USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 69
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(Include pregnancy within 3 months of death)
IMPORTANT
Major findings: Of operations none
Date of
Of autopsy non
What test confirmed diagnosis? X-ray, - clinica
changed sta- morally.
20 Was disease or injury in any way related to occupation of deceased
If so, specify
(Signed)
Jacob J. abrams M. W
M. D (Address562@haley.it HarAnthrop
21
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby
Boston
ADDRESS
Received and Filed
OCT 5
1948
19
(Registrar)
100M-7-46-19068
No.
(Usual place of abode)
Length of stay: In hospital or institution
(Before death)
3 SEX
4
COLOR OR RACE
male
white
5a If married, widowed or divorced
HUSBAND of .
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
Years
Usual
9 Occupation:
Pressman
11 Social Security No.
12 BIRTHPLACE (City).
Boston
13 NAME OF
FATHER
John Shea
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Ireland
16 BIRTHPLACE OF
MOTHER (City).
(State or Country) Ireland
17
James J. Shea
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
PARENTS
See instructions and extracts from the laws on back of certificate.
DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.
ÅGE 68
11
Months
19
Days
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
widowed
Mary O'Donnell
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
If less than 1 day .. Hours Minutes
Industry
10 or Business:
Post Publishing Co
011-09-5742
(State or Country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Catherine Marshall
Rsom, if any )
Informant (Address) 289 Pleasant Street Winthrop DATE OF BURIAL September 30 1948 19
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Makeeles. (Signature of Agent of Board of Health or other) Health Officer 9/28/48 (Official Designation) (Date of Issue of Permty
Winthrop Community Hospital
2 FULL NAME
James P. Shea
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
289 Pleasant Street Winthrop
St.
Hospital
years
months
1 Olays.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
18 DATE OF
DEATH
That I mended deceased from · Capt: 27, 1948
9:30 Aily Duration
Physician Underline the cause to which death should be
Date Sept. 20 48
1
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 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 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 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 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 heen sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten vi 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, 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 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 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 hody lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to 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 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 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 hy 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 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
FORM APPROVED Budget Bureau No. 41-R132-42
Stale File No.
Registrar's No.
194
State of
NEW HAMPSHIRE
1. PLACE OF DEATH:
2. USUAL RESIDENCE OF DECEASED:
(a) County
Carroll
(a) State
Mass
(6) County
Suffolk
(c) City or town
Winthrop
(b) City or town
Freedom
(c) Name of hospital or institution:
(If outside city or town limits, write RURAL)
(If outside city or town limite, write RURAL)
(d) Street No.
159 ... Winthrop St
(If not in hospital or institution. write stroet number or location)
(d) Length of stay: In hospital or institution
In this community
6_days
(Specify whether
years. months or days)
3. (a) FULL NAME Allen Clifford Bangs
20. Date of death: Month
July day
10
year
1948
hour
minute 45 pm
2L. I hereby certify that I attended the deceased from
19
to
19
4. Sex male
6. (b) Name of husband or wife
6. (c) Age of husband or wife f
alive
years
22,
1944
(Day)
(Year)
8. AGE: Years
Months
Days
If less than one day
Due to Code No. 83A1 97
3
9
18
hr.
min
Mass.
Due to
Congenital_vassular disease
(State or foreign country)
10. Usual occupation
(City, town. or county)
11. Industry or business
Other conditions.
PHYSICIAN
( 12. Name Allan C. Bangs
13. Birthplace
Winthrop
Mass
14. Maiden name
Margaret Crane
Major findings:
Of operations
15. Birthplace
Charlestown.
Mass
(City. town. or county)
(State or foreign country)
Of autopsy
16. (a) Informant's own signature __ Allan C.Bangs
(b) Address __ 159 Winthrop_St. Winthrop
22. If death was due to external causes, fill in the following:
(a) Accident, suicide, or homicide (specify)
(Yesr)
(6) Date of occurrence
(c) Where did injury occur? (City or town) (County) (State)
18. (a) Signature of funeral director Herbert Marsh
(b) Address _Winthrop-St-,Winthrop,Mass.
(Specify type of place)
While at work? (e) Means of injury
| 23 Sanature Francis J. C .Dube MD (M. D. or other)
Address Ctr. Ossipee, Med. Ref. Date signed 7/11/48
8-6917 a
U. S. GOVERNMENT PRINTING OFFICE
6-13493-1 OCT 19 1948
Carroll County
3. (b) If veteran, name war
3. (c) Social Security No.
5. Color or
race white ..
6. (a)Single, widowed, married,
divorcedsingle_(
that Nast saw h
alive on
19
and that death occurred on the date and hour stated above.
Duration
Immediate cause of death Cerebral Hemorrhage
7. Birth date of deceased Sept.
(Month)
MOTHER FATHER
-
Underline the cause to which death should be charged sta- tistically.
