USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 58
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.. Days
If less than I day
.Hours.
Minutes
Usual
9 Occupation:
Upholsterer
Industry
10 or Business:
Furniture
II Social Security No.
has lost card
Boston
12 BIRTHPLACE (City)
(State or country)
Mass
13 NAME OF
FATHER
James Gates
14 BIRTHPLACE OF
FATHER (City)
Durham
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Elizabeth Matthews
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Lancashire,
17
Informant ..
Alice B. McCavan
(Address)
73 Moseley St.
Dorchester
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
.Aug. 22, 1946
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH ..
August 21 1946
(Month)
(Day)
(Year)
19 I 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.) Heart disease, presumably
Coronary Sclerosis ( found dead.
in bed. )
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 public place ? (Specify type of place)
Manner of
Injury
Nature of Injury
While at work?
No
Was there an autopsy ?..
No
21 Was discase or injury la any way related to occupation of deceased ?.
No
If so, specily
(Signed)
Geo. D .. Dalton
M. D.
(Address)
Quincy.
Date
8/2119 46
22 Mt. Hope Cem.
Boston , ..... Mass ..
Place of Burial, Cremation or Removal.
(City or Town)
Relation, starr
DATE OF BURIAL
Aug. 23, 1946
19
23 NAME OF
FUNERAL DIRECTOR
John .... W ...... Baldyza
A TRUE COPY.
Hattiemann
Thomas
ADDRESS
So. Boston
Received and filed
SEP - 51945
19
(Registrar of City or Town where deceased resided)
Quincy. (City or towu making return)
156
Registered No
572
(If death occurred in a hospital or institution,
........... give its NAME instead of street and number)
2 FULL NAME
John A. Gates
(If deccased is a married, "widowed or divorced woman, give also maiden name.)
208 Cliff Ave. ..
......
Winthrop, Mass.
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution
(Specify whether)
years
months
days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
white
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
widowed
5a If married, widowod, or divorcedRogeanna Egan
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
G Age of husband or wife if alive.
Years
PLACE OF DEATH No
Norfolk (County)
Quincy (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
40 Harriet .Av.e .......
St.
(If U. S.
War Veteran,
specify WAR)
7 IF STILLBORN, enter that fact here.
England
301 A
1 Suffolk (County Winthro (City or Towa · Winthrop PLACE OF DEATH BABY GIRL
2 FULL NAME
(If deceased is a married, widowed of divorced woman, give also maiden name.)
(a) Residence.
No.
(Usual place of abode)
Length of stay: In hospital or institution (Before death)
Thep
(Specify whether)
years
= months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX F
4 COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
OF 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.
8
AGE
Years
Months
Days
If less than 1 day Hours 30 Minutes
Usual
9 Occupation:
Industry 10 or Business:
11 Social Security No ..
12 BIRTHPLACE (City)
(State or Country)
Winthrop, Mass
13 NAME OF
FATHER
Harry Tuskman
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Worcester, Muss.
15 MAIDEN NAME
OF MOTHER
Daris Kientzman
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Chelsea, Mass.
Samuel Mentzman David father
17 Informant (Address 86 Sagamme die, Withrye I HEREBY CERTIFY that a satisfactory standard certificate of death was filed withy me BEFORE the burial or fransit permit was issued: Walter & Baker (Sighnature of Agent of Board of Health of-oth.)
Health officer Official Designation) TDate of Issue of Permit)
8/21/46
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
aug
21, 1946
(Year)
(Month)
(Day)
19
I HEREBY CERTIFY,
That I attended deceased from
Cmq 21
, 19
×6,10
aug 21
. 19
×6
I last sauch Calive on
ang 21 /19 ×6 death is said to
A.
m.
have occurred on the date stated above. at
Duration
IMPORTANT
6 sua Barn até 4:30 4M. 8/21/46
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
7
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased? If so, specity
(Signed)
(Address) 0% comm AVE Dusty
Date
8/21
19 46
Workingmen Circle West Roxbury
Place of Burial//Cremation or Removal.
(City or Town)
.
1926
22 NAME OF
FUNERAL DIRECTOR
Benjamin Bünbach
ADDRESS
10 Washington St. Durch.
19
Received and Filed AUG 2 1 1946
(Registrar)
IMPORTANT
Physician
Underline the cause to which death should be charged sta- tistically.
100m-9-44-14955
notified 9/12/46
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.
157
Community Hospitals ..
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
INSHMAN
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
8 Keningtan Rd x
Warenfür (If nonresident, give city or town and State)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
21
DATE OF BURIAL
8-22
...
, M. D.
Immediate cause of death
Prematurity
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 by 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 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 inarine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, 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 acventeen. 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 been buried, until he has received a perinit 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 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 he issued until there shall have been delivered to such hoard, 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 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 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 hy 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 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 been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten ui chapter lolly.gia, tual 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 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 hody 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 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 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 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 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 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. 1
SPACE FOR ADDITIONAL INFORMATION
301 A
1
(City or Town) No Centrole comp
Community Hospita
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. 158
2 FULL NAME De Precio
(If deceased is a married, widower or divorced woman, give also maiden name.)
416 Saratoga. St.
(a) Residence.
No.
(Usual place of abode)
Length of stay: In hospital or institution
(Before death)
1
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
4
COLOR OR RAGE
Mute
MARRIED
WIDOWED
or DIVORCED
5 SINGLE
(wpite the word)
fugle
5a If married, widowed or divorced HUSBAND of .
(or) WIFE of
(Give maiden 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 Chielbow
8
AGE
Years
Months
Days
If less than 1 day Hours Minutes
Usual 9 Occupation:
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country))
13 NAME OF
FATHER
Sudalph Patrizio
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Haly
15 MAIDEN NAME
MOTHER Harquel Licardi
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
mars
17 Informant (Address' 16 Jacatora fl I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter Baker (Signature of Ageet of Beard of Health or other)
Healthe (Official Designation)
(Date of Issue of Peribit) 8/26/46
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
aug 23
[(Month)
(Day)
1946 (Ycar)
19
I HEREBY CERTIFY.
That I attended deceased from
, 19
, to
19
I last saw h alive on , 19 , death is said to
have occurred on the date stated above. at
m,
macerated
let
Duration
Immediate cause of death
Stillhorn macurated fita.
IMPORTANT
Due to
Primature Rupture of
Manchanes.
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
Chemine Exam
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
(Address)
318 Comments on Date Cruz 231946
21 th Michael
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
Que.
26,
19 76
22 NAME OF FUNERAL DIRECTOR Asbest Scaramella
ADDRESS
3) Orleans AV., East Breton
Received and Filed
19
SEP
3
1946
(Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
100m-9-44-14955
PLACE OF DEATH Jufalles (County)
Brator notifise 9/12/46
Baby Girl;
St. § (If death occurred in a hospital or institution, 1 give its NAME instead of street and number)
PHYSICIAN - IMPORTANT ( Was deceased a U. S. War Veteran, if so specify WARI
(If nonresident, give city of town and State)
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
.. , M. D.
Feston
Relation, if any)
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 othcer 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 been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, 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 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 permita, 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 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 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 obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter ionty-six, lust Loc ucceased 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 hy 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 hoard, 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 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 deathis 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 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 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 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
301 A
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
100m-9-44-14955
17 Informant (Address 4 Wordside Pack Wanthy
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Valter & Baker (Signature of Agent of Board of Health or other)
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