USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 71
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PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
White
4 COLOR OR RACE|
( write the word)
18 DATE OF
DEATH
1)
1945
(Month)
( Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deosesed from
19.
45. 00
200.17
1945
I last saw h. 1.welive on
m.17. 1945, death Is said to
have occurred on the date stated above, at
210P
m.
Duration
Immedlete osuse of death
IMPORTANT
88
8
AGE
Years
11,
Months
2
Days
If less then 1 dey
Hours
Minutes
Usual
9 Occupetion :
Merchantman (Retired)
Industry
Groceries & Provisions
10 or Business :
11 Social Security No. .
None
12 BIRTHPLACE (City)
( Siste or country)
Germany
13 NAME OF
FATHER
Ludwig
Henry Reusch
14 BIRTHPLACE OF
FATHER (Clly)
(State or country)
Germany
15 MAIDEN NAME I Meleriche
OF MOTHER
Freda Zeh
16 BIRTHPLACE OF
MOTHER (City)
(Siste or country )
Germany
17
Informent
( Address)
Bertha Rausch, Daughteron, If any
110 Circuit Rd. Winthrop
I HEREBY CERTIFY thet a galitfactory standard certificate of death was filed with me BEFORE the barfal .or tranalt permit was Issued ?
(Signature of Akpot of Board of [leafth or other)
11/20/15
( Date of Frque of Permit)
.......
St.
(If nonresident, give clty or town and State)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if elive 86
years
7 IF STILLBORN, enter that fact here.
PARENTS
100m.(g)-1-45 15510
If deceased was a U. S. War Veteran, Q. L. Chap. 46. Section 10, requires physicians to insert a recital to that effect. CI 1 ·· · UN· Vil Vack of certificate.
11/26/40 (Reparado Funeral)
terms, so that it may be arnnastu .lesall
20 Wes disease or injury in any way related to occupation of deceesed ?
If so, speolfy.
( Signed)
( Address)
Y LucyFranco Dato 11-5m
. M. D.
21 Woodlawn
Evere.t.t.
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and Aled Nov 2- 1945. ..... 19
( Registrar)
V
10/cys
Due to
Que to
arturo palermo
Other conditions
( Include pregnancy within 3 months of death)
Major findings:
Of operetion,
Date of
Of autopsy
What test confirmed diagnosis?
IMPORTANT
Physician
Underline the cause to which death should be charged st .. tistically .
Place of Burial, Cremation or Hamon
NOV. 20(City or Town)
45
19
Howard SOhumild
......
Health (Ofacial Designation)
No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Marrue
5a If married, widowed, or divorceAmelia Rudolph
HUSBAND of
(Give maiden name of wife in full)
2
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 helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired 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.
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 helief, served in the army, navy or marine corps of the United States in any war in which it has heeu engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate hoth 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, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican horder service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not heen huried, 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 tomh 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 hody is buried. No such permit shall he 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 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 he 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 hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence, the medi- cal examiner 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 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 removal shall constitute a permit for such removal; provided, that such hody shall he 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 hody has heen 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 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 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 hoard, from the clerk of the town where the body is to he huried or the funeral is to he 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 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 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 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 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 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 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
I R-301 A
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. extracts from the laws on back of certificate. terms. so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 180 Nahant 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 Registared No. (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Carrie A (Clark) Sherman
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No./
180 Madan't Que Winther
(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 10 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACEI
5 SINGLE
( write the word)
Female
White
MARRIED
WIOOWED
or DIVORCED
Widowed
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
(fivemaisen gutes Kife in full)
( Husband's neme In full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fect here.
8
91 Years
10
AGE
Months
6
Days
If less than 1 dey
Hours ...
Minutes
Due
antonio scherei
Usual
9 Occupallon :
At Home
Industry
10 or Business :
11 Social Security No.
None
12 BIRTHPLACE (City)
( Site or country)
Boston
Mass.
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(Stete or country)
Unable To Obtain
15 MAIDEN NAME
OF MOTHER
Mary Peabody
16 BIRTHPLACE OF
Boston
MOTHER (City)
( State or country)
Mass.