(d) Did injury occur in or about home, on farm, in industrial place, in public place?
19. (a) 7/11/48 (b) Edwin A. Calley
(Date received local registrar) (Registrar's signature)
MEDICAL CERTIFICATION
(If rural, give location)
(e) If foreign born, how long in U. S. A .? years.
STANDARD CERTIFICATE OF DEATH
DEPARTMENT OF COMMERCE
BUREAU OF THE CENSUS
(City. town, or county)
(State or foreign country)
17. (a) __ burial
(b) Date thereof
7/13/48
(Burial, oremation, or removal)
(Month) (Day)
(c) Place; burial or cremation Winthrop .Cemetery
(Inchide pregnancy within 3 months of death)
9. Birthplace
Winthrop
R-301 A Suffolk
1
PLACE OF DEATH
( Grunty) Winthrop (City or Town) 45 Walchineft
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. 195
Registered No. { {If death occurred in a hospital or institution. { give its NAME instead of street and numher) St.
2 FULL NAME
( If deceased is a married, widowed or dupred woman, give also maiden name.)
(a) Residence. No.
65 Wilshire
(Usual place of abode )
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
... .
yeara
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
( write the word) married
Sa If married, widowed, or divorced Georgia Sakzeelandis HUSBAND of
(or) WIFE of
outrouba ( Husband's name in full)
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
8 AGE
22 Years Months Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Retired
Industry
10 or Business :
Restaurant Business
11 Social Security No.
012-20-42.94
12 BIRTHPLACE (City)
( State or country)
Phestanna, Sparta
Greece
PARENTS
14 BIRTHPLACE OF
Phrestanna, Sparta
FATHER (Clty)
(State or country)
greece
15 MAIDEN NAME
OF MOTHER
Demetria Sakellarilis
Phestanna Sparta
16 BIRTHPLACE OF
MOTHER (City)
( State or country)
quece
17 Informations- Georgia Rozantes, Relatton, If any wife ( Address) 65 willshine V. We trop+
I HEREBY CERTIFY thet a satisfactory standard certificate of death was filed with me BEFORE the burial )or transit permit was Issued : Walter A. gallery
(Signeture of Agent of Board of Health or other) Wealth Milicer
10/4/48
(Official Designation)
(Date of Issue of /Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Oct
2
1948
( Month)
( Day)
( Year)
19 | HEREBY CERTIFY,
That I attanded deosased from
Sept 28
.
1948, to.
Oct. 2
1948
I last saw him
alive on
Oct 2
, 1948, death Is said to
have occurred on the date stated above, et
6 70 P.M.m.
Immediate cause of death Coronary thrombosis
& congestive heart failure
Duration
IMPORTANT
Due to
Due to
Other conditions
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings :
Of operations
Dete of.
Of autopsy
What test confirmed diagnosis?
5kg
20 Was disease or injury in any way related to oooupation of deceased ? NO
If so, specify
( Signed )
(Address) 4:47 Appley/t Whithrea Date
. M. D.
21
Winderop Com.
Sctv 1948
Withuop
Place of Burial, Cremation or Removal.
DATE OF BURIAL
Det .
4
(City or Town) 0 .48
22 NAME OF
Christy J. mauris
FUNERAL DIRECTOR
ADDRESS
77 Summer St. Sym, mass
Reosivad end Alad
OCT 5 1948
19
( Registrar)
100m-(g) - 1.45.15510
terms, so that it 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 effect. extracts from the laws on back of certificate.
No.
Nicholas Rozantes
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify W'AR)
no
0
St.
( If nonresident, give clty or town and State)
(Cive maidfh namOof wife in full)
46 years
13 NAME OF
FATHER
Costantinos Rozantes
Physician Underline the cause to which death should he charged st.t. tistically.
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 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 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 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 iu 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 shal forfeit ten dollars. For the purposes of this sec- tion and of secti fortych dorty-six and fort)-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 heen huried, 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 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 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 hody is huried. No such permit shall be issued until there shall have heen 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 he accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard 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 by 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 heen sooner obtained hereunder. If the death certificate contains a recital, as required
by section te navy or marı. engaged, suck or its agent, 11 countersign it The person to I vapter forty-six, that the deceased served in the army, cor s of the United States in any war in which it has been er .I shall appear upon the permit. The hoard of health, on receipt of such statement and certificate, shall forthwith ud transmit it to the clerk of the town for registration. whom the permit is so given aud the physician certifying the cause of de th shall thereafter furnish for registration any other neces- sary informat manner or cat
n which can he obtained as to the deceased, or as to the : 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 undertaken or other person shall hury a human hody or the ashes thereof which have heen brought into the commonwealth until he has re- ceived a permit so to do 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 hody is to he huried 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 ahortion, 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 morhid 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 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 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
M R-302
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
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