USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 54
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A physician or officer furnishing a certificate of death as required by the preceding section or hy 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 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 hody which has not been 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 hody 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 be issued until there shall have been delivered to such board, agent or clerk, as the case may he, 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, 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 hy 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 ahove 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 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 body has heen sooner obtained hereunder. If the death certificate contains a recital, as required
by section teu ul 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 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 by 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 hody 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 suchi 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 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 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 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 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
-302
1
PLACE OF DEATH
(County)
(City or Town)
No.
PETER ... BENT .... BRIGHAM ... Ho.S.P.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return) 146 7072
S (If death occurred in a hospital or institution, St. give ita NAME instead of street and number)
2 FULL NAME
HELEN. GEORGOUNTZOS
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
23 SHIRLEY ST
St.
W.A.N ..... T.H.R.D.P .... MAS.S.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
2
months
2 pays.
In this community
yrs.
1
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
FEMALE
4 COLOR OR RACEJ
WHITE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
SINGL
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve
yeard
Immedlate cause of death
CEREBRAL ... E.DEMA
T.E.RM
8
AGE
13 Years Months.
.. Days
If less then 1 day .. Hours Minutes
Usual
9 Occupation :
STUDENT.
Industry
10 or Business :
SCHOOL
11 Social Security No ...
12 BIRTHPLACE (City)
(State or country)
LOWELL MASS,
13 NAME OF
FATHER
GEORGE GEORGOUNTZOS
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
GREECE
15 MAIDEN NAME
OF MOTHER
KALIROE MANOLOPORDOS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
GREECE
17
Informant.
(Address)
.S.I.S.T.E.R
Relation, if any
A TRUE COPY.
ATTEST Michael & M.
(Registrar of cify or town where death occurred)
AUG 14/469
Reoelved and filed AUG 25 1945
19
DATE FILED
( Registrar of of City or Town where deceased resided)
Physician
Major findings :
Of operations
Date of.
should be charged sta- tistically.
Of autopsy
A.S .... A.B.Q.VE
What test confirmed diagnosis ?A.u.T.O.P.S.Y .... AND .... C.L.1.N .. 20 Was disease or injury in any way related to occupation of deceased?
If so, specify
NO
(Signed)
W R DUDEN
M. D.
(Address)
Bos.T.ON
Date 8/11/206
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ..... I.N.T.H.R.O.P.
I.N.I.H.R.O.P.
(Cemetery )
(City or Town)
DATE OF BURIAL
AUG 14/46
19
22 NAME OF
FUNERAL DIRECTOR
A C HASIOTIS
ADDRESS
BOSTON MASS.
50m-(b)-6-44-14607
18 DATE OF
DEATH
AUG 11/46
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
MAY 5/46
to
AUG 1 1 /46
19
That I attended deosased from
I last saw h ...... E.R ... allve on
AUG 11/199
death Is sald to
have ooourred on the date stated above, at
4
.m.
Duration
Due to. TUBERCULOS IS
Mos
Due to
Other conditions.
(Include pregnancy within 3 months of death)
Underline the cause to
which death
7 IF STILLBORN, enter that fact here.
-
(If U. S.
War Veteran,
speolfy WAR)
Registered No.
!
R-305 1
Barnstable
(County)
Provincetown
(City or Town) Railroad Wharf No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Provincetown
(City or town making return)
Registered No.
147
§ (If death occurred in a hospital or institution, give its NAME instead of street and number)
St.
Jessie Costa Grainger
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Coral
St.
Winthrop,
Mass
(a) Residenoe. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
years
months
days.
In this community
yrs. 1
mos.
14 days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Will vamide na figiern full)
(Husband's name in full)
6 Age of husband or wife if allve years
7 IF STILLBORN, enter that fact here.
8
AGE
63 Years
-
.. Months.
- Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
own home
Industry
10 or Business :
Housework
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
Provincetown
Mass
13 NAME OF
FATHER
Manuel Costa
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Azores
15 MAIDEN NAME
OF MOTHER
Jessie Cabral
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Azores
17
Mary Janopolis
Informant ...
(Address) 17 Conant St, Provincetown
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
August 12
46
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
August
11
1946
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Natural causes-
Probably pulmonary thrombosis
20 Accident, suicide, or homicide (specify)
Date of occurrence.
19
Where did
Injury occur ?
