Town of Winthrop : Record of Deaths 1953, Part 11

Author: Winthrop (Mass.)
Publication date: 1953
Publisher:
Number of Pages: 600

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 11

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MASS.

Walter

Baller

(Signature of Agent of Board of Health or offer .

Healthe Office

元々4/53

(Official Designationy

(Date of Issue of Permit)

SOM (A)1-51 903586

RM R-301 1

TRUCTIONS FOR AL CERTIFICATE

n giving E OF DEATH not enter than one se for each , (b) and (c)

's does not mean e of dying, such failure, asthenia, cans 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.

Major findings:

Of operations.

none

Date of operation

Was autopsy performed? no

What test confirmed diagnosis ?.

clinical

INTERVAL BE- TWEEN ONSET AND DEATH

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH

(a) natural causes

ANTE

CEDENT (b)

CAUSES

Due To

Presumably

Due To

Coronary

OTHER

SIGNIFICANT

CONDITIONS

PARENTS

(Was deceased a U. S. War Veteran, ( if so specify WAR)

NO.

4 I HEREBY CERTIFY,

19 .*** to .. ......

I last saw h- alive on

19 ........ , death is said to

have occurred on the date stated above, at.

5:30 PM.

A TRUE COPY ATTEST:

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 deccased, 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 shail 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 inanner 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; F & C General Laws, Chap. 38, Sec. 6.

No undertaker or other persons shall bury a human body or the ashes thereof which bare been brought into the commonwealth until he has received a permit so to de 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

Thetglfillingnt of the purpose of these laws calls for the observance of the follow- ing rules of practice:

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 +jury have died without recent medical attendance or whose physician is absent fromhome when the icertificate of death is needed.

731 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 Agonty)

3/6/53

The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD

To be filed for burial ·permit with Board of Health or its Agent.

Registered No. 36

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)

St.

Revere masa

(If nonresident, give city or town and State)

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

6 .. days. In place of residence

4.8 .years

.months ... days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

3 DATE OF

DEATH

(Monthy

23 (Day)

1953 (Year)

4 I HEREBY CERTIFY.

1953

That I attended deceased from

Det 150.

to.

Fel. 23

I last saw h

... alive on.

Zel - 23. 1053

death is said to

have occurred on the date stated above, at 6:55 A.m.

INTERVAL BE-

(Husband's name in

11 IF STILLBORN, enter that fact here.

AGE. 76 Years

- Months

Days

If under 24 hours

Hours

Minutes

13 Usual

Occupation:

Housework

(Kind of work done during most of working life)

14 Industry

or Business:

at Home

15 Social Security No ...

16 BIRTHPLACE (City)

(State or country)

Italy

17 NAME OF

FATHER

Ciriaco Carifio

18 BIRTHPLACE OF FATHER (City) (State or country)

Italy

19 MAIDEN NAME

OF MOTHER

Cannot Be Learned

20 BIRTHPLACE OF MOTHER (City) (State or country)

Italy

21 Informant. (Address)

anthony Caporale

9 ambracelet Beurre

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

Thatthe Office R. 25,53

(Official Designation) (Date of Issue of Permit)

50M-10-52-908091

7 NAME OF Paul Quanfiglio ADDRE 128 Revere Et Levere

Received and filed FEB 25 -1953

(Registrar)

6M00

OTHER SIGNIFICANT CONDITIONS

Cardine farlux

1day

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? lí so, specify ..... CATINe

(Signed) andrew Caro M. D. (Address) 9 4 Quanh Et Very Date 76 25 19354

6 mmx. Wollaston Cem. Quincy.

Place of Burial or Cremation (City or Town)

DATE OF BURIAL February 26, 1953

9 COLOR OR RACE

10 SINGLE

MARRIED

(write the word)

WIDOWED Married

or DIVORCED

10a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

Frank Caporale

TWEEN ONSET AND DEATH

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH (a)

Diabetes Mellitus

anten

electie heart.

ANTE CEDENT (b) CAUSES

To antenmilenio

6 years

informent / Calculate

NEVERE.

