USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 65
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(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
RM R-302 1
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible CAUSES 50m-(e)-10-48-24658
+
PLACE OF DEATH
NORFOLK
OKLINE BR City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BROOKLINE (City or town making return)
Registered No.
688201
No. Bournewood Hospital
J(If death occurred in a hospital or institution. St. \ give its NAME instead of street and number)
2 FULL NAME .. Bessie .Schneiderman ... Newman
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
56 Lewis Avenue
(Usual place of abode)
xx ... Winthrop,
Massachusetts
(If nonresident, give city or town and State)
Length of stay: In place of death
1
.years
1
.months
25
days. In place of residence
10
.years
months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October
17
1950
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
August 22
19.419
to
October 17
19 50
I last saw her
alive on
October 17 . 19 50, death is said to
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of.
David Newman
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Chronic Myocarditis
INTERVAL BE- TWEEN ONSET AND DEATH 5 yrs
11 IF STILLBORN, enter that fact here.
12
AGE
78 Years.
Months
Days
If under 24 hours
Hours .......
. Minutes
ANTE CEDENT (b)
Due To Coronary ... Sclerosis ....
10 yrs
13 Usual
Occupation :.
Housewife
14 Industry
or Business:
15 Social Security No.
none
OTHER SIGNIFICANT CONDITIONS
many yr$
16 BIRTHPLACE (City)
(State or country)
Russia
Major findings:
Of operations.
Date of operation
Was autopsy performed ?.
What test confirmed diagnosis?
Electrocardiogram
PARENTS
19 MAIDEN NAME
OF MOTHER
Mabel (cannot be learned)
20 BIRTHPLACE OF
MOTHER (City)
(State or country) Russia
ine. Mass Massachusetts 21 Informant. Philip Newman
DATE OF BURIAL. October .... 18
19 ... 50
(Address)
21 Supple Road, Roxbury, Mass.
7 NAME OF
FUNERAL DIRECTOR
Benjamin Birnbach
ADDRESS
10 Washington St., Dorchester, Ma
A TRUE COPY
ASTEST:
(Registrar of Alty or Town where death occurfed)
Received and filed ..
NOV 14 1950
19
(Registrar of City or Town where deceased resided)
8 SEX
9 COLOR OR RACE
(write the word)
Female
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widowed
have occurred on the date stated above, at
6:20 p. ... m.
Due To (c)
Generalized Arterio Sclerosis
5 Was disease or injury in any way related to occupation of deceased ?.... no
If so, specify.
Charles Saltzman
MER.
(Signed)
(Address) 300 South St Brook- Date Oct. 17
19.50
6 ... Ohel ... Jacob Cemetery, Woburn
Place of Burial or Cremation
"(City of Town)
17 NAME OF
FATHER
Louis Schneiderman
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
(Kind of work done during most of working life).
DATE FILED
October 23, 1950
Town Clerk
(Was deceased a
U. S. War Veteran,
if so specify WAR) .... no
+
PLACE OF DEATH
(County)
Boston 12/8/0
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
232
(City or Town) Winthrop Comm. hospital Baby Boy alszese
[(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)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 229 Everett St. C. (Boston, Wian
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death .. years. months.
2 days. In place of residence .. years
months. .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I
attended
deceased from
2000.1
50
19
to
nov. 2
٥ ج 19
I last saw ht WA . alive on www 2, 19 7, death is said to
have occurred on the date stated above, at
6:30 % m.
INTERVAL BE-
TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH, (a) attractions Prematurity
ANTE
Due To
CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
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 marina (Signed) (Address) 241 Mareridt St .Date
6
StmC. Carton, Was, Basta Place of Burial or Cremation
6 (City or Town)
DATE OF BURIAL $-1950 19
7 NAME OF FUNERAL DIRECTOR
ADDRESS 1 Chelsea Stt 5.3.1
Received and filed 19
NOV 6. 1950
(Registrar)
8 SEX
NI
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
5
10a If married, widowed, or divorced HUSBAND of .. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here/
12
AGE
Years
. Months
2.
.Days
If under 24 hours
Hours
. Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No. w withrap, mas.
16 BIRTHPLACE (City).
(State or country)
Ument abruzzese
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston Uran.
