USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 27
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19 I HEREBY CERTIFY,
Mar .....
14.5 ... , to ..... Mar ... 21
19 .. 45
I last saw h ..... j.r.alive on .......
Har ... 2.1, 19 .... 45death is said
1
1
Sev ... yrs.
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
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
(Signed)
Alpine L.Ricci
. M. D.
(Address)
807 Salem St .....
Date
......
3/22/45
21 PLACE OF-BURIAL, CREMATION VOR REMOYASS Malden
(City or Town)
DATE OF BURIAL
(Cemetery)
March 24, 1945
19
22 NAME OF
FUNERAL DIRECTOR
Kirby .... Bros ..
ADDRESS
210 ...... /inthrop St. ""inth-
Received and flød
APR & 3 1945
19
...
rop
(Registrar of City or Town where deceased resided)
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
18 DATE OF
DEATH.
March 21. 1945
.. mille Vitale
6 Age of husband or wife if alive.
to have occurred on the date stated above, at ........ 3 .... 30 .M. Duration
Immediate cause of death.
Cerebral ... Hemorrhage
Salesman
Underline the cause to which death should be charged sta- tistically.
Relation, if any
ORM R-30! !!
1 Suffolk (County) 1 Winthrop (City or Town) PLACE OF DEATH (a) Residence. No 3 SEX 4 COLOR OR RACE Male White (or) WIFE of 7 IF STILLBORN, enter that fact hero. AGE Usual 9 Occupation: Pharmacist 12 BIRTHPLACE (City) (State or country) 13 NAME OF 14 BIRTHPLACE OF FATHER (City) PARENTS 17 information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Drug
200m-10-'39. No. 8427-d
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Km DElehlar200
(Signature of Agent of Board of Health or other) Health article (Oficial Designation) (Date of Issue of Fermit) /
4/4/45
MEDICAL CERTIFICATE OF DEATH
18 DATE OF april
3
1945
(Month)
(Day)
(Year)
19 I HEREBY CERTOLY. That I attended deceased from
September 30,
.. , 1945, to april 3
. ...
19.45
I last saw bene alive on april 2 19.45, death is said
to have occurred on the date stated above, at. 3 48Am
Duration
Immediate cause of death.
Coronary Heart Disease with
Cardiac Failure
Due to
Coronary Thrombosis
6 months.
Due to
Other conditions
none
(Include pregnancy within 3 months of death)
Major findings :
Of operations
none
Date of.
Of autopsy
Kone
What test confirmed diagnosis ?
Clinical + Laborato
.. basically.
Acharged sta-
20 Was disease or lojury la any way related to occupation of deceased ? no
If so, specify ..
(Signed) Maurice Traunstein A. M.D. M. D.
(Address):
562 Shipley St.
Date April 3 1945
21
Winthrop
Place of Burial, Cremation of Rampval. 6. 1945 Town) DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
2.
Received and filed.
APR 5"
1945
19
A TRUE COPY ATTEST:
(Registrar)
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
DEATH
5 SINGLE
MARRIED
WIDOWED
Or DIVORCED
Married
HUSBAND of
Herehvis MeGough
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive. 55
years
8 56 Years. Months Days
If less than 1 day
Hours ...
Minutes
II Social Security No.
010-05-3564
Charlestown
Mass
FATHER James McGough
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Esther Campbell
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Informant.
Helen McGough
Relation, if any Nife
(City or town making return)
Registered No.
No. Winthrop CommunityHospital
5
(If death occurred in a hospital or institution,
....... St. { give its NAME instead of street and number)
2 FULL NAME
Charles J. McGough
(If deceased is a married, widowed or divorced woman, give also maiden name.)
322
... Revere ... S.t ...
St.
(Usual place of abode)
21
ength of stay : In hospital or institution
(Specify whether)
years
months3
days.
In this community
(If U. S.
War Veteran.
specify WAR).
(If nonresident, give city or town and state)
3 months.
PHYSICIAN Underline the cause to which death should be
(Address)
322 revere St. w.
.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH 6
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION Industry 10 or Business:
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 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 buried. 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 cxam- 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 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 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 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 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.)
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 by recognized discase 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 electrical agents, and deaths following abortion, but also deatbs from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized diseaso, 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 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 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 by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A 4 +
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No. 12 Sewall Ave.
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.
