Boy Mauro
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 408 Santona
(Usual place of abode)
Length of stay: In hospital or institution ..
years
(Specify whether)
St
(If U. S. War Veteran, specify WAR). Bratr
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Jungle
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,
Mittloon /
8 AGE. Years Months .. Days
If less than 1 day
.Hours
Minutes
Usual
9 Occupation :..
Industry 10 or Business:
11 Social Security No.
el
12 BIRTHPLACE (City) witherade med (State or country)
13 NAME OF
FATHER
R Homes Mauro
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Helen Barbara
16 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
Relatlon, if any
17 Diland DeBenedictis prellung real1408 Saratoga St. @B.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : William D. Children (Signature of Agent of Board of Health or other)
agent- Saft, 14/43
(Official Designation) (Date of Issue of Dermit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. That I attended deceased from
19 4,70
19
I last saw h
.alive on
19 ......
death is said to
have occurred on the date stated above, at 12:20 a. Immediate cause of death
.m.
Duration IMPORTANT
still bom
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
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 ..... عيسى
M. D.
(Signed) (Address) Lat
Date Li # 14
.19
21.
Place of Burial. Cremation or Removal. (City or Town) DATE OF BURIAL Letteste 17
22 NAME OF
FUNERAL DIRECTOR Lance Di Vetro
ADDRESS 204 Marclick of 1
19
Received and filed. SEF IS NOT3
(Registrar)
Is very important Se
100m-2-'40-D-729-a
PARENTS
Barbaz
Of autopsy.
What test confirmed diagnosis ?.
Major findings: Of operations
Date of
12
1943
1
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physiclan or registered hospital medical officer shall forthwith, after the death of a person wbom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief tbe name of the deceased, bis supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by 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 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 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 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 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, lis certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of liealtb, 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 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 sball constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed witbin thirty-six hours after such removal, unless a permit in the usual forin for the re- moval of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by sectiou 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 tbe permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwitb 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 be obtained as to the deceased, or as to the inanner 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 asbes 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 tbe 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).
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, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deatbs supposably 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 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 is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from 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, bowever, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
3-A
1
PLACE OF DEATH
Sallock (County) Hatterob (City or Town) No. Winthrop Community Hospital
The Sammanturalth 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.
202
St. [ { If death occurred in a hospital or institution, ( give its NAME' instead of street and number)
2 FULL NAME
Warren
Conrad
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
90 Main St. Wintherw/D
(Usual place of abede)
Length of stay: In hospital or institution Road
years
months
2 days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACEĮ
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
?
(Month)
(Day)
(Year)
5a If married, widowed, or divoroed
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 39 Years Months
Days
If less then 1 day
.Hours .....
.Minutes
Usual
9 Occupation :
Unknown
Industry
Unknown
10 or Business :
11 Social Security No ...
12 BIRTHPLACE (City)
(State or country )
Unknown
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Unknown
15 MAIDEN NAME
OF MOTHER
Mary
-
16 BIRTHPLACE OF
MOTHER (City)
Unknown
(State or country)
17 Welfare Dept
Informant.
( Address)
Town of Winthrop
(
Relation, if any
DATE OF BURIAL
I HEREBY CERTIFY thet a satisfactory standard certificate of deeth was filed with me BEFORE the burial or transit permit was issued: Ma-S. Children7
(Signature of Agent of Board of Wealth of other Health Officer 10/1143
(Official Designation) (Date of Issue of Permit)
21 Was disease or Injury in any wey related to occupation of deceased ?.......
If so, specify.
Huf. Tricklen u.D.
M. D.
(Signed)
( Address)
Besten
Sont-15-1}
22
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
1943
Oct. 2
23 NAME OF
FUNERAL DIRECTOR
Howard S Punolas
ADDRESS
Received and filed
OCT 1 1943
19
(Registrar)
1
Injury
Manner of
Ingested larga dere Phenolac
Injury
Nature of
Vital Sekt-12- at Winthrop
While at work ?
Was there an autopsy? yes
Presenall Suicidal
20 Accident, sulolde, or homicide (specify) ....
Date of ocourrenoe ..
Sept-12
1943
Where did
Injury oocur ?
(City or town and State)
Did Injury ooour In or about home, on farm, in Industrial place, or in pubilo
place ?
mit Krumen
(Specify type of place)
13 NAME OF
FATHER
Unknown
50m (g)-1-41-4667
v. v. Hat veteran, u. L. Chap. 46, Section 10, requires physiofans to Insert a reoital to that effeot -
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so specify WAR)
St.
(If nonresident, give city or town and State)
( Before death)
( Specify whether)
18 DATE OF
DEATH
Sept -
14-1943
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof Phenobarbital " vier involved, state fully.)
Bruncho Meununca
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 wiiom 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 helief 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 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 hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, 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 hoth 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 between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen bundred and two, and the Mexi- can horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall 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 tomh 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 he, 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, 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 hy violence, the medical examiner shall make such certificate. If such a permit for the 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 shall constitute a permit for such removal; provided, that such body shall he returned to the town from which it was removed within thirty-six hours after such re- moval, 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 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 beca engaged, such recital shall appear upon the permit. The hoard of health, or its agent, upon receipt of such statement and certificate, shall forthwithi countersign it and transmit it to the clerk of the town for regis- tration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish 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 re- quire .- 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 re- ceived a permit so to do from the board of bealth 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 be held, or from a per- son appointed to have the care of the cemetery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy 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.
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