USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 27
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.. , M. D.
St. Michael
Boston
(City or Town)
DATE OF BURIAL May 127
19.50
7 NAME OF FUNERAL DIRECTOR
Joseph Curso
ADDRESS 42 Green Street Boston
Received and filed 19
MAY 2 0 1950
(Registrar)
PARENTS
18 BIRTHPLACE OF FATHER (City) (State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Guiseppa Petrazzella (Foster mother)
20 BIRTHPLACE OF MOTHER (City) (State or country)
Italy
21 Sebastiano Faro
Informant (Address) 94 Sunnyside Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transit permit was issued: Walter A. Maker ) (Signature of Agent of Board of Health or other) Healthe Office 5/25/50
(Official Designation)
(Date of Issue of Permit)
no
(a) Residence. No. (Usual place of abode)
1
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.
82
RM R-301A 1
STRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean de of dying, such failure, asthenia, means the disease, plications which death.
orbid conditions. giving rise to the ause (a) stating derlying cause
nditions contrib- the death but not to the disease or n causing death.
100M.(D)-10-48-24658
ANTE CEDENT (b) CAUSES
3 1/2 70
(c)
OTHER SIGNIFICANT CONDITIONS
6 Place of Burial or Cremation
(Was deceased a U. S. War Veteran, if so specify WAR)
25
(Give maiden name of wife in full)
have occurred on the date stated above, at. INTERVAL BE-
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 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 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 section 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 nineteen 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 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 inter- ment, 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 physician 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 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 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 registra- tion. The person to whom the permit is so given and the physician 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 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 persons shall bury a human body or the ashes thereof 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 the observance of the follow- ing 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 physician 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 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. 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, however, 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
PLACE OF DEATH
Suffolk (County)
RM R-301A 1 & Winthrop, Mass. (City or Town)
No.
103
Summitt Avenue
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
83
2 FULL NAME .. Henry James Pugsley (If deceased is a married, widowed
i woman, give also maiden name.)
(a) Residence. No. 103 Summitt Avenue (Usual place of abode)
St. .
(If nonresident, give city or town and State)
Length of stay: In place of death .. years months ... .. .days. In place of residence
2 0years
.months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
May (Month)
23 (Day)
1950 (Year)
8 SEX Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWEMarried
of DIVORCED
4I HEREBY CERTIFY,
19
to
19
I last saw h
alive on
19 ., death is said to
have occurred on the date stated above, at
6 P .m.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH
ANTE Due To CEDENT (b) CAUSES
Erhthe Last
Due To
(c)
OTHER SIGNIFICANT CONDITIONS
dias 5-23-60
Major findings: Of operations
Date of operation Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify chantes functional (Signed) (Address) A Bond of Health May 2.3. 1950
M. D.
6 Woodlawn Cemetery Everett Mass (City of Town) Place of DEHaXX Cremation DATE OFXXXCremation May 25 .19 50
7 NAME OF FUNERAL DIRECTOR Alfred B. Marsh 17% Winthrop Street
ADDRESS.If
Winthrop, Mass.
19
Received and filed
MAY 26 1950
(Registrar)
10a If married, widowed, or divorced HUSBAND of .. Edith Hammond
(or) WIFE of (Husband's name in full)
INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN. enter that fact here.
12 AGE 65 Years 5 Months 5 Days
If under 24 hours
Hours . . Minutes
13 Usual
Retired
Occupation:
JoHid Handook Life "This life)
14 Industry
or Business:
Clerk, Mailing Dept.
15 Social Security No ...
023 09 8481
16 BIRTHPLACE (City)
(State or country)
Bath England
17 NAME OF FATHER James Pugsley
PARENTS
18 BIRTHPLACE OF FATHER (City) (State or country)
Cornwall. England
19 MAIDEN NAME
OF MOTHER
Mary
Gibbis
20 BIRTHPLACE OF MOTHER (City) (State or country)
Cornwall England
21 Informant (Address)
Mrs. Henry J. Pugsley wife 103 Summity Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Watter & Bakli (Sighature of Ageht of Board & Health or other)
Health Officer
5/25/50
(Official Designation)
(Date of Issue of Permit)
V
NSTRUCTIONS FOR CAL CERTIFICATE In giving SE OF DEATH
o not enter ore than one use for each a), (b) and (c)
his does not mean ode of dying, such rt failure, asthenia. means the disease. mplications which death.
forbid conditions, , giving rise to the cause (a) stating nderlying cause
onditions contrib- o the death but not to the disease or ion causing death.