80
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
James Allan Phillips
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
12 Sewall Ave.
St.
(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 5 yrs.
Inos.
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
Married
(Month)
(Day)
5
1945
(Year)
5a If married, widowed, or divorcedJoan Simpson
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
7 IF STILLBORN, enter that fact bere.
8
AGE 81
Years
Months.
Days
26
-
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Stone Quarrying
Industry
10 or Business:
Own Quarries
11 Social Security No. 029-12-0007
12 BIRTHPLACE (City)
Aberdeen
(State or country)
Scotland
13 NAME OF
FATHER
James A Phillips
14 BIRTHPLACE OF
FATHER (City)
Scotland
(State or country)
15 MAIDEN NAME
OF MOTHER
Agnes Allan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
17 InformantJoan Phillips Wife ifany
(Address)
12 Sewall Ave. Winthrop
was filcd with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death Com A Childrico
(Signature of Agent of Ward of Health of other)
april 6 45
(Official Designation) (Date of/Issuc of Permit)
Due to
Due
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 occupation of deccascd ?.
If so, specify
M. D.
(Signed)
Brand 1) tiltak aps. 5 1045
LOWSTI
(Address)
21 Edson
Place of Burial, Cremation or Removal,
DATE OF BURIAL.
April
9
(City or Town)
45
22 NAME OF
Houver & Purcolds
FUNERAL DIRECTOR,
ADDRESS
winthrop masa.
Received and filed APR 6 1945
19
(Registrar)
50m-(e)-3-43-11574
from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
Duration IMPORTANT
6 Age of husband or wife if alive. 79
19 I HEREBY CERTIFY, That I attended deceased front
19
to.
19
I last saw h
alive on.
19
_, death is said to
have occurred on the date stated above, at 2.300 M.
Immediate cause of death
4
18 DATE OF
DEATH
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
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 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 scetion 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 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 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 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 buried. No such perinit shall be issued until there shall have heen delivered to such board, agent or clerk, as the casc 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, 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 such certificate. If such a permit for the removal of a human body, not previously interred, froin 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 111 the army, navy or marine corps of the United States in any war in which it has been engaged, sueb recital sball 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 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 wbo, 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 inorbid 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 healthfulness of various pursuits can he 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
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town
3 The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
81 ...
Registered No § (If death occurred in a hospital or institution, { give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
...
2
South
St ..
Beverly
(Was deceased a U. S. War Veteran? If so, (specify WAR) Maas.
(If nonresident, give city of 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
Male
4 COLOR OR RACE
.
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Si
Sa 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.
STILLBORN
If less than 1 day
8 AGE Years Months Days Hours Minutes
9 Ocoupation :
Industry
10 or Business :..
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Winthrop,
maso
13 NAME OF
FATHER
Niels nielsen
14 BIRTHPLACE OF
FATHER (City) ...
East Boston,
(State or country)
mais.
18 MAIDEN NAME
OF MOTHER
Lena Cácicio
Boston
16 BIRTHPLACE OF
MOTHER (City) ...
(State or country)
Mass.
17 Niels nielsen (Father)
Informant
(Address)
2 South St Beverly
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit web issued: I m. D. Childrenas (Signature of Agent of Board of Health'or other)
Thealth Officer 4/9/45
(Official Designation)
(Date of Issue of Permit)/
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
anul
6.
(Month)
(Day)
(Year)
19 QKHERER 76 19
Y CERTIFY that I attended deceased from
I last saw hun .alive on apul 6 have occurred on the date stated above, at 1:30 2004 Immediate cause of death Inquations infant
m.
Duration Important ·
75 magnol papua Laureates cadax of
Due to.
nismes nek prolapsel
...
Important
Other conditions
(Include pregnancy within 3 months of death)
Major findings: Of operations.
Date of
Of autopsy
What test confirmed diagnosis ?.
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)
M. D.
(Address).
21 St. michael's
Place of Burial Cremation or Removal.
DATE OF BURIAL
april 10,
19.45
22 NAME OF
Paul Buonfiglio
ADDRESS ..
128 Revere St Revere
Received and filed
19
A TRUE COPY ATTEST:
APR .1 1 1945
(Registrar)
E.B. ... Date 4/6
Boston
kcity or Town)
Relation, if any
100m (h)-1-41-4695
1 PARENTS mation should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physician to insert a recital to that effect. See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. NN. D .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of infor- Usual
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