Town of Winthrop : Record of Deaths 1947, Part 78

Author: Winthrop (Mass.)
Publication date: 1947
Publisher:
Number of Pages: 544


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 78


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2 FULL NAME albert W. filcka


( If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence. No.


44 Fairview


(Usual place of abode)


Length of stay: In hospital or Institution


(Before death)


(Specify whether)


years


months


days.


In this community 20 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


4 COLOR OR RACE


malel White


5 SINGLE


MARRIED


WIDOWED


Widowed


·


5a If married, widowed, or divorced HUSBAND of


Delia G. Connelly (Give tnaiden 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


75 %


AGE


Years


Months


Days


If less than 1 day


Hours


Minutes


Usual


9 Occupetion :


Comparator


Industry


10 or Business :


Newspaper


11 Social Security No.


12 BIRTHPLACE (City)


( Siate or comitry)


East Boston Mass


13 NAME OF


FATHER


Frederick &-files


14 BIRTHPLACE OF


FATHER (City)


( State or country)


Denmark


15 MAIDEN NAME


OF MOTHER


Henrietta Smidt


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Germany


17 Fred Silch


Informant


( Address )


44 Faxaslew Al Wine


I HEREBY CERTIFY that a satisfactory standard certificata of death was Aled With me BEFORE the burtel or fransit permit was Issued : Matter of M'avez


(Signature of Agrat of Board of Health or other)


Health officer 12/1/47


/(Omcial Designation) 10 ( Date of Trque of Permit)


18 DATE OF


DEATH


nov


27 1947


(Sfonth)


( Day)


( Year)


19 | HEREBY CERTIFY,


20 No


.


1947. 10.


27 Now


134)


I last saw h ........... . allve on.


NN 27


....


. 19Y ... > death is sald to


have occurred on the date stated above, at.


9.15 A


m.


Immediate cause of death.


Chronic Ladoriti


IMPORTANT


1440


Due to


Due to


Other conditiona.


( Include pregnancy within 3 months of death)


Major findings:


Of operations


Date of


Of autopsy


What test confirmed diagnosis ?


Urinalysis


IMPORTANT


Physician Underline the cause to which death should be charged N.I. istically


20 Was disease or injury in ony way related to oooupation of decersed ?


If so, specify.


...


( Signed)


. M. O.


( Address)


late 11-4


19Y.2


21


Winthrop


Winthrop


If any


l'lace of Burial, Crematinn or Removal.


(City or Town)


DATE OF BURIAL


Dec 1


19


47


22 NAME OF


FUNERAL DIRECTOR


Charles H. Treanor


ADORESS


East Boston


Received and Alad


D- C 2 1947


19


( Registrar)


If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physiolans to insert a recital to that effeot. PARENTS


100m. (g)-1.45.15510


PLACE OF DEATH -


No.


PHYSICIAN · IMPORTANT (Was deceased a U. S. War Veteran. if so specify WAR)


no


St.


(If nonresident, give elty or town and State )


That I attended deosased from


Duration


( write the word)


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 hest 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 hetwecn 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 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 tomh 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 huried. No such permit shall be issued until there sball have been delivered to such board, agent or clerk, as the case may he, a satisfactory written statement containing the facts required hy 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 buman body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for 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


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 by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . .. - General Laws, Chap. 38, Sec. 6.


No undertaker or other person sball bury a human body or the asbes 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 sucb 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 sucb deaths only as tbose of persons who, though disabled by 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 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, astbenia, 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 be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


-301 A | + Suffolk


12/8/47


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.


237


§ (If death occurred in a hospital or institution. ¿ give its NAME instead of street and number)


2 FULL NAME Baby Boy Del Signore (If deceased Is a married, widowed or divorced woman, give also maiden name.) Summer Places. Cast


(a) Residence. No (Usual place of abode) Length of stay: In hospital or institution. (Specify whether)


years


months


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Male White


4 COLOR OR RACE


(write the word)


5 SINGLE


MARRIED


WIDOWED fugle


or DIVORCED


Sa If married, widowed, or divorced HUSBAND of.


