Town of Winthrop : Record of Deaths 1952, Part 68

Author: Winthrop (Mass.)
Publication date: 1952
Publisher:
Number of Pages: 572

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3 DATE OF

DEATH

September

1952

(Year)

(write the word

AGE

PARENTS

Place & Burial or Cremation Sept. 26

W. W. I.

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 pherrual or electrical agents or following abortion, or from discascs resulting from Injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. ... - Gencral Laws, ,38. Sec. 6., as amended by Chap. 632, Sec. 4. Acts of 1945. TOW 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 $6 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 br the funeral is to be held, or from a person appointed to have the care of the cemetery on burial ground in which the interment is made.

Chap 114, Sec246, G. L., (Tercentenary Edition).

RULES OF PRACTICE

de fusilim? of the purpose of these laws calls for the observance of the follow-

THE Dice ading physicians will certify to such deaths only as those of persons y have given bedside care during a last illness from disease unrelated to whel to any form of injury.

(2) Board of Health physicians will certify to such deaths only as those of SEP fo. thought Misabled by recognized disease unrelated to any form of ryhave 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 occup :- 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

10 - 7. 42 2-24- 46

DATE OF DISCHARGE

RANK, RATING

ORGANIZATION AND OUTFIT

SERVICE NUMBER 203-18-199

COPY OF CERTIFICATE OF DEATH

CERTIFICATE OF DEATH STATE OF NEW HAMPSHIRE

Vol, 1949

TOWN OR CITY

Tr.go 92

CLERK'S NO

1. NAME OF

DECEASED

(Type or Print)

a. (First)

b. (Middle)

Polacn

c. (Last)

Ichlintock

2. DATE

DEATH

(Month)

(Day)

(Year)

1952

3. PLACE OF DEATH

a. COUNTY

Coos

4. USUAL RESIDENCE (Where deceased lived. If institution: resid-

a. STATE

ence before admission).

last.

b. COUNTY

b. CITY

TOWN

c. LENGTH OF

STAY (in this place)

3 1

c. CITY (Give actual town of residence, NOT mailing address).

TOWN

Winthrop

d. FULL NAME OF (If not in hospital or institution, give street address or location)

HOSPITAL OR

INSTITUTION

lorsvon foordtel

d. STREET

ADDRESS

(If rural, give location) 2 Sargent Torraco

5. SEX

6. COLOR OR RACE |7. MARRIED, NEVER MARRIED.

WIDOWED DIVORCED (Specify)

8. DATE OF BIRTH

Jan. 13. 1673

9. AGE (In years

last birthday)

Days IF UNDER 1 YEAR Months

Min. IF UNDER 24 HRS. Hours

10a. USUAL OCCUPATION (Kind of work done during most of working life, even if retired)

10b. KIND OF BUSINESS OR IN- DUSTRY

11. BIRTHPLACE (State or foreign country)

12. CITIZEN OF WHAT

COUNTRY?

13. FATHER'S NAME

Nichani Polem

16. SOCIAL SECURITY 17. INFORMANT

NO.

Michard P. Mcclintock

MEDICAL CERTIFICATION

elvoyage lay meident

INTERVAL BETWEEN ONSET AND DEATH

(a) .. DUE TO

Iyportocion

Yerrs

ANTECEDENT CAUSES

Morbid con-

ditions, if any, giving rise to the above cause

(a) stating the underlying cause last.

(c)

DUE TO

Artemioari votic Heart, 01 cose

Youra

II. OTHER SIGNIFICANT CONDITIONS

Conditions contributing to the death but not

related to the disease or condition causing it.

19b. MAJOR FINDINGS OF OPERATION

20. AUTOPSY?

YES

21a. ACCIDENT

SUICIDE

HOMICIDE

(Specify)

21b. PLACE OF INJURY (e.g., in or about

home, farm, factory, street, office bldg., etc.)

21c. (CITY OR TOWN)

(COUNTY)

(STATE)

21d. TIME

(Month) (Day) (Year) [Hour)

INJURY

21e. INJURY OCCURRED

WHILE AT

WORK

NOT WHILE

AT WORK

21f. HOW DID INJURY OCCUR?

22. I hereby certify that I attended the deceased from

alive on

w. .... 19 ....... , and that death occurred at

19.

