USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 20
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(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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infectlon 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 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 important, so that the relative healthfulness of various pursuita 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 he returned as at school or at home. For a womau whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
+
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town) Wintrop Community Hospital No.
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.
54
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Baby Girl D'Amato
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
453 Frankfort
St
East .... Boston
(If nonresident, give clty or town and State)
Length of stay: In hospital or Institution.
( Before death)
years
months
days.
In this community
yrs.
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Scar.
( Month )
(Day)
17
1946
(Year)
191 HEREBY CERTIFY,
Mar 12
...
19.
26.
Ło
That I attended deosased from
Mon 17
19
I last sawh Er alive on
Juan 16
1986
death is sald to
have occurred on the date stated above, at.
235 A.
.m.
Duration
Immediate cause of death. Ouitracincial neuentiene
IMPORTANT
Due to.
Due to
Other conditions
( Include pregoancy within 3 months of death)
Major Andings: Of operations
Date of
Of eutopsy
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 occupation of deceased ?.
If so, spoolty.
(Signed)
(Address) 19 Breast ES VO
.. Dato
Jan 117 1946
21
St ..... Michael
Place of Burial. Cremation or Removal.
DATE OF BURIAL .....
March ...... 20
Boston. (City or Town)
19.46
22 NAME OF
FUNERAL DIRECTOR ....
COR Tabel Dafino
ADDRESS 9 .... Chelsea. Street .... East .... Boston ..
(Signature of Agent of Board of Health or other)
Health Officer 3//9/46
(Official Designation)/ ( Date of Toque of /Permit)
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEDsingle
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 ellve
years
7 IF STILLBORN, enter that fact here.
Months Daya
If less than 1 day Hours Minutes
-5
11 Social Security No.
12 BIRTHPLACE (City)
(Siate or country)
Winthrop, 27
13 NAME OF
FATHER
Henry Df Amato
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston 22
. .
15 MAIDEN NAME
OF MOTHER
Theresa Saccaro
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston-2- 2
17 Henry DI Amato
Relation, If any .. father
Informent.
( Address)
453 Frankfort St. E. Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the Burial/or transit permit was Issued ;
100m-(g)-1-45-15510
1 3 SEX female Usual 9 Ocoupation : Industry 10 or Business : PARENTS If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physiolans to insert a recital to that effect. extracts from the laws on back of certificate. ....... . .... . my · property class. SAM ULLUN s very important Instructions 8 AGE Years
R-301 A
...
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR).
(Usual place of abode)
( Specify whether)
Boite Pitiful 4/10/46
Registared No.
Received and Aled. MAR 1 3 1346
.19
{ Regtotr tetrar)
.. 7. M. D.
4 COLOR OR RACEJ
White
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwitb, 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 tbe family of the deceased, furnisb for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, bis supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of bis last illness, when last seen alive by the physician or officer and the date of bis 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 beeu 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, eigbteen hundred and ninety-eigbt and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen bundred and seventeen. G. L. Chap. 46, See. 10.
No undertaker or other person shall bury or otherwise dispose of a buman 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 110 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 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 buman 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 auch 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 bereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, tuat 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 fortbwith go to the place where the body lies and take charge of the same; ... - General Laws, Cbap. 38, Sec. 6.
No undertaker or other person shall bury a buinan body or the asbes thereof which have been brought into the commonwealth until be 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 forin 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 deatb. 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
DRM R-301
PLACE OF DEATH
1 Suffolk (County) Winther (City or Town)
notified
115/ 46
The Commonmealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
55
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
(If deceased'is a matried, widowed or divorced woman, give also maiden name.)
331 boule St
mass.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
years
months
days.
4 hrs. 40 min.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
w.
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Sangle
Sa If married, widowed, or divorced HUSBAND of.
(Give malden name of wife In full)
(Husband's name In full)
6 Age of husband or wife if alive. years
7 IF STILLBORN, enter that fact here.
AGE
Years
Months.
Days|
If less than 1 day
4 Hours 40 Minutes
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Winecling man
13 NAME OF
anthony Lo Ra
14 BIRTHPLACE OF
FATHER (City) ...
Boston
(State or
y) Massacanales
15 MAIDEN NAME
OF MOTHER
resa Ponovo
Cosson
16 BIRTHPLACE OF
MOTHER (City) ....
(State or c
ry) Massachenales
17 anthonyLy Re
Relation, if any Taches) (Address) 331 Lasheel ST. Clararule
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Nm .S. Fuldresig (Signature of Agent of Board of Health of other)
Health Officer 3/19/46
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
# 17, 19×6.
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY.
That I attended deceased from
mar 16
,1976 to munt617
1946
1
.m. I last saw h or alive on marit6 1946 death is said to Duration Important have occurred on the date stated above, at 12:55 4 Immediate cause of death. trematurity-5 months
Due to
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Major findings: Of operations.
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? 1
If so. specify.
2. Potito
(Signed)
, M. D.
(Address)
7 Central Ss 2 B Date 3/17
19 46
21 9. Michael
Roslindale
(City or Town)
Place of Burlal. Cremation or Removal!
DATE OF BURIA
March 20
1946
22 NAME OF
mini & Sementa
FUNERAL DIRECTOR
ADDRESS.
215/2018i. dost m
Received and filed.
MAR 1 9 1946
19
A TRUE COPY ATTEST: (Registrar)
100m(h)-1-41-4695
1 3 SEX $ (or) WIFE of. ver Industry 10 or Business: PARENTS 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. mation should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of infor- Usual 9 Ocoupation :.
Winthrop Community Hospital. No ..
St.
(Was deceased a U. S. War Veteran? If so, specify WAR)
(a) Residence. No
(Usual place of abode)
In this community yrs.
mos.
days.
Date of.
Of autopsy
What test confirmed diagnosis ?.
Important
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 required by section one, where same was contracted, the duration of his last iliness, when last seen alive by the physiclan 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 sectlon or by section forty-five of chapter one hundred and fourteen, 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, specifying 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 pro- vision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this section 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 hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen .- General Laws, 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 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 receiv- ing tomb to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesald or from the clerk of the town where the body is huried. No such permit shall he issued until there shall have heen 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 he 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or hy the selectmen for the purpose. shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical 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 ahove 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 re- moval 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 necessary information which can be ohtained 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 vlew 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 hury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or Its agent appointed to issue such permita, 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 burlal 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 physician is absent from home when the certificate of death Is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly by 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 disahled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the dlsease, 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 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 heen 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, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
PLACE OF DEATH -
Suffolk 0 (County)
Winthrop (City or Town)
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.
56
Winthrop Community Hospital
§ (If death occurred in a hospital or institution,
St ( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
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