(or) WIFE of.


(Husband's name in full)


6 Age of husband or wife if alive ... 22 years


7 IF STILLBORN, enter that fact bara allcom


8


ÅGE .Years Months .Days


If less than I day Hours Minutes


Usual 9 Occupation :. Industry 10 or Business:


Il Social Security No ..


12 BIRTHPLACE (City)


(State or country)


13 NAMĘ OF


Laurence Del Signore


PARENTS


15 MAIDEN NAME


OF MOTHER


Florence Fratelli


16 BIRTHPLACE OF MOTHER (City) ........ (State or country)


Botten


made


117 Jaurquellel Signing father Relation, if any


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Walter & Bakes f (Sighature of Agent of Board of Health or other) Healthe Alicer 13/1/47


(Date of Issue of Permity


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


28 1947


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY. 25,


That I attended deceased from


1997, RN. 28


19.99


I last saw h .........


.. alive on


19


death is said to


have occurred on the date stated above, at ... m.


Immediate cause of death.


Duration IMPORTANT


Due to


Due to.


Other conditions.


(Include pregnancy within 3 months of death)


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.


Yesquale Color


(Signed)


......... M. D. (Address) 238 Daniil 025 Date 11/28 1947


Maldin Place of Burial, Cremation or Removal. Kelty or Town)


DATE OF BURIAL ........


184.7


22 NAME OF


balance Is the tro


ADDRES 20KMared LSB


Received and filed DEC 2 1947 19


(Registrar)


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of decor ATION is very important. See instructions and extracts from the laws on back of certificate.


100m-2-'40-D-729-a


PLACE OR DEATH


(County)


1


Manthrop (City or Towny


intherap Community


St.


(If U. S. War Veteran, specify WAR) ......


(If nonresident, give city or town and state)


Of autopsy.


What test confirmed diagnosis ?.


Major findings: Of operations.


14 BIRTHPLACE OF FATHER (City) (State or country) mass


Bastin


.Date of


21


29 Dec-1


(Officlal Designatlon)


(Give maiden name of wife in full)


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, definded as required 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 liis death . . . Gen. Laws, Chap. 46, Sec. 9.


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 receiv- ing 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 In- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make tbe certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as 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 re- moval of such body bas 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 and the physiclan certifying 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 deatb, which the clerk or registrar may require .- Chop. 114, Sec. 45, G. L., (Tercentenary Edition).


No undertaker or other person shall bury a buman body or the ashes tbereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or Its agent appointed to issue such 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 tbe observance of tbe following rules of practice:


(1) Attending physicians will certify to sucb 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 tbose of persons who, though disabled by recognized disease unrelated to any form of injury, bave died without recent medical attendance or whose pbysiclan Is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemla), 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 tbe disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principai cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.


Statement of Occupation .- Precise statement of occupation is very Important, so that the relative healthfulness of various 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 bousework, write housework. For a person engaged in domestic service for wages, bowever, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


R-302


The Commonfocalth of Massachusetts


State Board of Health Bureau of Vital Statistics


NON RESIDENT TH


FLORIDA


State File No. 14595


Registrar's No.


41


1. PLACE OF DEATH:


(al County.


Pinellas


District No.


39-02


Precinct No.


(b) Precinct


(Write name, not number)


Tarpon Springs


City or


Town No/39-522


(d) Name of hospital or institution Tarpon Springs Hosp (If not in hospital or institution. write street number or location)


(e) Length of stay: In hospital or institution


22 days


At place of death


22 days


(Specify whether years, months or days)


2. USUAL RESIDENCE OF DECEASED:


(a) staMassachusetts


(b) couSuffolk


(c) Ofty or Town


Winthrop


(d) Street No.


12 Jefferson Street


(If rural, give location)


(e) Citizen of Foreign country?


no


yes or no


If yes, nama country


238


return)


ation, haber )


te)


days.


r)


sed from 19 is said to


Duration


Physician


Underline e cause to hich death hould be arged sta- tically.


ed ?


