USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 58
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Date of.
Of autopsy
What test confirmed diagnosis?
Clamal
PHYSICIAN Underline the cause to which death should he charged sta- tistically.
20 Was disease or lojury in any way related to occupation of deceased ? 200
If so, specify
(Signed)
(Address): 148 NULup St. Date 8/29
M. D.
Withrop Str
Place of Burial, Cremation or Removal.
DATE OF BURIAL
1944
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Boston
Received and filed
SEP S 1944
..........
19
A TRUE COPY ATTEST: (Registrar)
200m-10-'39. No. 8427-d
1 PLACE OF DEATH 8 PARENTS 17 is very important. See instructions and extracts from the laws on back of certificate. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Usual
(County)
Winthrop
No ...
2 FULL NAME
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Itrute
male
5 SINGLE
MARRIED
WIDOWBS
or DIVORCED
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
62
7 IF STILLBORN, enter that fact hero.
AGE.
76
Years
A .. Months.
.Days
9 Occupation:
10 or Business:
none
13 NAME OF
ATHER John Brat
14 BIRTHPLACE OF
FATHER (City)
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
Industry
mill - cottre
Santhrop Community St.
(If nonresident, give city or town and state)
years
-
months
10
days.
In this community
3
yrs. mos. - days.
(If U. S.
War Veteran.
specify WAR)
50
.... 3 whas
.
...
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 regis- tration 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 required hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
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 hoard 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 hody 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 de- livered to such hoard, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, hy 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 physician who is a member of the hoard of health, or employed hy it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If sueh a permit for the removal of a human body, 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 a 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 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 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 elerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish 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 require .- Chap. 114, See. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall hury 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 Ita agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the hody 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 observ- ance 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 ill- ness 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 hy recognized diseasc un- related 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 deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and hy 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 occupa- tion, 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 morhid con- ditions, 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 ycars 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 busi- ness, 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 hy 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 ||
BOSTON NUTIT! 9/9/+
(County) Winthrop City or Towar) Winthrop Comunity Stop.
(City or town making return)
1.CO
Registered No.
(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
Baby Girl France
(If deceased is a married, widowed or divorced woman, give also maiden name.)
19 Mateus
St.
(If nonresident give city or town and state)
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female White
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
write the word)
5a If married, widowed, or divorced
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive. years
7 IF STILLBORN, enter that fact hero.
8 ÅGE Years .Months. Days
If less than 1 day 13 Hours Minutes
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Muito Mais
Santo Cianci
14 BIRTHPLACE OF
FATHER (City)
Italy
15 MAIDEN NAME
OF MOTHER
Michelina Ferro
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 tanto France R Lation, if any
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Wmv D. Celulares
HO.
(Signature of Aggpt of Board of Health or other)
affe
9/7/44
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Quan 30, 1944
(Months
(Day)
(Year)
19 | HEREBY CERTIFY. That I attended deceased from
19×5
aug. 29
194%
I last saw h.& ......... alive on ...
36
to have occurred on the date stated above, at.
f 10
...... m.
Duration
Immediate cause of death ...
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 ?
20 Was disease or injury In any way related to occupation of deceased ?
If so, specify
....
J. Quang 4
... M. D.
(Address)
21 Lx Michael Ceualin Both
Place of Burial, Cremation om Removal. (City of Town)
DATE OF BURIAL 8 1944
22 NAME OF FUNERAL DIRECTOR .... oh Cincotti + Jours
ADDRESS
1 Corper Ix Contar
Received and filed 19
A TRUE COPY ATTEST:
SEP 8 1944
.....
(Registrar)
-
200m-10-'39. No. 8427-d
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Usual 9 Occupation: Industry 10 or Business:
No PLACE OF DEATH HUSBAND of (or) WIFE of 13 NAME OF FATHE PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION (State or country) is very important. See instructions and extracts from the laws on back of certificate.
2 FULL NAME
(a) Residence. No .. (Usual place of abode) Length of stay : In hospital or institution (Specify whether)
...
years
months
days.
In this community
(If U. S.
War Veteran.
specify WAR na
death is said
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
....
(Signed)
238 mavait 82
Informant! (Address) C 19 Waveno 4
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
F
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth with, 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 regis- tration 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 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 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 de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 cnough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a 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 armny, 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 fur- nish 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 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 be has received a permit ao 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.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance 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 ill- ness from disease unrelated to any forni of injury.
(2) Board of liealth physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related 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 deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and by the action of chemical (drugs or poisons), thermal, or clectrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupa- tion, 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 con- ditions, 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 discase causing death, report the usual occupation prior to illness. If the deceased had retired from busi- ness, 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
i C
t 1 t
(
C i
2
-
1 1
1
(
1
-
1
-
-
R-302
SUFFOLK BOSTON
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return) 450 6913
Registered No.
(If
3 give its NAME instead of street and number)
2 FULL NAME.
Michael Ward
(If deceased is a married, widowed or divorced
woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
76 Sunnyside Ave
St.
Winthrop .. Mass.
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution ..
(Before death)
(Specify whether)
years
months
7
days.
In this community 20
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
AGE
8
73
Years
Months
Days
If less than 1 day Hours. Minutes Due to.