(City or town and State)
Did Injury occur in or about the home, on farm, In Industrial place, or In publio place? (Specify type of place)
Manner of Injury
Nature of
Injury
While at work?
no
Was there an autopsy ?.
no
21 Was disease or injury In any way related to occupation of deceased? no
If so, specify.
(Signed)
Frank O. Cass
M. D.
(Address)
Provincetown, MassDate 8/11 1946
22
Holy Cross Cemetery
Malden
Place of Burial, Cremation or Removal.
August
14
(City or Town) 19
46
23 NAME OF
Henry W. Carlson
FUNERAL DIRECTOR
ADDRESS
Provincetown Mass
Received and filed AUG 19 1945
19
(Registrar of City or Town where deceased resided)
.
25m (h)-1-41-4667
PLACE OF DEATH
1
occurred. (See Chap. 46, Sec. 12, G. L.) or the city or town in which the deceased resided as soon as possible after the close of the month in which the death PARENTS
pushany DATE OF BURIAL
(If U. S.
war Veteran,
specify WAR)
(Specify whether)
+
Suffolk
(County)
Winthrop (City or Town)
No. 795 Shirley St.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filled for barial permit with Board of Health or its Agent.
St.
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAMEAnthony R. Muriaty
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
795
Shirley St
St.
(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
25yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced
HUSBAND of
Anna C.
Nobis
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive. 59
years
7 IF STILLBORN, enter that fact here.
8
AGE.62 Years
Months.
Days
If less than 1 day
Hours ..
Minutes
Usual
9 Occupation :
Retired
Industry
10 or Business:
Bowling Alleys
11 Social Security No.
025# 03-1103
12 BIRTHPLACE (City)
(State or country)
Austria
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Of autopsy
What test confirmed diagnosis Clinical Signs
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, specify.
(Signed).
M. D.
(Address) WinThroyo Mass Date Quy 13 1946
21 .
Winthrop
Winthrop
(City or Town)
Place of Burial, Cremation or Removal. DATE OF BURIAL
Aug
16
2946,
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
John Or Males
Winthrop
Received and filed AUG-2-1 1946
19
(Official Designation)
(Date of Issue of Permit)
18 DATE OF
DEATH
Luquet 12
(Month)
(Day)
1946
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
tab. 10,44 15
to
Cung 12
19_
46
I last saw him alive on
aug 12, 1946
is said to
have occurred on the date stated above, at
12.30 PM.
Immediate cause of death Tuberculosis of
Kidneys
Due to.
Due to.
13 NAME OF
FATHER
Anthony Muriaty
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Austria
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Austria
17 Anna C Nobis me
Relation, if any Wife
Inform
(Address)
795 Shirley St
was filed with me BEFORE the burial or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death Wollte
(Signature of Agent of Board of Health or other).
Health Office 8/15/46
(Registrar)
Duration IMPORTANT 3 years
50m-(e)-3-43-11574
PLACE OF DEATH
1
148
Registrar's No.
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Male
White
PARENTS
Date of.
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 belicf the name of the deceased, his supposed age, the disease of which he died, defined as rc- quired by section one, where samc was contracted, the duration of his last illness, wlien 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 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 forfcit 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, eightcen 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 seventcen. 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 cemetcry, until he has received a permit from the board of health or its agent aforcsaid 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 mcdi- 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 ton 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 certificatc, 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, Scc. 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 suchi 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; . . . - Gencral 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 forin of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized discase unrelated to any form of injury, have died without recent inedical 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 mcans 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 cvery 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 whosc 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
1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) winthrop Community Hospital No. . Bay ( Boy ) Picardi (If deceased is a married, widowed or divorced woman, give also maiden name.)
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.
Registered No.
149
St.
1 (If death occurred in a hospital or institution, }
I give its NAME instead of street and number)!
2 FULL NAME
(a) Residence.
No.
72 St. Andrew
Road
(Usual place of abode)
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
4 CDLDR DR RACE
white
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here. stifés
8 AGE Years Months Days
If less than 1 day
. Hours
Minutes
Usual
9 Dccupation:
Industry 10 or Business:
11 Social Security No.
Winthrop
12 BIRTHPLACE (City)
(State or Country)
Mass.
13 NAME OF
FATHER
Louis Picardi
14 BIRTHPLACE DF
FATHER (City)
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