.. M. D.


(City or town) (County) (8tn ts) 19


(d) Did injury occur In or about home. on farm, In industrial place, In public place? (Specify type of place)


43A While at work ? (s) Means of injury


3. Signature


M. D.


(a) Address


Date Signed 7-1-47


(Registrar of city or town where death occurred)


DATE FILED


19


Received and filed


DEC 161947


( Registrar of City of Town where deceased resided)


Day


hour


9


Minute SES 8 3.


21. 1 hereby certify that I attended the deceased from


may 30


19 47


To


Thely 10 47:


that I last saw his_,


alive on


1947:


and that death occurred on the date and hour stated above.


Duration


Immediate cause of death Cerebral


1 catro


Due to


Due to


Other conditions (Include pregnancy within 8 months of death)


Major findings: of operationa


(Give date of operation)


Undertino the cause to which death shauld ba charged sta- tistically.


of autopay


22. If death was due to external causes, fill in the following:


(a) (Probably) Accident. suicide, homicide (specify)


(b) Date of occurrence


(c) Where did Injury occur?


17. Burial, cremation or removal?


Removal


17 (s) Date


7/9/47


17 (b) myBoston, Mass.


M. Poderal Director's Signatur Sene Aneta


18 (a Address


Tarpon Springs / Florida


19. Filed 2/9 1047


Local Registra


MEDICAL CERTIFICATION


name war


no


No.


none


L Bex female


& Single, married, widowed or divorced widowed


6 (a) If married, widowed or divorced, husband of (or)


wife of William H. H. Young


6 (b) Age of husband or wife, If allve years


December


16. 1876


(month)


(day!


(year)


8. Ago: Years


Mantha


Days


If less than one day


70


6


21


hrs.


min.


England


9. Birthplace


(City, town or county)


(State or foreign country)


10. Trual occupation


Housewife


11. Industry or business


Home


12. Name


Samuel J. Jukes


13. Birthplace England


14. Maiden name


Helen Sarah Rudman


15. Birthplace


England


Harrys. Matteo


16. Informant's Signature


16 (n) Address


Tarpon Springs, Florida.


Mother Father


7. Birth date of deceased


3 (b) Social Security


3 (a) If veteran,


3. FULL NAME OF DECEASED Christabel Helen Young


20. Date of Death; Month,


5. Color or race


white


Year


(c) City or


Town


(If outside city or town limits, write RURAL)


19


Town) 1.9


IR-302


Middle sex


The Commonlocalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Wal tham


(City or town making return)


239


Registered No.


(If death occurred in a hospital or institution,


give its NAME instead of street and number)


Peter Edmands


2 FULL NAME


(If deceased


in a married, widowed or divorced woman, give also maiden name.)


tlantic


(a) Residence. No.


(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


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Ilale


4 COLOR OR RACE|


white


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Single


5a If married, widowed, or divoroed


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.


Stillborn


8


AGE


Years


.Months.


Dayı


if less than 1 day Hours .Minutes


Usuai 9 Occupation :


industry 10 or Business :


11 Soolal Security No ...


12 BIRTHPLACE (City)


(State or country)


Mass.


13 NAME OFVaughn Frederick Edmands FATHER


PARENTS


14 BIRTHPLACE OF


FATHER (City)


laino


(State or country).


harriot Coboy


15 MAIDEN NAME


OF MOTHER


Boston


16 BIRTHPLACE OF


MOTHER (City)


Mass.


(State of country) anniet Camands mother


17


7 Atlantic st., Wint Relation if any


Informant


( Address)


A TRUE COPY.


ATTEST :


(Registrar of city or town where death occurred) November 6 47


19


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


(Month)


(Day)


(Year)


That I


attended deceased from


CERTIFY


autopsy.


7 ....


X


Oct.


29


147


death Is said to


have oocurred on the date stated above, at.


9:25AM ... m.


Duration


immediate cause of death


Congenital atelectasis


Due to.


Due to.


Other conditions


(Include pregnancy within 3 months of death)


Physician




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