17 Informent ( Address) Harry Wright Son Relatlon, If any 180 Nahant Ave. Winthrop
I HEREBY CERTIFY that a astisfeotory standard certificala of death wes led with me BEFORE the burial or transit permit was Issued:
1
(Signature of Sepet of Board of Health as other)
11/20145
(Ofiele! Designation)
( Date of Imque of Perunit)
18 DATE OF
DEATH
nommen 18 -1945
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Thet I attended decaased from
Dan-22, 1944, 10
Zumles 18, 19 45
last saw h In alive on
17
, 19-+3, death Is said to
have occurred on the date stated sbove, at 12 m. Duration
Immediate cause of death Thune J ..... xd 142 5
IMPORTANT
Due to
Other conditions.
( Include pregnancy within 3 months of death)
Mejor findIngs:
Of operations
Oste of
Physician Underline the cause to which death should be
1 4 anniof based ... tistically.
20 Was disease or injury in any way related to occupetion of deceased ?.... ....
If so, specify.
( Signed )
wyndham W. Dato 11-19.1415
(Address)
21 .
Cedar Grove
Dorchester
Place of Buriel, Cremation or Removel.
DATE OF BURIAL
Nov. 21
(City or Town)
945
22 NAME OF
FUNERAL DIRECTOB ...
Howa: S Pani
ADDRESS
Received and Alad Now 20 1945 19
( Registrar)
100m(i)-1.44-13634
IMPORTANT
13 NAME OF
FATHER
Unable To Obtain
Of autopsy
What test confirmed diagnosis trafic
M. D.
Health Officer
No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last 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 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 delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
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 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 bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that 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
R-301 A f
1
PLACE OF DEATH
Suffolk {County)
Winthrop ..... (City or Town)
No.
Winthrop Community Hospital
S ( If death occurred in a hospital or institution, St.
give its NAME Instead of stefAN4ª IMPOR
2 FULL NAME
Domenic Massucco
(If deceased is a married, widowed or divorced woman, give also maiden name.)
100 Leyden
St.
E Boston Mass
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
hospital
yeara
months
6
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE]
5 SINGLE
( write the word)
18 DATE OF november 19 1945 DEATH
(Month )
(Year)
19 | HEREBY CERTIFY,
hinanden 13 1945
to.
november 19 1945
last saw hun
.alive on
November 1904 death is said to
hava occurred on tha data stated abova, at.
6:50 PM
6 Age of husband or wife if aliva
yaars
> IF STILLBORN. enter that fact hera.
8
AGE
71 Years
Months
Days
If less than 1 day Hours Minutes
Usual
9 Dccuoatlon :
Retail Grocer (Retired)
Industry
10 or Business :
Grocery
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or conutry)
Boston
Mass.
13 NAME DF FATHER Guiseppi Mas succo
14 BIRTHPLACE DF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Maria Aratto
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
20 Was diseasa or injury in any way related to occupation of daogased ? 50.
If so, specify
...
(Signed) Carob J. abrams
(Add ) 562 finley IT
MiW. M. D. ......
Date 11/19/1945
2St.
Michael ChlapBieron
Place of Burial, Cremation or Removal.
DATE OF BURIALNOV. 22
1945
22 NAME DF
FUNERAL DIRECTOR
Michael / Forcella
ADDRESS
10 No. Bennet St., Boston
Received and Aled. NOV-26 1945- 19
( Registrar)
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a reoital to that effect. PARENTS extracts from the laws on back of certificate.
100M-6 · 2·42-8855
Informant
Rotting If any (Address) 187 Shore Dr. Winthrop Mass
I HEREBY CERTIFY, that a satisfactory standard certifioale of daath was fled with me BEFORE the burim) or transit parmit was Issued :
...... (Signature of Agent of, Board of Health of other 1/21/40
Health Office /(omcial Designation) -
(Date of Issue of Permit)
Immediate oeuse of deato.
Cenehal temontage
Duration IMPORTANT 7 days.
Due to.
arteriosclerosis
Due to.
Paralysis agitano
ana
e
Other conditions ...
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings:
Df operations
none
Data of
Of autopsy.
none
What test confirmed diagnosis ? clinicaly lah
2 years
Physician Underiina the cause to which death should ba charged sta- tistically.
(City or Town)
17 Walter Massucco
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
215
Registerad No.
(Was daoaased a
U. S. War Veteran,
if so spaolfy WAR)
(a) Residenca. No.
male white
MARRIED
WIDOWED
or DIVORCEWidowed
5a If married, widovgdgjerBiggi
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
Boston Mortified
r
( Before death)
(Specify whether)
(Day)
That I attendad daosasad from
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
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