USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 80
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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, sliall forthwith countersign it and transmit it to the clerk of the town for regis- tration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- Chiap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or ita 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 ia to be held, or from a per- son appointed to have the care of the cemetery or burial ground in which the interment ia made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion).
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.
.. lle shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- General Laws, Chap. 38, Sec. 7.
. . The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 illneas from disease unrelated to any form of injury.
(2) Board of Health physlclans will certify to such deatha 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 physi- cian is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- pcsably due to injury. Thesc include not only deaths caused directly or in- directly 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 disabied by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will atate the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Com- pound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with asso- ciated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sus- tained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease. specify : (1) Under cause its known or presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- taneous of the brain (basal ganglia) (found dead in bed)." "Ileart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
301 A
Suffolk
(Couoty)
Winthrop
(City or Town)
No. 104 Highland Ave.
st.
{ (If death occurred in a hospital or institution,
{give its NAME instead of street and number)
2 FULL NAME
Harriet H McNeill
(If deceased is a married. widowed or divorced woman, give also maiden name.)
(a) Residence. No.
104 Highland Ave.
St
(Usual place of abode)
(If nonresident, give clty or town and State)
Length of stay: In ansoltal or Institution
( Before death)
( Specify whether)
years
months
deys.
In this community
yra.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
Or DIVORCED Widowed
Female
White
50 If married, widowed, or divorced HUSBAND of
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fect here.
8
AGE
Yeers
88
2
Months
26ay.
lays
If less than 1 dey Hours Minutes
Usual
9 Occupetion :
Housewife
Industry
10 or Business :
At Home
11 Social Security No.
None
Pembroke
12 BIRTHPLACE (City)
( Siate or country)
Novia Scotia
13 NAME OF
FATHER
Robert Hazel
....
Of eutopsy.
What test confirmed diegnosis ?
clinical
IMPORTANT
Physician Underline the cause to which death should be charged st.i. tistically.
20 Was diseese or injury in any way related to occupation of deceesed ?...... Q If so, specify.
( Signed).
M. D.
(Address) Mutterof mass
Oete
11- 21- 1946
everett
21
Woodlawn
Place of Burial, Cremation or Removal.
DATE OF BURIAL
19
22
City or Town)
46
I HEREBY CERTIFY that a satisfgotory standard certificate of death was fled with BEFORE the burial or transit permit was issued :
{Bichature, of Agrut of Board of Health or, other) Health Thiele 11/21/46
(Official Designation) ( Date of Inque of/Permits
18 DATE OF
DEATH
november
14
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Thet ! ettended deosased from
Nov.12
1946.toNov.19
1946
I last saw h ........... . alive on
nov 19., 1946 death Is said to
have occurred on the date stated above, at
6.30 p.m.
Immediate ceuse of death.
IMPORTANT
Generalized arterial sclerosis
Due to
Due to
Other conditions
( Include pregnancy within 3 months of death)
Major findings :
Of operetions
Date of.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Novia Scotia
15 MAIDEN NAME
OF MOTHER
Martha Rolfe
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Novia Scotia
17 Informent Charles McNeill ( Address) Kingston R .F.
Relation, if any
Son (7
100m-(g)-1-45-15510
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physlolans to Insert a recital to that effeot. PARENTS
PLACE OF DEATH
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. 223
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
.....
MEDICAL CERTIFICATE OF DEATH
1946.
Duration
... 12 yrs.
Received and Aled NOV 25 10:0
19
( Registrer)
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Nachos mais
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 hody 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 hoard, 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 hy 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 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 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 aud 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 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 hody is to he 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 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 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 he returned as at school or at house. 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
-302
Essex
(County)
Danvers
(City or Town)
No. ......
Danvers State Hospital
§ (If death occurred in a hospital or institution, St. give its NAME instead of street and number)
2 FULL NAME
Arthur Costonis
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
75 Shirley
(Usual place of abode)
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Separated
5a If married, widowed, or divorced. HUSBAND of
Sylvia Bonoccoso
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve
years
7 IF STILLBORN, enter that fact here.
8 AGE. .L.g.Years Months Days
If less than 1 day Hours Minutes
Usual
9 Ocoupation :
Junk .... dealer
Industry
10 or Business :
11 Social Security No .....
Unknown
12 BIRTHPLACE (City)
(State or country)
Albania
13 NAME OF
FATHER
Charles Costonis
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Albania
15 MAIDEN NAME
OF MOTHER
Anna Vito
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Albania
17
Informant
M. K. McPhillips(
Relation, if any
(Address)
DSH-
A TRUE COPY
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED November 25, 1946
18 DATE OF
DEATH
November ..... 20
(Month)
"(Day)
1946.
