USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 12
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FEB= 51051 CH
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of deatlı.
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
M R-301 A
If deceased was a U. S. War Veteran, G. L. Chap. 46 , Section 10, requires physicians to insert a recital to that effect. See instructions and extracts from the laws on back cf certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.
1
PLACE OF DEATH
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.
31
Registered No ..
CIAN-IMPORTANT
2 FULL NAME
(If deceased Is a married, widowed or divorced woman, give also maiden name. )
(a) Residence. No ..
(Usual place of abode)
125 Cliff ave
St.
(If nonresident, give cit, or town and State)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
years months days.
In this community
15 STE.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed or divorced HUSBAND of
Louise Hoffees
(Give maiden name of wife in full)
(or) WIFE of
(Husband's namein full)
18 DATE OF
DEATH.
Feb.
4
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
fai
19.
,49
to ..
That I attended deceased from
5%
Feb 4
19
I last saw how alive on
Feb 3
19.2 ... , death is said to
have occurred on the date stated above, at
1:00 P
m.
6 Age of husband or wife if alive. years
7 IF STILLBORN, enter that fact here.
8
AGE
5%
ars
Months.
Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :.
Lawyer
Industry 10 or Business :
11 Social Security No. none
12 BIRTHPLACE (City).
South Boston
(State or Country)
Mais
13 NAME OF
FATHER
Shubael Paul
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Solan
Maine
15 MAIDEN NAME
OF MOTHER
Flora a. Kincaid
Madison
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Maine
17
Informant
Mro. Louise Paul
(Addres)
125 Cliff ave
wife
I HEALBY CERTIFY that a satisfactory standard certificate of death ffled xfyh me BEFORE he bprialor transit permit was issued : Walter DI gales
Ognature of Agent of Board of health or other)
Health Offici 2/5/5/
Onfacial Designation)
(Date of Issue of Permit)
(Reg lidt )
Received and Filed
FEB & 1951
19
19.5.1
21 ..
Forest Hillo - Boston
Place of Burial, Cremation or Removal.
(City of Town)
DATE OF BURIAL ..
Feel J.
1951
22 NAME OF
FUNERAL DIRECT
Samuel M. Burroughs by Robt.J. Bolyca
ADDRESS
21 Virginia It - Dorchester
3 gs. IMPORTASI
Major findings:
Of operations
have
Date of
Of autopsy
have.
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased? ku
If so, specify
(Signed)
Human n. King
.M. D.
(Address) 25 Surges St Coudre Date 2/4
100M-10-47-22153
No ........
125 Cliff ave
George Edgar Baxter Paul
St. § (If death occurred in a hospital or in
( give its NAME instead ofpuesICIA
(Was deceased a
U. S. War Veteran,
if so specify WAR)
none
1951
Duration
IMPORTANT
Immediate cause of death
Chovery insufficiency
.
Cor pulmonale
Due to
Inplugsene & besprochenclases
Due to
Chimie biustral aschema
10 ups.
Other conditions,
Eneral arterioscheini
(Include profancy within 3 months of dratt)
Physician Underline the cause to which death should be charged sta- ti: tically.
PARENTS
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 dawn of a person whom he has attended during his last iuness, at the request of an undertaker or other authorized person or of ary mem' er of the family of the deceased, furnish for registration a standard cert .. cate 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, de .... ed as re- quired by section one, where samc 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 seetion 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 wur 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 physic.an or officer shall forfeit ten dollars. For the purposes of this sec- tion and of seetions 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 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 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. lavy or ribrine corps of the United States in any war in which it has been engaged, auch recital shall appear upon the permit. The board of health, or its are .. t, upon receipt of such statement and certificate, shall forthwith countersign it v.d transmit it to the clerk of the town for registration. The person to w .om the permit is so given and the physician certifying the core of death shall thereafter furnish for registration any other neces- sory information which can be obtained as to the deceased, or as to the hianner or crise of the death which the clerk or registrar may require .- Chap. 114. Ser. 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 Fury 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 ci.rk 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 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 tlie mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name tlie 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 usval 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-301A 1
PLACE OF DEATH
1 .Suffolk (County)
Winthrop (City of Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
J(If death occurred in a hospital or institution,
St. \ give its NAME instead of street and number)
VENTURA.
(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. 247 Saratoga .... Street
St. East. Boston
(If nonresident, give city or town and State)
Length of stay: In place of death. C years. Q.months ...
Q .. days. In place of residence. Q ..... years .Q.months 0 .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
female
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCEBingle
4 I HEREBY CERTIFY,
That I attended deceased from
19
19
I last saw h ....
alive on
19
death is said to
have occurred on the date stated above, at
m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
FETAL-DEATH.
IN-ISTEPO of6 /2MO.
ANTE
Due To
CEDENT (b) CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation
Was autopsy performed? Clinical FINDINGS
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify
(Signed)
(Address) 3 Coment Ar. Barbate Z/X
M. D.
1911
6
Holy Cross Cemetery Malden Place of Burial or Cremation (City or Town)
DATE OF BURIAL February 5 1951
19
7 NAME OF FUNERAL DIRECTOR Richard .C ....... Kirby East.Boston Mass
ADDRESS
Received and filed FEB 5 1951 19
(Registrar)
PARENTS
18 BIRTHPLACE OF FATHER (City) Maderia (State or country) Portugal
19 MAIDEN NAME OF MOTHER Clara Garden
20 BIRTHPLACE OF MOTHER (City).Lowell (State or country) Mass
Joseph .... Ventura .... Father
21 Informant (Address) 247 Saratoga Street E. Boston I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE, the burialpr transit permit was issued: Walter S. Bakery (Signature of Agont of Board of Health or other)
Health Officer
3/5/07
(Official Designation) (Date of Issue of Permit) /
To be filed for burial permit with Board of Health or its Agent.
32
Registered No.
No. Winthrop Community Hospital
2 FULL NAME .... Eomale Ventura
FEB
(Month)
4 (Day)
1951 (Year)
9 COLOR OR RACE
(write the word)
10a If married, widowed, or divorced HUSBAND of. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full) STILL BORN
11 IF STILLBORN, enter that fact here.
12
AGE ...
O ... Years
.O .. . Months
0 Days
If under 24 hours
Hours ... ... Minutes
13 Usual
Occupation:
none
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No. none
none
16 BIRTHPLACE (City)Winthrop
(State or country)
Mass
17 NAME OF FATHER Joseph Ventura
NO .
What test confirmed diagnosis?
50M·2-19-25666
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure. asthenia, ns the disease, cations which th.
id conditions, ing rise to the e (a) stating lying cause
tions contrib- death but not the disease or ausing death.
3 DATE OF
DEATH
(Usual place of abode)
to
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, Scc. 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. of 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
A R-302 1
PLACE OF DEATH
Suffolk (County)
Boston (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
11933
2 FULL NAME Baby Boy Carinha
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 14 Sunnyside Ave.
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In place of death. .. years .. months .... days. In place ofresidence. .. years .months .days.
22
23 Mins.
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Feb.7/51
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
Feb.6
19
57
to
I last saw h
imalive on
Feb. 7 1, 51
death is said to
have occurred on the date stated above, at
8;08P
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
.. Years
Months.
Days
1
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.
Winthrop Miss.
16 BIRTHPLACE (City).
(State or country)
17 NAME OF
FATHER
Joseph Carinha
18 BIRTHPLACE OF
Woburn Mass.
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Catherine Kirby
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston Mass.
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL
Feb.9/51
19
7 NAME OF
FUNERAL DIRECTOR
M W Kirby
ADDRESS Winthrop Mass.
Received and filed FEB 24 1951
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