19 MAIDEN NAME OF MOTHER
Marion Carpein.
20 BIRTHPLACE OF
Sharon, Mass
21 Informant
(Address) 241 Manuel ET C. Bister
I HEREBY CERTIFY that a satisfactory standard certificate of death was« filed with me BEFORE the burial or transit permit was issued: Walter A. Baker (Sigflature of Agent of Board of Health or other)
/ health
11/6/50
(Official Designation)
(Date of Issue of Permit)
M R-301A 1
TRUCTIONS FOR L CERTIFICATE giving : OF DEATH not enter e than one e for each , (b) and (c)
s does not mean e of dying, such failure, asthenia, eans the disease, lications which Path.
bid conditions, iving rise to the use (a) stating erlying cause
ditions contrib- he death but not the disease or causing death.
PARENTS
Latua M. D. .19.527 MOTHER (City) (State or country) Manon @ Sala ME
50M-2-19-25666
No.
To be filed for burial permit with Board of Health or its Agent.
2 FULL NAME ..
1950
(write the word)
17 NAME OF
FATHER
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 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 discasc, or when any person is found dead. .. - General Laws, Chap. 38, Scc. 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 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
RM R-301A 1
PLACE OF DEATH
+ Supports (County)
Winthrop
(City or Town) 16 Lewis Terrace No.
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. 203
Registered No.
J(If death occurred in a hospital or institution, St. (, give its NAME instead of street and number)
Nina Many D'angelo
(Vitale
(If deceased is a married, widofred or divorced woman, give also maiden name.) 16 Lewis Terrace .
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years months. .days. In place of residence. ...... .. years. .months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
Married
4 I HEREBY CERTIFY,
That I attended deceased from
19
- to
19
I last saw h-
.alive on ..
19
death is said to
about 12:30 p.
have occurred on the date stated above, at
.. m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE 52 Years
7
Months 30 Days
If under 24 hours
Hours
Minutes*
13 Usual
Occupation:
House wife
(Kind of work done during most of working life)
14 Industry
or Business:
at home
15 Social Security No.
none
16 BIRTHPLACE (City)
(State or country)
Vigiano
17 NAME OF
FATHER
Salvatore Vitale
18 BIRTHPLACE OF
FATHER (City)
Vigiano
(State or country)
19 MAIDEN NAME
OF MOTHER
Rachielle Pugliese
20 BIRTHPLACE OF
MOTHER (City)
Vigiano
(State or country) Italy
21 Laurence D'angelo
(Address)
16 Leurs Terrace Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: alter - Makers
(Signature of Agent of Board of Health of other)
11/2/50
Health Officer (Official Designation)
(Date of Issue of Permit)
100M-(D)-10-48-24656
5 Was disease or injury in any way related to occupation of deceased? MD. If so, specify Archy@horay.b M. D. (Address)
porand of Date Mot 2 1950
Winterof Health Wanted
6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
nov. 6, 1950
19.
7 NAME OF
FUNERAL DIRECTOR
alexander Struzziero
ADDRESS 493 Somerville ave, Somewille
Received and filed. 19
NOV 6 1950
(Registrar)
PARENTS
10a If married, widowed, or divorced
HUSBAND of .....
Lauren (Give maiden name
(or) WIFE off
Laurence
D'angelo
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Natural causes
ANTE
CEDENT (b) .. .
CAUSES
Due To
To Presumably
coronary
Due To
occlusion
(c)
Known to have
OTHER SIGNIFICANT CONDITIONS
hypertension
-
Major findings:
Of operations
Date of operation
Was autopsy performed? no
2 FULL NAME
(a) Residence.
(Usual place of abode)
PHYSICIAN - IMPORTANT . (Was deceased a U. S. War Veteran, if so specify WAR)
TRUCTIONS FOR AL CERTIFICATE
n giving E OF DEATH not enter e than one se for each , (b) and (c)
's does not mean e of dying, such failure, asthenia, eans the disease, lications which eath.
bid conditions. iving rise to the use (a) stating derlying cause
ditions contrib- the death but not o the disease or causing death.
Italy
What test confirmed diagnosis?
3 DATE OF
november 2, 1950
DEATH
(Year)
(Month)
(Day)
(write the word)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the 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 shallexhume 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.
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