19 I HEREBY CERTIFY, That I attended deceased from April 17, 19 41, to November 20 1946 I last saw h ..... i.m ... allve onNovember ...... 20 19.446 death Is sald to have occurred on the date stated above, at ....................... m. Duration Immediate cause of death
Lobar pneumonka
2-3days
Due to.
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?.
.Clinical
20 Was disease or injury in any way related to occupation of deceased ?
If so, spoolfy (Signed) .... Pasquale ..... Buenicento M. D.
(Address) ...... D.S.H.
Date 77/220 46.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ..... H.olten.
(Cemetery)
Ranvers
...
DATE OF BURIAL
November .... 21
22 NAME OF
FUNERAL DIRECTOR
Clarence .... R ...... Lyons.
ADDRESS
Danvers
Received and filed DEC 7 1946 19
(Registrar of City or Town where deceased resided)
{
(If U. S.
War Veteran,
speolfy WAR)
5 years 7 months
3 days.
In this community
yr8.
mos.
days.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
.Danvers. (City or town making return)
Registered No.
221
1
PLACE OF DEATH
50m- (b)-6-44-14607
Physician
301 A
1
PLACE OF DEATH
Jutfolk (County) Winthrop (City or Towr Cembulano
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.
225
Registered No.
d in a hospitalor instituti ". !
i give '.ts NAME :- steal i stree: ard numberi )
PHYSICIAN - IMPORTANT
2 FULL NAME
If deceased is a married. : d Med ir divorced woman, g.fe a.so na. le?
a) Residence. NO. 472 Winterag
( Usual place of abode
Length of stay: In hospital or institution
(Before death
( Specify whether
years
months
days.
In this community
mus. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4
COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
write the word undound
5a If married, widowed or divorced HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
William
Ciclar
Husband's name in fal
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE 54
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Industry 10 or Business:
house wife at home
11 Social Security No ...
12 BIRTHPLACE (City).
(State or Country)
Bastão mais.
13 NAME OF
FATHER
William Saving
14 BIRTHPLACE OF
FATHER (City)
(State or Country
Boston, mint.
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Burton
Relation, if any
17 Informant (Add: 72 Winthro
N
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with the BEFORE the burial or transit pergut was issued: Watters
(Signature of Agent of Board of Health of other)
Officer
11/29/46
(Date of Issue ci Permit)
18 DATE OF DEATH
Month 28
1946
19 I HEREBY CERTIFY. That I attended deceased from
2
I last saw h 3
have occurred on the date stated above al
m.
Duration IMPORTANT
Immediate cause of death cardiac
failure.
Due to
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to cecupation of deceased? It so, specify
(Signed)
Edward
. M. D.
(Address
148 winter
Date 11/28 19 16
21 Holy Cross
Malden (City r Town
DATE OF BURIAL
Dec 2
46 19
22 NAME OF
FUNERAL DIRECTOR
Murray, Hurray
ADDRESS
Revere What.
19
Received and Filed NOV 2 9 1946
( Registrar)
If deceesed wes a U. S. Wer Veteren, G. L. Chep. 46. Section 10, requires physicians to insert e recital to thet effect. Corrected
100m-9-44-14955
(Official Designation)
IMPORTANT
Physician
Underline the cause to which death should be charged sta- tıstically. A
Place of Bunal, Crematie
or Removal.
Winthrop
Adamon rue Savey
Was deceased a 2. S. War Veteran, if so specify WAR
St.
Winter uf nuntes dent. give citf rt wi and State 4 yes.
-
MEDICAL CERTIFICATE OF DEATH
6,10 Mais-28 1150
, 19
19 . death is said to
12/1/16
PARENTS
route Whatthey Com
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 hy 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 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 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 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 110 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 hoard 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 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, 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 ohtained 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 by 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 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 body has been sooner obtained hereunder. If the death certificate contains a recital, as required
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