USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 40
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12 BIRTHPLACE (City)
(State or country)
Winthrop, Mass.
13 NAME OF
FATHER
Robert Vincent Atcherly
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Winthrop, Mass.
15 MAIDEN NAME
OF MOTHER
Grace Leitch
If so, specify
C. A. Powell
(Signed)
M. D.
(Address)
Mass. Mem.
Hosp
Date
6/5/449
21 "PLACE OF BURIAL, Winthrop Cem. Winthrop, Mass. CREMATION OR REMOVAL ..
(Cemetery)
(City or Town)
DATE OF BURIAL
June 7 1944
.19
22 NAME OF
FUNERAL DIRECTOR
C.R. Bennison
ADDRESS
Winthrop, ... Mass ..
Received and filed
-JUN 1-2-1944
19
(Registrar of City or Town where deceased resided)
.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE|
5 SINGLE
(write the word)
F
W
MARRIED
WIDOWED
or DIVORCED Single
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
Immediate cause of death
Pulmonary hemorrhage
1 day
Due to.Erythroblastosis fetalis
4 days ...
Due to
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings:
Of operations
Date of.
should be charged sta- tistically.
Of autopsy
Above
What test confirmed diagnosis?
Autopsy
20 Was disease or injury in any way related to occupation of deceased ?
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston, Mass.
-
1
(City or Town)
No.
Mass.Memorial Hosp
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return)
121
Registered No.
5230
(If death occurred in a hospital or institution,
St.
give its NAME inetead of etreet and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
164 Woodside Ave.
Winthrop
(a) Residenoe. No.
(Usual place of ahode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
.... years
months
2
days.
In this community
yrs.
mos.
2
days.
( Specify whether)
SUFFOLK BOSTON
PLACE OF DEATH
(County)
Joan Atoherley
(If U. S.
War Veteran,
specify WAR)
That I attended deceased from
er
June 5/44
19
death Is sald to
Underline the cause to which death
-
R-301 A
PLACE OF DEATH
Suffolk (County) Winthrop (City or Towy) 595 Shirley St.
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or its Agent.
Registered No.
122
{ ( If death occurred in a hospital or Institution, * ¿ give ita NAME instead of street and number) st.
No.
archibald J. Hakay
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St.
595. Shirley St
1
2 FULL NAME
(a) Residence. No.
(Usual place of abode)
neither
Length of stay: In hospital or Institution ..
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACEJ
male White
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
(ITusband's name in full)
6 Age of husband or wife if alive
52.
7 IF STILLBORN, enter that fact here.
8
60
Years
9
Months
15 Days
AGE
Usual
9 Occupation :
Iron Worker.
11 Social Security No ..
023-14-6204.
12 BIRTHPLACE (City)
13 NAME OF
FATHER
Trongr Hakey.
14 BIRTHPLACE OF
FATHER (City)
alburg
(State or country )
rt
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
17
Mary J. Hakey
if deceased was a U. S. War Veteran. G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
extracts from the laws on back of certificate.
terms, so that it may be property classified. Exact statement of OCCUPATION is very important. See instructions and
(State or country )
Berkshire ost.
5 SINGLE
(write the word)
MARRIED
WIDOWED
Or DIVORCED Married
5a If married, widowymiary.
Livre Jane Surette
years
If less than 1 day
Hours
Minutes
Industry
Bethelhem Star Co-
10 or Business :
15 MAIDEN NAME
OF MOTHER
Margaret Kennedy
Waterloo
(State or country)
Canadas
Relation,
Informant
( Address)
595 Shirley St. Winthrop D
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : nuo Childers
(Signature of Agent of Board of Health or other)
· alte fine 10/44
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
(Month)
(Day)
(Veaf)
19 | HEREBY CERTIFY,
That I attended deceased from
UNE 3 to JUNE 8 19 ... last saw h .... 4.1.17 alive on NUN2. 8, 19:4, death Is sald to
have occurred on the date stated above, at. 2.30 A .m.
Immediate cause of death. Broncho- PNEUMONIA
Duration IMPORTANT
5 days.
Due to
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
Date of.
Of autopsy
What test confirmed diagnosis ?
