USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 13
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-301 A
See instructions and extracts from 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
PLACE OF DEATH
County) 1 Suffollo Winthrop 3
Boston 9/4
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.
31
Registered No.
-
(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)
(If nonresident, give city or town and State)
In this community
yrs.
mos,
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4
COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Single
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.
If less than 1 day
8 AGE Years Months Days Hours 35 Minutes
Usual 9 Occupation:
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City) (State or Country)
Winthrop,
muss
13 NAME OF
FATHER
Joseph anthony Bognami
Boston
14 BIRTHPLACE OF FATHER (City) (State or Country)
Man
15 MAIDEN NAME
OF MOTHER
Tereza Uliano
16 BIRTHPLACE OF MOTHER (City). (State or Country)
Boston Mars
17 Joseph R Boguand ( Relation if any
Informant (Address) 687 Bennington & Cn
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial gr transit permit was issued: Walter it Walker (Signature of Agent of Board of Health or other) Health Officer
"(Official Designation) (Date of Issue of Permit)
18 DATE OF DEATH Fab. 25- 1948
(Mont 2 6
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
Fab . 25 , 19
2/9, to trh. 26
19 8 8
I last saw h alive on Fab. 26 1549 4 death is said to 1 a. m.
have occurred on the dale stated above, at
Duration
IMPORTANT
Immediate cause of death Premature
5 months 4 days
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 occupation of deceased? If so, specify Charen Melonion (Signed) 305 Hanno V ErBer Dat (Address)
. M. D
Twan 3 1948
Woodlawn
Everett (City of Town)
DATE OF BURIAL 1945
22 NAME OF FUNERAL DIRECTOR Scaramella Funeral Lerince
ADDRESS 39 Cleans St EastKvotero
19
Received and Filed 3/3/48
MAR 4
1943
(Registrar)
X
2 FULL NAME
Baby Boy
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
68) Bennington . St.
Length of stay: In hospital or institution (Before death)
(Specify whether)
years
1 hs
months
days.
35 min
MEDICAL CERTIFICATE OF DEATH
1
IMPORTANT
Physician Underline the cause to which death should be charged std- tistically.
21 Place of Burial, Cremation or Removal. Mai 3
100M-7-46-19068
(City or Towny
Wintherof Community Hospital St. 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 persou 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 relief 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 body in a town, or remove therefrom a human hody 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 hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving 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 body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten ol 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 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 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 bealth or its agent appointed to issue such permits, or if there is no such board, from the elerk 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 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 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 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 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
R-301 A
extracts from the laws on back of certificate. Terms, so thar ir may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to insert a recital to that effeot.
1
PLACE OF DEATH
Suffolk (County)
Winthrop
-
No.
(City or Town)
97 Circuit Rd.
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.
32
Laura (Woodbury ) Close
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
97 arecent Road.
St.
(Usual place of abode)
( If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months days.
In this community
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
-
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Widow
5a If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
SamueGive gaidenrams af wife In full)
( Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE
74
Years
0
22
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupetion :
Housewife
Industry
At Home
10 or Business :
11 Social Security No.
None
12 BIRTHPLACE (City)
Aylesford
(State or country)
Nova Scotia
13 NAME OF
FATHER
William Woodbury
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Novia Scotia
15 MAIDEN NAME
OF MOTHER
Margaret Neilly
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Unable to obtain
17
In faw
Informant ..
Natalee Gilberet Daugiipefeny
(Address) 106 Circuit Rd".
21 Woodlawn
Everett
Place of Burial, Cremation or Removal.
(City or Town)
March
1
1548
DATE OF BURIAL.
22 NAME OF
Lowand 50 Ermulds
FUNERAL DIRECTOR .....
ADDRESS
Unchus make.
....
(Official Designation)
( Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH ...
Tele.
26
1948
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deosased from
19
1947, ko
84.26
I last saw h ... & ......... alive on
Feb. 2 6
19 48, death is said to
48
have occurred on the date stated above, at
m
Duration
Immediate cause of death. Broncho pneumonia
IMPORTANT
....
..............
1 dag
Dua to chelnovoscelor accident.
Due to.
gemenbizal
years
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
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, spoolfy ...
(Sig
(Address) 376 Summer Stile 8 Date 2/26
M. D.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with me BEFORE the burial or transit permit was Issued : Walter
(Signature of Agent of Board of Health or other) We allthe officer 3/1/48
Received and fled. MAR 1-1943 19
( Registrar)
100m-(g)-1-45-15510
Registered No.
{ (If death occurred in a hospital or institution, St. { give its NAME instead of street and numher)
lose
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
27 yrs.
Female
White
Months
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 persou 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 buman 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 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 sucb 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- eian wbo 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, tbe 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 sball constitute a permit for auch removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained bereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, tuat the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, sucb recital sball 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 shall bury a human body or the ashes thereof which have been brought into the commonwealth until he bas 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 sucb deaths only as those of persons who, though disabled by recognized disease unrelated to any forin of injury, bave 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 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-botel, 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
R-301
PLACE OF DEATH
SUFFOLK (County)
1 WINTHROP (City or Town) KIRKPATRICK REST HOME
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 Health3. or its Agent.
Registered No.
33
(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 WAR) .
(If nonresident, give city or town and State)
In this community
yrs.
F mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4
COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
SINGLE
5a If married, widowed or divorced
HUSBAND ot ..
(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 tact here.
8
AGE 93
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual 9 Occupation:
AT HOME
Industry
10 or Business:
"
11 Social Security No.
12 BIRTHPLACE (City)
BELFAST
(State or Country) IRELAND
13 NAME OF FATHER HUGHCORRIGAN
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
IRELAND
15 MAIDEN NAME
OF MOTHER
MARY BURNS
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
SCOTLAND
BEVERLY(
Relation, if any )
NIELE
17 31 PRATTAVIS Informant LILLIAN M. BOYD (Address) HO STATERST MALDEN
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFOREthe burial or transit permit was issued: Walter
(Signature of Agent of Board of Health or other) Health officer (Official Designation) (Date of Issue of/Permit)
3/1/48
18 DATE OF
DEATH
February 29/
1948
(Ycar)
(Month
19
I HEREBY CERTIFY,
That I attended deceased from
Feb. 25
. 19/2 . to
Fieb 29
, 19
I last saw h Or alive on
Feb 28
. 19 %, death is said to
have occurred on the date stated above, at
6.30 A
m.
Immediate causo of death
Chronic Myocarditis
IMPORTANT
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
20000
Date of
Of autopsy
Clinical Signs
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased? 720
It so, specity
...
. M. D.
(Signed)
Winthrop mais Date Fact 29 1948
(Address)
WYOMINGCEMETERY
Place of Burial, Cremation or Removal.
(City or Town)
MELROSE
DATE OF BURIAL MARCH 22
1948
22 NAME OF
Wendell M. Dyhuman
FUNERAL DIRECTOR
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