USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 85
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(Usual place of abode)
SŁ
(If nonresident, give city or town and State)
Length of stay: In nosoltal or Institution
(Before death)
years
months
days.
In this community
yra.
3
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
White
4 COLOR OR RACE|
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Widowee
18 DATE OF
DEATH
( Month)
Dec.
20
1944
(Day)
(Year)
5a If married, widowed, or divorced
2
HUSBAND of
(or) WIFE of
Susie Whitcomb.
( Give maiden name of wife in full)
( Husband's name in full)
6 Age of husband or wife if alive
years
IF STILLBORN. enter that fact here.
8
60
AGE
Years
3
Montha
25 Days
-
If less than 1 day
Hours
Minutes
Usual
9 Occuoation :
Owner
Industry
10 or Business :
Gift Shop
11 Social Security No.
027-20-3048
Provincetwon
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
Isaac Lewis
14 BIRTHPLACE OF
FATHER (City)
not known
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Laura Freeman
16 BIRTHPLACE OF
MOTHER (City)
Provincetown
(State or country)
Mass.
17 Marion Powers
Relati ons If any
Informant.
( Address)
Johnson Ave., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued: Mais, Childrenx (Signature of Agents of Board of Health or other)
Health Office 12/22/44
(Official Designation) (Date of Issue of Permit)
20 Was disease or injury in any way related to occupation of deceased?
If so, specify .........
(Signed
148 Wochepst wova
Date zumy , M. D.
2 - 2 2 19 /4
Provincot
21
Provincetown
l'lace of Burial, Cremation or Removal.
DATE OF BURIAL
(City or Town)
Dec. 23,
1944
.19
22 NAME OF
FUNERAL DIRECTOR.
Richard16 Auto
ADDRESS
147 Winthrop St ...... Winthrop.
Received and Aled.
DEG 2 6 1944
19.
( Registrar)
100M-4 - 2-42-8855
1
No.
St.
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so apeoify WAR)
(Specify whether)
19 | HEREBY CERTIFY,
Geef 8
That I attanded deosased from
19 .. 4.40, 40 ..
Que 20
1945
1 last saw h ............... alive on
Que 20, 1944, death Is said to
have occurred on the date stated above, at 9:28 Pm.
Duration
Immediate oause of death ..
IMPORTANT
......
4 + yer
Due to.
Coronaz.
Due to.
Hypertémoin Hent Dance
Central
...
6+you
IMPORTANT Physician
Major findings :
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
clusal
Underline the cause to u hich death should be charged sta- tistically.
(Addrass)
Other conditions ....
Diabetes mel . Controlled
(Include pregnancy within 3 months of death)
=
R-301 A
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shail forthwith, after the death of a person whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of 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. deflued as re- quired by section one. where same was contracted. the duration of his last Illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Cirap. 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 ariny. usvy or marine corps of the I'nited State's in aus 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 certificste both the primary and the secondary or immediate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, such physician or officer shali forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one humilred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shsil, for said purposes. he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety-eiglit and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred aud sixteen and nineteen hundred and seventeen. G. L. Chiap. 46, Sec. 10.
No undertaker or other parson 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 ita ageut 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 reulove it froin a town, from ote cemetery to another, or from one grave or tomb other than the receiving tonib to another in the same cemetery, until be has received a permit from the board of heaith or its agent aforexaid or from the cierk of the town where tire body is buried. No such permit shall be issued until there sball have been delivered to such board, agent or clerk, as the case may be. a satisfactory written statenrent containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original internrent, by a satisfactory certificate of the attending physician, if any, as required by law. 01 in lieu thereof a certificate as irereinafter 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, shaii 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, froin oue 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 shail be returned to the town from wbich it was removed within thirty-six hours after such removai, 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 bren 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 transnit 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 or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 46. G. L., ( Tercentensry Editlou).
No undertaker or other person shali bury a hunian body or the ashes thereof which have been brought luto the commonwealth umil ire has re- ceived a permit so to do front the board of health or its agent appointed to issue such permits, or if there is no such board, front the clerk of the town where the body is to be buried or the funeral is to he held, or from a pierwun 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 ouly such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within itis county the body of such a person. he shall forthwith go to the place wirere the Ixxly lies aud take charge of the same; ... - General Laws, Chap. 38, Suc. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla 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 iliness from disease unrelated to any form of injury.
(2) Board of Health physlolans will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died witirout recent medical atterlance or whose phyaf- cian is absent from home when the certificate of death is needed.
(8) Medloai Examiners will investigate and certify to all dicathe sup- posably due to Injury. These include not only deaths canned directly or in- directly hy traumatism (including resuiting septicemla), and by the action of cienrical (drugs or poisons), thermal, or electrical agents, aml deaths following abortion, but also deaths from diseasa resulting from Injury or infeotlon ralated to oooupation, the sudden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of deathi means the disease, or complication which causes death. not the modie of ilying. 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 the relative healthfuiness 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 death, report the usual occupation prior to illness. If the deceased had retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned an at school or at home. For a woman whose only occupatiou was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, aa housekeeper-private fanrily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
RM R-302
SUFFOLK BOSTON
(County)
(City or Town)
No.
Carney Hospital
The Commontucalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return)
Registered No.