M R-301A 1 Winthrop (City or Town), Winthrop So Pleasant No. 142 Luisa Caporale 2 FULL NAME ..

CERTIFICATE OF DEATH

(If deceased is a married, widowed or divorced woman, give also maiden name.) 9 ambrose Lx

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

RUCTIONS FOR L CERTIFICATE

giving CF DEATH not enter than one for each (b) and (c)

does not mean of dying, such ilure, asthenia, ans the disease, ications which 3th.

id conditions. ving rise to the se (a) stating rlying cause

itions contrib- e death but not the disease or causing death.

PARENTS

8 SEX

Female White

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 nincteen 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 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 whichhave 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 of 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

1 3

M R-301A 1

PLACE OF DEATH Suffothe (County) Ministerof (City or Town) 22 Ctis SL 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 ite Agent.

Registered No. 37

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

Martha C. Coffey Thompson)

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

22 Otis AVV

St.

(If nonresident, give city or town and State)

.years. .. months ... days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

8 BEX

9 COLOR OR RACE Female While

10 SINGLE MARRIED WIDOWED or DIVORCED

(write, the word) Widowed

10a If married, widowed, or divorced HUSBAND of ..

(or) WIFE of

(Give maiden name of wife in full) Daniel M Coffey

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

13 Usual

Occupation :

home

Days

If under 24 hours

Hours .. . Minutes

ANTE

Due To

acute Coronary

CEDENT (b)

CAUSES

Thrombosis

Due To (c) Uremia

OTHER

SIGNIFICANT

CONDITIONS

Sevenlized

Major findings:

Of operations

none

Date of operation

What test confirmed diag

clinical x laboratory

5 Was disease or injury in any way related to occupation of deceased? If so, specify ... (Signed) Jacob (Address) 5062 Jaulin Dat

abramo mano

¡M. D.

2/26/02.

(City of Town)

DATE OF BURIAL. Sich 27

195.3

7 NAME OF FUNERAL DIRECTOR

Mouse W/ Lucky

ADDRESS

FEB 2

Received and filed .19

(Registrar)

1950

48 kg.

14 Industry or Business:

15 Social Security No. Aone, Cash Boston

16 BIRTHPLACE (City). (State or country)

стьи

17 NAME OF FATHER John FI Thompson

PARENTS

18 BIRTHPLACE OF FATHER (City) (State or country)

houdin

19 MAIDEN NAME OF MOTHER Sarah (Unknown)

20 BIRTHPLACE OF MOTHER (City) (State or country)

Boston.

21 Informant

Josephy Coffey

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter

(Signature of Agent of Board of Health or other)

7.26.53

(Official Designation) (Date of Issue of Permit)

100M-(D)-10-46-24656

February 23 1953

(Month)

(Day)

(Year)

That I attended deceased from

4 I HEREBY CERTIFY, Jan 17 50 19-

to ..

February 23

I last saw her alive on

Febrig

2305 death is said to

have occurred on the date stated above, at 6 A.M.m.

DISEASE OR CONDITION DIRECT Cerebral

TO DEATH (a)

lemontage

INTERVAL BE- TWEEN ONSET AND DEATH Jau 12 12 AGE Years ./Months

(Kind of work done during most of working life)

12 hours

3 yrs.

Was autopsy performed? 20

2 FULL NAME ..

(a) Residence. No. (Usual place of abode) Length of stay: In place of death 36 years .months.

days. In place of residence 36

PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)

TRUCTIONS FOR L CERTIFICATE

giving OF DEATH not enter than one e for each (b) and (c)

does not mean of dying, such ailure, asthenia, eans the disease, lications which ath.

bid conditions. ving rise to the ase (a) stating erlying cause

litions contrib- he death but not the disease or causing death.

6 Place of Burial or Cfepration

3 DATE OF

DEATH

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

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Town of Winthrop : Record of Deaths 1953, Part 11

Author: Winthrop (Mass.) Publication date: 1953 Publisher: Number of Pages: 600

Author: Winthrop (Mass.)
Publication date: 1953
Publisher:
Number of Pages: 600