USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 87
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Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how. ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
-301 A
occ Instructions anfd extracts ffoff the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Canada
(State or Country)
15 MAIDEN NAME
OF MOTHER
Emma Ramacourt
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Canada
17 Samuel Rinellil
Informant (Address! 122 Trenton St. East Bos ton I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health of other) Health Offices (Official Designation) (Date of Issue of Permit}
12/23/46
MEDICAL CERTIFICATE OF DEATH
3 SEX Female
4 COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed or divorced HUSBAND of ..
(or) WIFE of
(Give maiden name of wife in full)
Samuel Rinella
(Husband's name in full)
35
years
7 IF STILLBORN, enter that fact here.
ÅGE32 Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
House wife
Industry
10 or Business:
At Home
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or Country)
Canton Mass.
apr . 6,4% IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased? 200
If so, specify
(Signed)
. M. D.
(Address) 186/ Lanceen STCB
12-22
1946
21
St. Michael Cemetery
Bos ton
Place of Burial, Cremation or Removal."
(City of Town)
DATE OF BURIAL
Dec. 24 -46
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
laga St. kg
OR túlon RaBino
100m-9-44-14955
PLACE OF DEATH
Suffolk (County)
notified 1/10/17
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.
246
(If death occurred in a hospital or institution, !
No.
Winthrop Community Hosp.
St.
-
give its NAME instead of street and number) )
2 FULL NAME
Bar bara Rinella (If deceased is a married, widowed or divorced woman, give also maiden name.)
3
PHYSICIAN - IMPORTANT ( Was deceased a U. S. War Veteran, if so specify WAR) no
(a) Residence.
No.
122 Trenton St. East Boston
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
months
2
days.
In this community
yrs.
mos. days.
18 DATE OF
DEATH
December
22
(Day)
(Month)
1946
(Ycar)
19 I HEREBY CERTIFY,
That I attended deceased from
, 1976
, to
Wer 22,
, 19
46
I last saw her
alive on
Der 22 , 19 46, death is said to
have occurred on the date stated above, at
4 AM m.
Duration
Immediate cause of death
Eclampsia . diemario
IMPORTANT Va20, 1048
Due
Tocenia of Programy
Mer 29,1446
Due to ...
Other conditions
Programy
(Include-pregnancy within 3 months of death)
Healed luberculosis - thomasplanty
Major findings: Tuberculos, The pirate
Of operations
Date of.
Received and Filed DEC 30 194Registrar)
19
1
-Berton Winthrop
(City or Town)
(Usual place of abode)
years
PERSONAL AND STATISTICAL PARTICULARS
×
6 Age of husband or wife if alive
13 NAME OF
FATHER
Joseph Dube
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 e death of a person whom he has attended during his last illness, at the quest of an undertaker or other authorized person or of any member of e family of the deceased, furnish for registration a standard certificate death, stating to the best of his knowledge and helief the name of the ceased, his supposed age, the disease of which he died, defined as re- ired hy section one, where same was contracted, the duration of his last ness, when last seen alive by the physician or othicer and the date of s death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the eceding section or hy section forty-five of chapter one hundred and four- en, shall, if the deceased, to the best of his knowledge and belief, served the army, navy or marine corps of the United States in any war in which has been engaged, insert in the certificate a recital to that effect, speci- ing the war, and shall also certify in such certificate both the primary ad the secondary or immediate cause of death as nearly as he can state e same. For neglect to comply with any provision of this section, such ysician or officer shall forfeit ten dollars. For the purposes of this sec- on and of sections forty-five, forty-six and forty-seven of said chapter e hundred and fourteen, the word "war" shall include the China relief pedition and the Philippine insurrection, which shall, for said purposes, deemed to have taken place between February fourteenth, eighteen indred and ninety-eight and July fourth, nineteen hundred and two, and e Mexican border service of nineteen hundred and sixteen and nine- en hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human ody in a town, or remove therefrom a human body which has not been ried, until he has received a permit from the board of health, or its gent appointed to issue such permits, or if there is no such board, from e clerk of the town where the person died; and uo undertaker or other erson shall exhume a human body and remove it from a town, from one metery to another, or from one grave or tomb other than the receiving mb to another in the same cemetery, until he has received a permit from e board of health or its agent aforesaid or from the clerk of the town here the hody is buried. No such permit shall be issued until there shall ve been delivered to such board, agent or clerk, as the case may be, satisfactory written statement containing the facts required by law to he turned and recorded, which shall be accompanied, in case of an original terment, by a satisfactory certificate of the attending physician, if any, required by law, or in lieu thereof a certificate as hereinafter provided. there is no attending physician, or if, for sufficient reasons, his certificate innot be obtained early enough for the purpose, or is insufficient, a physi- an who is a member of the board of health, or employed by it or by the lectmen for the purpose, shall upon application make the certificate re. tired of the attending physician. If death is caused by violence, the medi- al examiner shall make such certificate. If such a permit for the removal a human body, not previously interred, from one town to another within e commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the ndertaker desiring to make such removal shall constitute a permit for ich removal; provided, that such body shall be returned to the town from hich it was removed within thirty-six hours after such removal, unless 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 stetiun ten vi chapter lolly -six, luat toc 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 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 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 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 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 deatlis 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, but also deaths from disease resulting from injury or infection related to occupation, the sudden.deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
01 A
1
PLACE OF DEATH
... County) Winte (City or Towny ... Wm. Comm. Hopital 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.