... , to.

19. that I last saw the deceased m., from the causes and on the date stated above.

23a. SIGNATURE

Ihrold B. Denn, M. D.,

( Degree or title)

23b. ADDRESS

23c. DATE SIGNED

9-23-1952

24a. BURIAL, CREMATION,

ENTOMBMENT, REMOVAL

( Specify)

24b. DATE

Sept. 26.1952

Winthr

COUNTERSIGNED - AGENT (City Bd. of Health)

DATE

flot given

DATE REC'D BY TOWN OR CITY CLERK

ort, 22, 1952

CLERK'S OWN SIGNATURE

old L. Koir

CLERK OF

Whitori in, N. H.

A true copy, Attest:

Harold L. KEir.

Whit Mola, ". il.

Dated

Sept. 23, 1952

V. S. 17

6-50-25M

SGP 2 6 1952

Clerk of ..... .

DATE

IF ENTOMBED

24e. PLACE OF BURIAL

( Name of Cemetery)

LOCATION (City, Town, County)

(State)

25. FUNERAL DIRECTOR

Lost. F. Stanard, Lanester, N. T.

ADDRESS

24c. NAME OF CEMETERY OR CREMATORY

24d. LOCATION (City, town, or county ) (State)

19a. DATE OF OPERA-

TION

(b)

14. MOTHER'S MAIDEN NAME

Jork

15. WAS DECEASED EVER IN U. S. ARMED FORCES?

(Yes, no, or unknown) | (If yes, give war or dates of service)

18. I. DISEASE OR CONDITION DIRECTLY LEADING TO DEATH This does not mean the mode of dying, such as heart failure, asthenia, etc. It means the disease, injury, or complication which caused death.

200 ℃

RECEIVEL

TOW

THROPA

SEP26 AM

-301A 1

...

39 Grovers Que. No.

[(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)

Salvatore Vitale 2 FULL NAME

(If deceased is a married, widowed or divorced woman, give also maiden name.)

89 Marshall

St.

Winthrop

(If nonresident, give ciey or town and State)

Length of stay: In place of death ............ years ... - months.

4 .days. In place of residence.

32 years.

months ..... days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

Je/2c

21,

1952

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY.

That I attended deceased from

Tp_claC

to Sufre 25

I last saw halive on.

Sepet 2 195 Les

death is said to

have occurred on the date stated above, at

445

.m.

INTERVAL BE- TWEEN ONSET AND DEATH

DISEASE OR CONDITION

DIRECTLY LEADING 225 moment-

TO DEATH (a)

Comme

Duodenum

ANTE CEDENT (b) CAUSES

Due To/

alcuni

Due To (c)

OTHER

SIGNIFICANT

CONDITIONS

Major findings:

Of operations.

Date of operation friend 2c/5-2

.. Was autopsy performed ?.

What test confirmed diagnosis? 41

11 IF STILLBORN, enter that fact here.

AGE

17 Years

: Months

Days

If under 24 hours

Hours .. ... Minutes

13 Usual

Occupation :

Pressman

(Kind of work done during most of working life)

14 Industry

or Business:

Clothing Business

15 Social Security No. 022-10- 3572

16 BIRTHPLACE (City)

(State or country)

Italy

17 NAME OF

FATHER

Salvatore Vitale

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Italy

19 MAIDEN NAME

OF MOTHER

Gratana Vomera

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Italy

Holy Cross Cem, malden Place of Burial or Cremation (City or Town)

DATE OF BURIAL

Sept. 27.

19521.

7 NAME OF

FUNERAL DIRECTOR

G. M. Linehan

ADDRESS.

19 Chambers St. Boston

Received and filed.

SEP 2-6-195

(Registrar)

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

9 COLOR OR RACE

(write the word)

10 SINGLE

MARRIED

WIDOWED

or DIVORCED

Pugliese

Widowed

10a If married,

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of.

(Husband's name in full)

not mean ing, such asthenia, e disease, s which

ditions, se to the stating cause

contrib- h but not isease or g death.

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 1ts Agent.

201

Registered No.

PHYSICIAN - IMPORTANT

(Was deceased a

U. S. War Veteran,

if so specify WAR)

220.