Usual
9 Occupation :
Clerk
Industry
10 or Business :
Printing Office
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
"St John N.B
13 NAME OF
FATHER
John Ward
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Margaret Madden
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant
Ella Ward
Sister
(Address)
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
Aug ... 9., .... 19.54
19
18 DATE OF
DEATH
Aug 5/44
(Month)
(Day)
(Year)
19
HEREBY, CERTIFY,
July 29 /44 19
to
Aug 5/44
19
That I attended deceased from
I last saw h
im .. alive on
Aug ... 5/44
.. , 19
death Is sald to
have occurred on the date stated above, at
1:50p
m.
Duration
Immediate cause of death Intestinal obstruction due to
valvular of sigmoid colon
2 wks
Due to.
Other conditions.
Broncho pneumonia
12 dys Physician
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Cecostomy
Date of
7/29/44
Of autopsy
What test confirmed diagnosis ?
Autopsy
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify
F Haase
(Signed)
M. D.
(Address)
Boston
Date ..
8/5/459
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
St Joseph Baton
(Cemetery)
(City or Town)
DATE OF BURIAL
Aug 8/44
19
22 NAME OF
FUNERAL DIRECTOR
W J Cassidy
ADDRESS
Boston Mads
Received and filed
SEP 12 1944
19
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
resided In another elty or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk of the city or town in which the deceased resided. (Sce Chap. 46, Sec. 12, G. L.)
PLACE OF DEATH
(County)
1
(C'ity or Town)
No. Mass ...... General.Hospital
( If death occurred in a hospital or institution,
St.
(If U. S.
war Veteran,
specify WAR)
(Give maiden name of wife in full)
PARENTS
Relation, if any
Underline the cause to which death should be charged sta- tistically.
M R-302
SUFFOLK BOSTON
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
UNTON
(City or towu making return)
141 7391
Registered No.
5 ( If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) 1 (If U. S. War Veteran, specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
21 ... Summit ... Ave.
St.
Winthrop Mass.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
9
days.
In this community
yrs.
mos.
9
days.
PERSONAL ANO STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH
5 SINGLE
(write the word)
MARRIEO
WIDOWED
DIVORCEO
Single
(Give maiden name of wife in full)
(Husband's name in full )
years
If less than 1 day Hours ... . .. Minutes
12 BIRTHPLACE (City)
( State of country)
Somer ville Mass.
13 NAME OF
FATHER
Patrick J Coyne
16 BIRTHPLACE OF
MOTHER (CIES )
(State or country)
Waltham Mass.
Relation, if any
Father (
A TRUE COPY.
ATTEST:
( Registrar of ohy or town where deuth/occurred)
DATE FILED Aug 23, 1944 .19
18 DATE OF
DEATH
Aug 19, 1944
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Aug 10/44
19
That I attended deceased from
to
Aug 19/44
19.
1 last saw h.
im alive on
Aug ... 19/44 .... , 1
death is said to
have occurred on the date stated above, at. 10:50 .... p. m.
Duration
Immediate cause of death
Bronchopneumonia
10 dys
Due to.
Que to.
Other conditions
Prematurity
Physician
(Include pregnancy w.that 3 months of death)
Major findings :
Of operations.
Underline the cause to which death
Oate of
should be charged sta- istically.
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased ?
If so, soecify
no
(Signed)
G Hutchins
M. D.
(Address)
Boston Mass
Date ..
8/20.19 44.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ... Winthrop
Winthrop
(Cemetery ) (City or Town)
OATE OF BURIAL
Aug 22/44
19
22 NAME OF
FUNERAL DIRECTOR
..... F .... . Maley
ADDRESS
Winthrop Mass.
Received and filed
SEP 12 1944 19
(Registrar of City or Town where deceased resided)
X
1
PLACE OF DEATH
( County)
(City or Town)
No.
Infants Hospital
2 FULL NAME
Patrick J Come
1
(a) Residence. No. (Usual place of abode) 3 SEX 4 COLOR OR RACE Ma le White Sa If married, widowed, or divorced HUSBAND of (or) WIFE of 6 Age of husband or wife if alive 7 IF STILLBORN, enter that fact here. 8 AGE. . Years. 1 ... Months. 14 Days Usual 9 Occupation : Industry 10 or Business : Il Social Security No. 14 BIRTHPLACE OF FATHER (City) 15 MAIOEN NAME OF MOTHER PARENTS 17 Informant. (Address) resided in another city or town at the time of death should be made forthwith and transmitted ou Form R-302 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) Copies of returns of deaths recorded during the previous month when occurred in your city of town in case the deceased (State or country) Salem Mass.
50m (e)-1-41-4667
Laura Kelly
Of autopsy
M R-305
SUFFOLK BOSTON
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
(City or town making return)
724
Registered No.
172
St.
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Churchill Gerry
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
75 Upland Rd
St.
(If nonresident, give city or town and State)
Mass.
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months
days.
In this community 8 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced
Lois Markley
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 47
years
7 IF STILLBORN, enter that faot here.
8 AGE.48 Years .5 .. Months ... ....... Days
If less than 1 day Hours. Minutes
Usual
9 Occupation :
Engineer
Industry
10 or Business :
N E Tel & Tel Co
11 Social Security No ..
011-07-6012
12 BIRTHPLACE (City)
(State or country)
Lowell Mass.
13 NAME OF
FATHER
Gear ge Gerry
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Ella Churchill
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17
Informant
(Address)
Wife
(.
Relation, if any
A TRUE COPY Narcis × 4 ans
ATTEST:
(Registrar of city or town where death occurred)
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