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to ocoupation of deceased ?.
If so, specify.
(Signed)
(Address) 20, Harware
M. D.
Art Date INE19 ....
21
Wildwood
1
Wilmington
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
June 12
1944.
22 NAME OF
FUNERAL DIRECTOR
Joseph B. mcmahon.
ADDRESS
116 Middlean Gue Wilmington
Received and filed
JUN 1 8 1917 (Rep
1 ... 19 ........
trar)
-mos.
-
days.
MEDICAL CERTIFICATE OF DEATH
9.
19:+
( If nonresident, give city or town and State)
years months days.
in this community
3 yra.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
100m (d)-1-41-4667
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 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 ilhiess, 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 belicf, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he 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 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 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 permit from the board of health, or its agent appointed to issue such permits, or if there is no sueli 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 fron 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 selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall inake sucb certificate. If such a permit for the removal of a human body. not previously interred, from one town to another within tbe conunouwealth 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 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 Statea in any war iu which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certlfcate, shall fortliwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit ia so given aud 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 has 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 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., (Terccuteuary 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 tlie 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.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Atlending physiolans 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 physiclans 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 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 deathis 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 canses death, not the mode of dying. e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and auy important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as bousekeeper-private family, cook-botel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
..............
1 A
If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
50m-(e)-3-43-11574
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death
(Signature of Agent of Board of Heagn br other) Seattle Hvert 6/14/48
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
3 SEX
male White
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
Banned
5a If married, widowed, or divorced HUSBAND of
mary
antonuccio
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive. 48
years
7 IF STILLBORN, enter that fact here.
8
AGES 6
Years
Months.
Days
If less than 1 day Hours. Minutes
Usual
9 Occupation ;
Plater
Industry United Least Master Ler
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
eltab
13 NAME OF
FATHER
Ventone gro
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
antonina Catanese
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
ettale
(Address) 235 Maniche &
Date 6,13 xkb
21
ET michals
Place of Burial, Cremation or Removal.
DATE OF BURIAL.
Sune
(City or Town)
26
19.
44
22 NAME OF
FUNERAL DIRECTOR Zederik Y magrato
ADDRESS
Ear Button
Received and filed. JUN 23 1944
(Registrar)
1941
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Of autopsy ..
What test confirmed diagnosis?
Clinical
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
(Signed).
1. Putong
M/ D.
17 mary gro 236 Dabus It- Experten
Relatong if any
1
PLACE OF DEATH
Suffolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registrar's No.
[ (If death occurred in a hospital or institution, { give its NAME instead of street and number) { PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, if so specify WARY
none
(I deceased is, a married, widowed or divorged woman, give also maiden name.)
(a)
Residence. No.
236 Warles St
St.
East Boston, Mass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution (Before death)
(Specif& whether)
PERSONAL AND STATISTICAL PARTICULARS
18 DATE OF
DEATH
June
(Month)
13, 1944
(Day)
(Year)
19
HEREBY
CERTIFY,
19
440
to
That I attended deceased from Jun 13 44 19
I last saw bean
alive on.
Jec 13
195, death is said to
have occurred on the date stated above, at
Immediate cause of death
Duration IMPORTANT
Due to.
BOSTON NOTIFIED 1/10/04et
County) Winthrop (City or Town) Winthrop Community Hop No.
St.
natale Sgra
2 FULL NAME
Hospital
years
months
1
days.
In this community /0 yrs.
mos.
days.
19
Due to.
Hypertension
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 best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last scen alive by the physician or officer and the date of his 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 belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as 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 expedition 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 hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen 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, 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 perinit 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 selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained 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 been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other 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 has 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 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 dicd by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall fortliwith go to the place where the body lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillinent 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 phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that thic relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
Suffolk
(County)
Winthrop
(City or Town)
No. 37 Dolphin Ave.,
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.
Registered No.
124
¡ ( If death occurred in a hospital or institution, ¿ give its NAME Instead of atreet and nuniber)
2 FULL NAME
Julia M
Rourke
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
37 Dolphin Ave., Winthrop
St
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hosoltal or Institution
(Before death)
(Specify whether)
years
months days.
In this community
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