11219256
5 (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
(Usual place of abode)
Fort .... Banks St.
Winthrop
.... Ma.s.s.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
M
4 COLOR OR RACE|
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)
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
.. 1.9 .... Hours ..
Minutes
Usual
9 Oocupation :
Industry
10 or Business :
Il Social Security No. .
12 BIRTHPLACE (City)
(State or country)
Boston, Mass.
13 NAME OF
FATHER
Norman E. St. Onge
14 BIRTHPLACE OF
FATHER (City)
Marlboro, Mass.
15 MAIDEN NAME
OF MOTHER
Ruth Bolton
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Pelham; N.H.
17 Informant (Address)
Relation, if any Father
A TRUE COPY
tai)
ATTEST:
(Registrar of city or toyen where death occurred)
+
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Dec. 22, 1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
12/22/44
19
That
I attended deceased from
to.
12/22/44
19
I last saw him alive on 12/22/44
19
death Is sald to
have occurred on the date stated above, at ....
7.445 ... p
Duration
m.
Immediate oause of death. Respiratory .... & .... cardiac .... failure
19 ... hrs.
Due to ....
Prematurity
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Underline the cause to
which death
Date of
should be charged sta- tistically.
What test confirmed diagnosis ?
20 Was disease or Injury in any way related to ocoupatlon of deceased ? ...
(Signed)
(Address)
Carney .... Hos.p.
Date12/23/44
21 PLACE OF BURIAL, Winthrop Cem., Winthrop
CREMATION OR REMOVAL
(Cemetery)
DATE OF BURIAL
Deo .... 2.8., .... 1944
19
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
Kirby Bros.
ADDRESS
Winthrop.
Received and filed.
19
DATE FILED
Jan 2, 1945
50m (e)-1-41-4667
VTIWITH ! AANTAL, MITT UNT REINO DEAUR INK THIS IS A PERMANENT RECORD PARENTS
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
1
PLACE OF DEATH
Baby Boy St. Ongo
(If U. S.
War Veteran,
specify WAR)
5 SINGLE
(write the word)
(State or country)
If so, specify.
Robert Gorfine
M. D.
Of autopsy
(Registrar of City or Town where deceased resided)
RECEIVE
TOM
OFFICE O.
1,1 72 1
GLEMK
WIN
6
MAS
ROP
JAN-91945 AM
CASTOR NOTIFIED
1 A
PLACE OF DEATH
Suffolk (County)
Boston
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filled for burial permit with Board of Health or its Agent.
Registrar's No.
257
[ (If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number) PHYSICIAN-IMPORTANT
Fiorita Possetti
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
50 Prince
St.
Boston, 2222
(a)
Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify'whether)
years - months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
Thite
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
midd
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Michael Rossetti
(Husband's name in full)
6 Age of husband or wife if alive. years
7 IF STILLBORN, enter that fact here.
8 AGE 65. Years.
Months ......... Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation:
Housewife
Industry
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Italy
PARENTS VI
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Emilia Dotolo
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Lina Fuccillo
Informant
(Address)
50 Prince St Roston
was fi)ed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death Will. D . Coulde
Signature of Acent of Board of Health & other) Health Officer 12/22/44
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
Dec 22 1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY
Oct 31
That I attended deccased from
1944, to.
Dec 22
19 44
I last saw hor
alive on
Dec 27, 1944, death is said to
have occurred on the date stated above, at.
21
5:02 AM.
Immediate cause of death
Solar Priemmonia
ac. heplinti È Uremia
Due to.
Hipertensão het. derene
3 -4 years 1 mini
Due to.
Other conditions
Diabetes
,
(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 ? Le
If so, specify
D. D. Potito
M. D.
(Address)
Central 89. 26 Date 12/22/19 44
21
St Michael Boston
(City or Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL
Tec 26 1944
19
22 NAME OF
FUNERAL DIRECTOR
Ciro L'incotti
ADDRESS
3 North Sa, But
19
Received and filed DEC 26 7044
(Registrar)
-
50ml-(e)-3-43-11574
. - If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. Ccio Cincotti
Duration IMPORTANT 2 dans 3 0
4 years IMPORTANT
13 NAME OF
FATHER
Angelo Tecc
Physician Underline the cause to which death should be charged sta- tistically.
(Signed)
No.
Winthrop Community Hospital
(Was deceased a
U. S. War Veteran,
if so specify WAR)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registercd 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 deccased, furnish ior registration a standard certificate of death, stating to the best of his knowledge and belief the uame of the deceased, his supposed agc, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, wben last scen alive by the physician or officer and the date of his death ... Gen. Laws, Cbap. 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 bas heen engaged, iusert 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 see- 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 sball, for said purposes, be deemed to have taken place between February fourteentb, eighteen bundred 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 buman body in a town, or remove therefrom a human hody which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such perinits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person sball exhume a human body and remove it from a town, from one cemetcry to another, or from one grave or tomh other than the receiving tomb to another in the same cemctery, until he bas 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 sball 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 wbicb 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 bereunder. 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. Tlc 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 buman body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the hoard of health or its 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 died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose pby- sician is absent from bome 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 uot 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 deatb, not the mode of dying, e. g., heart failure, asphyxia, astbenia, 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 int- 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, 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
RM R-301 !!
Suffolk
(County)
Winthrop (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
258
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