247 [ .....
SŁ { {If death occurred in a hospital or institution, give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR).
no
122 Brookfield 19d.
St.
( If nonresident, give city or town and State)
Length of stay : In hospital or Institution ..
( Before death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
Marcel
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
...
( Give maiden Fame of wite/in hills
(or) WIFE of
( Husband's name In (full)
6 Age of husband or wife if aliva
838
years
7 IF STILLBORN, enter that fact here.
8 AGE/ 2 Years Months Days
If less than 1 day
Hours
Minutas
Usual
9 Ocoupetion :
Broken: D
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( Siate or country)
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (Clty)
(State or country)
Lutand.
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 Informant ( Address)
Relation, Ifany
I HEREBY CERTIFY that a satisfactory standard oartifioate of death was filled with one BEFORE the burial or trangty permit was Issued: Walter Baker
(Signature of Apart of Board of Health or other)
# Dec. 28/46
(Official' Designation) ( Date of Toque of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Dew.
25
1946
(Month)
(Year)
19 | HEREBY CERTIFY.
(Day) That I attended deosased from aug 1943. 1943 Ło 194/6
I last saw h ( b) aliva on
Dec 25, 1946 death Is said to
have occurred on tha dato stated abova, at 2.45 Pm.
Immediata oause of daath. Coronary Thrombosis
IMPORTANT
Sudden
5 years 8 days
Other conditions.
( Include pregnancy within 3 months of death)
Major findings: Of operations 2
Data of.
Of autopsy
X-Pay
What test confirmed diagnosis? Clinical Signs
20 Was disease or injury in any way ralated to occupation of deceased ?
If so, specify
(Signed) (Address) Winthrop
M. D.
Date Lpc 27 1944
21
Place of Burial, Cremation of Removal. (City or Town DATE OF BURIAL 12/28/46 19
22 NAME DF
FUNERAL DIRECTOR ..
ADDRESS
Received and Alled
DEC 30 1945
19
100m- (g) - 1-45-15510
if deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
2 FULL NAME.
Dancial Nechal Felcher
( If deceased is a married,/widowed or divorced goman, girejalsy maiden name.)
(a) Residenca. No.
(Usual place of abode)
years
months
4
days.
In this community 35
mos.
Duration
Due to
Chronic hypertension
Due to
Virus Premonia
.........
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
Winthrop
HO
Registared No.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or 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 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 hetwecn February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican horder service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human hody in a town, or remove therefrom a human hody which has not 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 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 tomh 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 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, 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 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
hy section ten oi 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 he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the 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 such hoard, from the clerk of the town where the hody is to he buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled 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 hcen 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) No.
Winthrop Community Hospital
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. 248
(If death occurred in a hospital or institution, { give its NAME instead of street and number) }
2 FULL NAME
Miss Adelaide Belcher
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, „if so specify WAR) -ass.
St.
Winthrop,
(If nonresident, give city or town and State)
LG
mos.
-
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4
COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Single
18 DATE OF
DEATH
December
30
1946.
(Month)
(Day)
(Ycar)
1911 am-HEREBY CERTIFY,
That I attended deceased from
Dec. 30, .19 46 . to
Dec. 30, .1946
I last saw h er alive on
Dec. 30
.
19 46 death is said to
have occurred on the date stated above, at
12:45 Pm.
6 Age of husband or wife if alive
years
7 IF STILLBORN, enter that fact here.
AGE.
8 66 Years 2 Months -. Days
If less than 1 day
. Hours
Minutes
Usual
9 Occupation:
At Home
Industry 10 or Business:
11 Social Security No. .
None
12 BIRTHPLACE (City)
Winthrop
(State or Country)
Mass.
13 NAME OF
FATHER
Wilbur Belcher
14 BIRTHPLACE OF
FATHER (City)
Winthrop
(State or Country)
Mass.
15 MAIDEN NAME
OF MOTHER
Sarah Morse
16 BIRTHPLACE OF
MOTHER (City)
Buxport
(State or Country)
Maine
17 Eunice Belcher CouBaron, if any
Informant (Address 339 Winthrop St Winthrop I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Baker
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