USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 63
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by section ien of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has heen engaged, 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 he 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).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody 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.
No undertaker or other person shall hury a human hody 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).
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 hedside 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 hy recognized disease unrelated to any forum 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 hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy 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 conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupatlon .- 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 he 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 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 A
Suffolk
(County)
(City or Town)
No. Winthrop Community Hospital
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.
192
Registered No. [ (If death occurred in a hospital or institution, st { give its NAME instead of street and number)
2 FULL NAME.
Lucian L. Frye
( If deceased le a married, widowed or divorced woman, give also maiden nome.)
(.) Residence. No.
180.Pauline .... St.
(Usual place of abode)
St.
(If nonresident, give clty or town and State)
Length of stay: In Ansoltal ne Institution
( Before death)
Hospital
Jeers
months
7
days.
In this community
27 yrs.
mos.
deys.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Married
5a If married, widowed, or divorced
HUSBAND of
.ho.se ... Ann ... Pendleton
(Give maiden name of wife In full)
( Husband's name In full)
6 Age of husband or wife if aliva 65
years
7 IF STILLBORN, enter that fact hera.
AGE .. 66 Years 7 Months 30 Days
If less than 1 day
Hours
Minutes
Usual
9 Ocouoation :
Bakers Helper
11 Social Security No.
022-10-4778
12 BIRTHPLACE (City)
( Siste or country)
N. H.
13 NAME OF
FATHER
William Frye
FATHER (Clty)
Webster.
(State or country )
Mass.
15 MAIDEN NAME
OF MOTHER
Mary Ennerson
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Rncde Island
17 Rose P. Frye
Relation, If any
Informant
( Address )
80 Pauline St., Winthrop
I HEREBY CERTIFY thet a satisfaolory standard omrllfloata of death was filed with me BEFORE the buffat on transit barmit was Issuedt Mildred
(Signature pl Arght ef Board nf Realth or other)
Health Office 10/13/45 (Official Dealgnation) ! ( Date of Imque of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
October
11
19 45
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY,
Thet
L altendad deocasad from
1945
to.
11
19
45
I lest saw h .............. alive on ....
Out 10, 194 Sheath Is said to
have occurred on the date steted .bova,
6,50 A.
Immediato cause of death.
EPORTANT
...
Due to
Due to
Other conditions
( Include pregnancy within 8 moutbe of death)
Major AndInga: Of operations
Deta of
Df autopsy
What test confirmed dlagnosla ?
IMPORTANT
Physician
Underline the cause to which death should be charged sta. tistically.
20 Was disease or injury in any way related to occupallon of deceased?
If so, spoolfy
. M. D.
( Signed )
(Address) 4 Colombia In Date 10-14 1941
21
Lee
NEW Hampshire
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL ..
Oct .14, 1945
19
.......
22 NAME OF
FUNERAL DIRECTOR: . Segnare 16 Wbudo
ADDRESS 147 Winthrop St., Winthrop, Mass.
Reosived end Aled OCT 1-6 1945
1
( Registrar)
100m-(R)-1 45-15510
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a rooital to that effect. PARENTS
PLACE OF DEATH
1
Winthrop
3 SEX
Male
(or) WIFE of
8
10 or Business :
14 BIRTHPLACE DF
....; ve properly classified. Exact statement of OCCUPATION is very important. See Instructions and
Industry
Bakery
( Specify whether)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Duration
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 be died, defined 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, 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 relicf 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 hoard, 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 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 wbo is a member of the board of bealth, 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).
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.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he bas 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).
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 deatbs 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 sucb 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 wben 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 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT SERVICE NUMBER
--
RM R-301
Sufflok
(County)
1
Winthrop
(City or Town)
PLACE OF DEATH
(Usual place of abode)
3 SEX
4 COLOR OR RACE
-
Female
White
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of.
6 Age of husband ok Wile if alive
7 IF STILLBORN, enter that fact here.
Usua!
V
Il Social Security No ........ no.no.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
Industry
10 or Business:
a.t .... hom.e.
is very important. See instructions and extracts from the laws on back of certificate.
PARENTS
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:
William D. Childress
(Signature of Agent of Board of Health or other)
agent
cet, 20/45-
(Official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Codv
18,1945
(Month)
(Day)
( Year)
19 | HEREBY CERTIFY, That I attended deceased from
Qual 20
1945, to COcl18
1980
.....
I last saw h.A ..... alive on.
Cod18
...... ,
, 19 45
death is said
to have occurred on the date stated above, at ...
50m.
Duration
.yoars
Immediate cause of death ..
Pulmon
tacak meghetis
...
06/12/48
Seful 15/45
...
Due to
Other conditions
7 months programs
.... ...
(Include pregnancy within 3 months of death)
Major findings :
Of operations
...
Date of.
Of autopsy
What test confirmed diagnosis ?
Sab + Chinapara
...
charged sta-
tistically.
20 Was disease or lojury lo any way related to occupation ol deceased ?
If so, specify ....
(Signed)
Jonas Steluffa
(Addre
) 1903am LES Del19 1945
21 St. Michael Boston
(City or Town) ... Place of Burial, Cremation or Removal.
DATE OF BURIAL
Oct
-
22
22 NAME OF
FUNERAL
ADDRESS
9 .... Chelsea .... Street ... East ... Boston
Received and filed
........ .. 19
A TRUE COPY ATTEST:
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
Boat motifer /9/40
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No
193
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
tres. Rose Calford
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No ...
187 London D
St.
East Boston, Masa.
....
(If nonresident, give city or town and state)
Length of stay : In hospital or institution
(Specify whether)
-
years
months
4 days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCEDMarried
(Give maiden name of wife in full)
Le.o.n.
.Clifford.
(Husband's name in full)
21
8 ÅGE 19 Years Months. Days
If less than I day
Hours.
Minutes
9 Occupation:
.Hos.e .... work.
12 BIRTHPLACE (City)
(State or country)
East Boston, 2 ...
13 NAME OF
FATHER
Antonio Di Marino
15 MAIDEN NAME
OF MOTHER
Antonia Laizza
17 Antonio Di Marino
Relation, if any
Father
Informant ...
(Address)
212 Bremen St. East Boston
V
PHYSICIAN
Underline the cause to which death should be
...
Due to
Toxemia Programas
Dapino
......
19 .45.
No ..... Winthro Comunity Hospital
(I U. S.
War Veteran.
specify WAR)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or rogistered bospital 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 hody 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 exbume 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 hercinafter 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 selcctmen 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 hody, 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 ahove provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal ; provided, that such hody 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 ohtained 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 appcar upon the permit. The hoard 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 he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of 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 discasc unrelated to any form of injury.
(2) Board of llealth 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 scptice- mia), 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 occupa- tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Causo 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- ditlons, if any, related to the principal cause and any important complication of the principal causc.
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 had no occupation whatever write none.
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