USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 76
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
........
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
-301 A
Suffolk (County)
12/8/48
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.
219
No.
Winthrop Community Hospital
St. { (If death occurred in a hospital or institution, I 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 It 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 wite if alive
years
7 IF STILLBORN, enter that fact here. Still-born
8
AGE
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual 9 Occupation:
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City).
(State or Country)
winthrop
Mass.
13 NAME OF
FATHER
Gasto Sousa
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Portugal
15 MAIDEN NAME
OF MOTHER
Maria Palmarino
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Boston
17 Gasto Suosa
Antormant (Address)
father any ) 337 Maverick St. East Boston
I HEREBY CERTIFY that a satistactory standard certificate of death was filed with me BEFORE the burial or fransit permit was issued: Walter & Bakery (Signature of Agent of Board of Health-of thef) Healthe Officers .. 4 (Official Designation) (Date of Issue of Permit) 148
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH nor (Month)
nov.
.
That I attended deceased from 11
. 19 xf
I last saw him
alive on
have occurred on the date stated above. at
Immediate cause ot death 8:31
Stillborn
Due to Prolapsed Cord
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date ot
Of autopsy
What test confirmed diagnosis?
clinical
Duration IMPORTANT
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease of injury in any way related to occupation of deceased? It so, specify
(Signed)
M. D.
(Address)
21 Holy Cross Cemetery
Malden
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
Nov. 3
48
19
22 NAME OF FUNERAL DIRECTOR
Vincent
ADDRESS
9 Chelsea St. East Ro ston
Received and Filed
19
NOV 4 1948
(Registrar)
7- 138
pcc IlIst uctions and catracts from the laws off 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.
100M-7-46-19068
1
PLACE OF DEATH
2 FULL NAME
Baby Boy Sousa.
(If deceased is à married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
337 Maverick St. , E. Boston
St.
(Usual place of abode)
Length ot stay: In hospital or institution
(Before death)
(Specify whether)
years
months
days.
(Day)
1948 (Year)
19 I HEREBY CERTIFY, 48 , to
?you.
١
. . 19% , death is said to
t= G. m.
"Garten 238 Trever che ate
PARENTS
Winthrop (City or Town)
de of thì be di co or pr na in: ce
of p th of re be
an bc se b ur to th ar to ck tl a re 111 by at ea of ×1 If If Or fo DE fri 11€ 1 S
D D R 0
S
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 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 in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate hoth the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human 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 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 tomh other than the receiving tomh 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 hody 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, 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 board of health, or employed by 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 body, not previously interred, from one town to another within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as 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
by section ten ui 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 be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the 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 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 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 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 rause 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 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
...
IR-301 A
Suffolk (County)
Winthrop (City or Town)
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 .. 220
........ St. § (If death occurred in a hospital or institution, } give its NAME instead of strect and number)
2 FULL NAME
William P. Boudreau
(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)
(a) Residence. No.
30
Valdemar Ave.
St.
(Usual place of abode)
(If nonresident, give city or town and State)
3
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 Male
4 COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORLPrried
5a If married, widoved or divorød nnegan
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. 68
years
7 IF STILLBORN, enter that fact here.
8
AGE72
Years.
Months
Days
If less than 1 day
Ilours .
Minutes
Usual
9 Occupation:
FiremanRetired
Industry
10 or Business :
Boston Fire DEpt
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country)
Gloucester
Mas's
13 NAME OF
FATHER
Lamong Boudreau
14 BIRTHPLACE OF
FATHER (City)
Arichat
(State or Country)
N S.
15 MAIDEN NAME
OF MOTHER
Delena
Landry
16 BIRTHPLACE OF
MOTIIER (City)
(Statc or Country)
Arichat
N. S.
17
Informant
Mary
Budreau
(Relation, if any)
(Address)
30
Waldemar Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : 1 (Signature of Agent of Fond of Health or other) Walter Sahen 11/6/48
(Official Designation) H.O.
(Date of Issue of Permit)
18 DATE OF
DEATH
(Month)
(Day)
(Year)
I HEREBY CERTIFY,
September 6, 1998,
Fpat I attended deceased from
to.
19.
48
I last sawh I'm alive on
No. 5, 1948,
ath is said to
have occurred on the date stated above, at
2P.
.. m.
Duration
IMPORTANT ....
Due to
1
Due to.
General anTeri aclemi
Other conditions
(Include pregnancy within 3 montlis 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 }.24
If so, specify
O Juma Stoffer
M. D.
(Signed)
(Address)
21Breed SEL Date Wo J 19 43
21.
Oak Hill
Gloucester
Ma.s.s.
...
Place of Burial, Cremation or Removal.
8
Site or Town)
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Received and Filed.
NOV 1 0 1948
......
.. 19
(Registrar)
DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.
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
100M-10-47-22153
1
PLACE OF DEATH
No
30 Waldemar Ave.
-
MEDICAL CERTIFICATE OF DEATH
5
1448
Immediate cause of death
Cerebral Familiares- N.
3 mes
Underline the cansc to which death should be charged sta- tistically.
DATE OF BURIAL
John F. O malley
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 wnom 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 ana of scctions 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 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 shail 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 shail 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 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 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 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 funcral 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 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 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-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. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that offoot. PARENTS
100m. (g) - 1-45-15510
17
Informant.
Ralph .K ... Burns
( Address)
198 Somerset Ave. Winthrop
DATE OF BURIAL.
22 NAME OF
toward SUturer.6
FUNERAL DIRECTOR
ADDRESS
nevres nais
.......
(Signature of Agent of Board of Health or other) 11.8 145
(Date of Imque of Permit)
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
Or DIVORCEO Married
Sa If married. widowed, or divorced
HUSBAND of
Ralphfiromain remegof wife In full)
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if aliva 53
years
7 IF STILLBORN, enter that fact hera.
8 AGE 5.4 Years O ..
Months
.16 .. Days
If less than 1 day
Hours
Minutes
Usual
9 Ocoupetion :
Housewife
Industry
Own home
10 or Business :
11 Social Security No.
021-09-8325
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
William J Gatter
14 BIRTHPLACE OF
FATHER (Clty)
London
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Florence E Diffin
16 BIRTHPLACE OF
MOTHER (City)
Calais
(State or country)
Maine
21
Winthrop
Winthrop Nov.6.
Place of Burial, Cremation or Removal.
(City or Town)
Nov .
9
48
19.
I HEREBY CERTIFY that a satisfactory standard certificata of death was filled with me BEFORE the burist or transit permit was Issued : if alter
Realite luces
(Official Designation)
18 DATE OF
DEATH
200.
6
1948
( Month )
(Day)
(Year)
Sept 5,
1948
to ...
400 5,
19.
48
I last saw h.C ............. allva on
Nov5
19.5%, death Is said to
have occurred on tha date stated above, at.
10 45 A m.
Immediate gause of death.
Mesenteric Thrombosis
IMPORTANT
.... ........ 8 weeks
Due to.
Due to
Other conditiona.
( Include pregnancy within 8 montbe of death)
Major findings :
Of operations
ExsanguinAted Bowels
2076 Data of Sept7, 1945
Of autopsy.
Whet test confirmed diagnosis ?.... Eberation.
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way ralated to gooupation of deceased ? 200
If so, spaolfy.
( Signed)
Damil 200/Jun.
M. D.
(Address)
78Wash Left WinthropBate 2506,
19/22.
1
PLACE OF DEATH
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
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