·50M (B)- 12.49-900722
To be filed for burial permit with Board of Health or its Agent.
f (If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
-
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR) NO
(write the word)
That I attended deceased from
(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, defined 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 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 section 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 nineteen 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 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 elerk 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 inter- ment, 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 physician 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 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 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 pernuit. 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 registra- tion. The person to whom the permit is so given and the physician 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 of 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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. -- General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof 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 nave 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 follow- ing 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 physician 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 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work dore during most of working life even if retired. 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, however, 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
+
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or ite Agent.
84
75 Temple Avenue No.
.
f(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME
Robert Carroll Daly (If deceased is a married, widowed or divorced woman, give also maiden name.)
-
No PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. 75 Temple Avenue
St. .
(If nonresident, give city or town and State)
Length of stay: In place of death. years . months
days. In place of residence
6 .years ... months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
May (Month)
26 (Day)
1950 (Year)
8 SEX
Male
9 COLOR OR RACE White
10 SINGLE
MARRIED
WIDOWBH Forced
or DIVORE
4 I HEREBY CERTIFY, 2 30 しカ May 26 19 to
I last saw h .. alive on.
May 22
50
19 , death is said to
have occurred on the date stated above, at 5.20 Pm.
INTERVAL BE-
(Husband's name in full)
TWEEN ONSET AND DEATH 11 IF STILLBORN. enter that fact here.
12 AGE59 Years 9. Months 25 Days
If under 24 hours
Hours
Minutes
Due To To Hypertencina
ANTE CEDENT (b) CAUSES Healt Deceaus
Due To Hyjutemin
(c) ..
00
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
have
Date of operation
Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, specify / 0 7
(Signed)
Rescue para
(Address)
M. D.
Date 27 May
1050
6
Winthrop Cemetery Winthrop, Mass . . I.a. or Cremation City of Town?
DATE OF BURIAL May 29
21 Informant (Address) Marion Irene DeRoo
daughter 78 nias !!!!
7 NAME OF
FUNERAL DIRECTORE
alfred B. Manske
ADDRESS
174 Winthrop St. Winthrop Mass
19
(Sighature of Agent) of Board of Health or other)
/ Health Ofrecer 5/29/50
(Official Designation)
(Date of Issue of Permity 1
ISTRUCTIONS FOR CAL CERTIFICATE
In giving SE OF DEATH o not enter ore than one use for each ), (b) and (c)
his does not mean ode of dying. such t failure. asthenia, means the disease. n plications which death.
orbid conditions. giving rise to the cause (a) stating nderlying cause
unditions contrib- o the death but not to the disease or on causing death.
17 NAME OF FATHER Richard W. Daly
PARENTS
18 BIRTHPLACE OF FATHER (City) Boston, Mass
(State or country) Suffolk
19 MAIDEN NAME
OF MOTHER
Grace Carroll
20 BIRTHPLACE OF MOTHER (City) (State or country)
Boston, Mass Suffolk
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter S Bakery
Received and filed
JUN 6 1050
(Registrar)
3 years
14 Industry
or Business:
Raytheon Production Crop
4 years
15 Social Security No. .
023-07-7607
Boston, Suffolk Hass
16 BIRTHPLACE (City)
(State or country)
13 Usual
Occupation :.
Salesman
(Kind of work done during most of working life)
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) acute Pulmonary Edema
That I attended deceased from
10 50
10a If married, widowed, or divorced HUSBAND of Elizabeth Nagle
(Give maiden name of wie in full)
(or) WIFE of
(write the word)
(Usual place of abode)
Registered No ..
RM R-301A 1
/50M (B)-12.49.900722
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 are, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last scen 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 scetion 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 nineteen hundred and seventeen. G. L. Chap. 46. Sec. 10.
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