(a) Residence. No. (Usual place of abode)

ONS IFICATE g DEATH ter one each nd (c)

50M-(D)-6-51-904917

5 Was disease or injury in any way related to occupation of deceased? 27

If so, specify.,

(Signed) 1 ----- 2

(Address) 1512

M. D.

8 / Dates RiTed, 19.

PARENTS

21 Informant

Salvatore F, Vitale

89 Marshall 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 A. Hakerig- (Signature of, Agent of Board of Health or other) ... Theatthe Office 9/26/02

(Official Designation) (Date of Issue of Permit)

Rachael

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.

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 fsupposed 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 recognizal-le disease,or when any person is found dead. .. - General Laws, Chap. 38, Ses.6., as amended by Chap. 632, Sec. 4, Acts of 1945.

No undertaker another person 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 froin the board of health grits agent appointed to issue such permits, or if there is no such heard, from the clerk of the town where the body is to be buried or the funeral is to be kek, or from a person appointed to have the care of the cemetery of burial groundEin which the interment is made.

Chap. 11+, Sec. 46 "C" Vi Tercentenary Edition).

WINS The fulfillment

6 'RULES OF PRACTICE C hese 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

(2) Boardof Health physicians will certify to such deaths only as those of persons who. though disabled by fadognized 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)

Winthrop (City or Town) NO.45 Chester Avenue

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.

202

J(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)

2 FULL NAME

John H. Sullivan

(If deceased is a married, widowed or divorced woman, give also maiden name.)

PHYSICIAN - IMPORTANT

(Was deceased a

U. S. War Veteran.

45 Chester Avenue

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

3 DATE OF

DEATH

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY,

That I attended deceased from

19.

10a If married, widowed, or divorced

HUSBAND of ..

Sarah Costello

(Give maiden name of wife in full)

I last saw h .........

alive on

death is said to

have occurred on the date stated above, at

3:40 Am.

INTERVAL BE- TWEEN ONSET AND DEATH

11 IF STILLBORN, enter that fact here.

AGE

7 0 Years

Months

Days

If under 24 hours

Hours ..... . Minutes'

13 Usual

Occupation:

Marine Engineer

(Kind of work done during most of working life)

14 Industry or Business:

15 Social Security No.

16 BIRTHPLACE (City)

(State or country)

Massachusetts

17 NAME OF

FATHER

Cornelius A. Sullivan

18 BIRTHPLACE OF

FATHER (City)

County Cork

(State or country)

Ireland

19 MAIDEN NAME

OF MOTHER

Mary A. Harrington

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Ireland

County Cork

21 Mrs. Grace C. Phinney

Informant (Address)

45 Chester Ave. Winthrop

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Kaker (Signature of Agent of Board of Health or other)

Health Officer 9/26/52

(Official Designation)

(Date of Issue of Permit)

ONS IFICATE 8 DEATH ter one ach nd (c)

tot mean ng, such asthenia, e disease, s which

ditions. se to the stating cause

contrib- but not sease or g death.

Date of operation

Was autopsy performed ?.

What test confirmed diagnosis ?..

X-ray Mass ren Hosp.

5 Was disease os injury h any way related to occupation of deceased?

PARENTS

Health M. D.

(Signedy.

(Address) Winthrop Board of A

Date 26 Deky

1952

Holy Cross Cemetery

Malden

Place of Burial or Cremation

(City or Town)

DATE OF BURIAL

Sent. 29, 1952

7 NAME OF

FUNERAL DIRECTOR

Alice M.Kelly

ADDRESS

Meridian St.East ..... Boston

Received and filed

SEP 2 6 1952

..... ..... 19

(Registrar)

8 SEX

Male

9 COLOR OR RACE

White

10 SINGLE

MARRIED

WIDOWED Widow ed

or DIVORCED

(or) WIFE of

(Husband's name in full)

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH

i)Matural causes.

ANTE

Massive Hemorrhage sudden

CEDENT (b)

CAUSES

Due (c)

Carcinoma of Lung

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Town of Winthrop : Record of Deaths 1952, Part 68

Author: Winthrop (Mass.) Publication date: 1952 Publisher: Number of Pages: 572

Author: Winthrop (Mass.)
Publication date: 1952
Publisher:
Number of Pages: 572