USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 79
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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)
Winthrop (City of 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 its Agent.
392 Revere Street No. Alice (Boardman) Kendall 2 FULL NAME
J(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)
392 Revere Street (Usual place of abode)
St. .
(If nonresident, give city or town and State)
$0 years months .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
DECEmber (Month)
13 (Day)
1950 (Year)
4 I HEREBY CERTIFY,
That I
attended deceasedl from
February 6
1950
to
December 13
1950
I last saw h.
alive on
December 13, 1950, death is said to
8:15 P.m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
23 days
AGE
8.7 Years
6 Months 28. Days
If under 24 hours
Hours
Minutes
13 Usual
Housewife
Occupation :..
(Kind of work done during most of working life)
14 Industry
or Business:
Own home
15 Social Security No.
none
16 BIRTHPLACE (City)
(State or country)
Germany
17 NAME OF
FATHER
Boardman
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Germany
19 MAIDEN NAME
OF MOTHER
Unable to obtain
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
21 Informant Marion Coffin
(Address) 392 Revere St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Walter & Bakery (Signature of Agony of Board of Health or other)
Lealtre
Officer
12/15/50
(Official Designation)
(Date of Issue of Perrait)
2
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
Female
White
MARRIED
WIDOWED
DIVORCED Widow
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Ambrose Boardman
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADK.
TO DEATH
(a)
Cerebral Hemorrhage
with left hemiplegia
ANTE
CEDENT
(b)
Hypertensive + arterio -
CAUSES
Scheatic heart disease
Generalized arterio-
(c)
Sclerosis
Branchofneumonia
3 days
Major findings:
Of operations.
KONE
Date of operation
What test confirmed diagnosis?
Was autopsy performed?
Clinical + Laboratory
5 Was disease or injury in any way related to occupation of deceased?
If so, spechy
Chiauxice Traunstein fr.
M. D.
(Signed)
1562 Shelly St. Wink pre Dat 14
1950
6 ..
Winthrop
Place of Burial or Cremation
Winthrop
(City or Town)
DATE OF BURIAL
Dec.16
1950
7 NAME OF
FUNERAL DIRECTOR
Howard S Thymoldo
ADDRESS Winchof mais
Received and filed
19
DEC 18 1950
(Registrar)
1 year
2 years
OTHER SIGNIFICANT CONDITIONS
'50M (B)-12-49-900722
M R-301A
STRUCTIONS FOR AL CERTIFICATE n giving E OF DEATH not enter e than one se for each , (b) and (c)
is does not mean le of dying, such failure, asthenia, eans the disease, plications which eath.
rbid conditions, giving rise to the use (a) staling derlying cause
ditions contrib- the death but not o the disease or causing death.
Registered No.
239
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
Length of stay: In place of death 33Q-ears.
months days. In place of residence
have occurred on the date stated above. at
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 leath of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person nr 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 seetion forty-five of chapter one hundred and four- teen, shall. if the deceased. to the hest 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 imine- 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 nr marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the pernut. 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 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 pernut 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 disahled 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 husiness, 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
Suffolk & County
Winthrop (City or Town) Winthrop Comm. No.
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 its Agent.
Registered No. 240
j(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.) 76 Freemodel
St.
(If nonresident, give city or town and State)
.years months .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR OR RACE White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Single
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
Days
Hours .. Minutes
13 Usual Occupation : (Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City) .. (State or country)
mass
17 NAME OF Francia FATHER - Franta Costa
18 BIRTHPLACE OF FATHER (City) (State or country)
East Boston
Mars
19 MAIDEN NAME OF MOTHER anna M Gibbons
20 BIRTHPLACE OF MOTHER (City) (State or country) Masa
Francis
Costa
Informant. (Address) 767 reamount 24 Winthe
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter, & Peake.
(Signature of Agent of Board of Health or other)
tto -
Fica, 151950
(Official Designation) (Date of Issue of Permit) X
50m-(b)-11-49-900,560
Received and filed
19
DEC 1.5 1950
(Registrar)
PARENTS
M ._ D.
1950
6 Winthrop
Place of Burial or Cremation
DATE OF BURIAL
Dec 15
1050
7 NAME OF
Ernest Plaggiquo 147 Winther St Walther ADDRESS
ho
Date of operation.
What test confirmed diagnosis?
Was autopsy performed? Clinical+ Laboratory
5 Was disease or injury in any way related to occupation of deceased? to If so, specify. maurice Traunstein fr (Address) 562 Shirley SE, Winthro Date Doc. 14
Prematurity 7 mor. baby
Major findings:
Of operations.
none
antrecrinale
ANTE Due To CEDENT (b) CAUSES
have occurred on the date stated above, at INTERVAL BE- TWEEN ONSET AND DEATH 2 hrs
DISEASE OR CONDITION
DIRECTLY LEADIN Coital
TO DEATH (a)
Cranio-Schisis+ anchocephaly
2:00 P.m.
death is said to
I last saw h &M alive on
December 14
(Month)
(Day)/
1950 (Year)
4 I HEREBY CERTIFY,
That I
attended deceased from
Decemberly 1950 to. December 14 1950
(a) Residence. No. (Usual place of abode) Length of stay: In place of death.
years ..
..... months ... .... ... days. In place of residence
1 hr 20 min.
3 DATE OF
DEATH
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.
OTHER SIGNIFICANT CONDITIONS
Due To (c) ..
If under 24 hours
20
Winthrop
East Boston
Winthrop (City or Town)
Mary Costa 2 FULL NAME.
December 14, 1950
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 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 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 deathsonly 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
1 Suffolk (County)
Winthrop (City of 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 pormit with Board of Health or its Agent.
241
Registered No.
J(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.
(a) Residence. No. (Usual place of abode)
10 Orlando Avenue
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years months.
days. In place of residence
35
years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
male
white
10 SINGLE
MARRIED
(write the word)
WIDOWED
of DIVORCEDmarried
10a If married, widowed, or divorced
HUSBAND of
Effie May Kesselmire
(Give maiden name of wife in fuil)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
acute
Coronary
TO DEATH (a)
Occlusion
angina Pectoris
ANTE CEDENT (b) CAUSES
deitensclerotic
heart disease
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
nine
Date of operation
What test confirmed diagnosi clinical~
Was autopsy performed?
laboratory
5 Was disease or injury in any way related to occupation of deceased ?.
If so, specify ...
ed ance J. abrams 2 2
M. D.
(Sig
(Address) 562 APlay IT (Patento) 2/15 14, 2
6 .
Ellsworth Cemetery Ellsworth, Ohio
Place of Burial or Cremation
(City of Town)
DATE OF BURIAL
December 18,1950
19
7 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
174 Winthron St, Winthrop Mass.
Received and filed DEC 18 1959 15 (Registrar)
.19
PARENTS
200
FATHER (City)
(State or country)
Ohio
19 MAIDEN NAME
OF MOTHER
Evelyn Cessna
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