USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 18
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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.
X PLACE OF DEATH
Suffolk (County) riste 20 -/7/53
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. 60
J(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME ..
Luigi Serignano
(If deceased is a married, widowed or divorced woman, give also maiden name.)
I86 Leyden
East Boston. St.
(If nonresident, give city or town and State)
Length of stay: In place of death years 6 months .days. In place of residence I2
.years
months
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
March
(Month)
(Day)
28
I953.
(Year)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWEDWidowed
or DIVORCED
10a
If married, widowed, or divorced
HUSBAND of ... Assunta Puzzo.
(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
2
Months
13
Days
If under 24 hours
.Hours . .. Minutes
13 Usual
Occupation :
Retired
(Kind of work done during most of working life)
14 Industry
or Business:
Railroad -Track Walker. Foreman
15 Social Security No.
Mirabella,
16 BIRTHPLACE (City).
(State or country)
Italy.
17 NAME OF
FATHER Francesco Serignano
18 BIRTHPLACE OF
FATHER (City)
Mirabella,
(State or country)
Italy.
19 MAIDEN NAME
OF MOTHER
Unknown
20 BIRTHPLACE OF MOTHER (City) Mirabella,
(State or country)
Italy.
21 Informant
(Address)
Henry DeAngelis ( Son-in-law) HOW. 186 Leyden St. East Boston.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transitpermit was issued: Walter A. Lakers (Signature of Ageht of Board of Health or other)
health Office 3-3/153
(Official Designation)
(Date of Issue of Permit)
50M (D)-6-50-902253
6
St .Michaels .... Cemetery, ..... Boston, Mass. Place of Burial or Cremation March 31, 1953(City of Town)
DATE OF BURIAL Michael Gaggiano 19
7 NAME OF FUNERAL DIRECTORY ADDRE 39 Orleans 88. 8. Breton.
Received and filed Marele 31. 1953 19
(Registrar)
TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
generalized
arteriosclerosis
ANTE
Due To
Cerebral Remonhave
1982
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
none
Date of operation.
. Was autopsy performed ?.
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
(Address)
6278
24Parade gate
Date
M. D. -30058
PARENTS
(Was deceased a U. S. War Veteran, { if so specify WAR)
None
4 I HEREBY CERTIFY,
april
52
0
That I
to manda
attended deceased
from
53
I last saw h .. .... alive on.
Feb 208
19
death is said to
have occurred on the date stated above, at
7.30A
m.
INTERVAL BE-
PERSONAL AND STATISTICAL PARTICULARS
(a) Residence. No. (Usual place of abode)
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying. such ilure, asthenia, - ans the disease, cations which ith.
id conditions. ing rise to the se (a) stating rlying cause
tions contrib- e death but not the disease or causing death.
0
M R-301A 1 Winthrop (City or Town) Convalescent Mounts Rest Home- Grost Ave. 104 H ... No.
CEDENT (b)
CAUSES
Section
631-05-7877A.
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, h's supposed age, the disease of which he died, defined as required hy 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 secti" forty-five of chapter one hundred and four- teen, shall. if the deceased, to the best of his knowledge and helief, 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, eightcen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border () ing rulesof practice: 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 hody 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 Bes persons found dead
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 heu 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 hy 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 hy, 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 pernuit. 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 he buried or the fureral is to be held, or from a person appointed to have the care of the Hi 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- (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 hy recognized disease unrelated to any form of Byjury, have died without recent medical attendance or whose physician is absent infattibuthewhen the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably dueto injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs of 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
i
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. Fo- 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
(City or Town) PLACE OF DEATH fulfolle. (County)
4/7/53
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.
61
Auclop low Thack. Hemale Boudreau
S(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,
Levere
-
if so specify WAR)
St.
([f nonresident, give city or town and State)
Length of stay: In place of death years ...
months. days. In place of residence .years
months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR ØR RACE Female Hjerte
(writg/the word) 10 SINGLE MARRIED WIDOWED or DIVORCED4
Single
10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full))
Stillfor
12
AGE
Years
Months
Days
If under 24 hours Hours . . Minutes
13 Usual Occupation : (Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No ... .
16 BIRTHPLACE (City). (State or country)
Thank
17 NAME OF FATHER
Buitin Boudreau
18 BIRTHPLACE OF FATHER (City) (State or country)
PARENTS
19 MAIDEN NAME
OF MOTHER
Margaret Broadbent
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Miambuda
Bertram Boudreaux
21 Informant (Address) 120 Malden IX Parere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or fransit permit was issued: Walter A. Haker (Signature of Agent of Board of Health of other) Health Officer 4.2.53
(Official Designation)
(Date of Issue of Permit)
CTIONS OR ERTIFICATE
iving F DEATH tenter han one or each ) and (c)
es not mean dying, such tre, asthenia, s the disease, tions which
conditions. g rise to the (a) stating ing cause
ons contrib- eath but not , disease or using death.
100M-(D)-10-48-24858
Holy Cross Place of Burial or Cremation (City or Town)
DATE OF BURIAL April 2 195
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed.
APX 2 13
19
(Registrar)
0
march 29, 1953 (Year)
(Month)
(Day)
1
4I HEREBY CERTIFY,
That I attended deceased from
men 29
1953
to.
men 29
1953
I last saw
19 ...... , death is said to
have occurred on the date stated above, at INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Stillborn
ANTE
Due To
Prematuria
CEDENT (b)
CAUSES
Due
Prematins separation
(c)
plancenter
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation
Was autopsy performed? no
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
(Address) 186Pmncele st LB Date 3:31
195.3
a. n. Caplan
M. D.
No.
2 FULL NAME ..
(If/deceased is a married, widowed or_divorced woman, give also maiden name.) 126 MoldowM
(a) Residence. No. (Usual place of abode)
HETERE
Registered No.
3 DATE OF
DEATH
5:26 Pm.
11 IF STILLBORN, enter that fact here.
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 deccased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . General Laws, Chap. 38, Sec.6.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or bumal ground in which the interment is made.
hap. 115, 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 ruler 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 formofof injury
(2) ' Boardhar, 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 tolimity. 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
M 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
Bostan
(City or town making return)
Registered No.
2927 62
1(If death occurred in a hospital or institution. St. Į give its NAME instead of street and number)
2 FULL NAME.
Mary S Simons
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 46 Winthrop St
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ..........
.years ..
months ... 23 .... days. In place of residence.
......... years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March 13/53
(Day)
(Year)
8 SEX
F
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED,
or DIVORCED.do wed
4 I HEREBY CERTIFY.
That I
attended deceased from
Feb. 20 19.53
to.
March 13 19 ... 53.
I last saw her
.alive on
.March 13., 19.53, death is said to
have occurred on the date stated above, at 8. 50PM m. INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
78
Years
Months.
Days
If under 24 hours
Hours .... . Minutes
13 Usual
Occupation:
(Kind of Work done during most of working life)
14 Industry
or Business:
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
Southbride Iss.
17 NAME OF FATHER
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
P .... Bommet
M. D.
(Address)
Bosten MASS
Date
3-13 1953
6 Place of Burial Werefally ary
Boston Mas. (City or Town)
DATE OF BURIAL.
March 16/53
19
7 NAME OF
FUNERAL DIRECTOR
Maurice W Kirby
Winthrop Mass.
ADDRESS.
Received and filed. APR 27 1953 19
(Registrar of City or Town where deceased resided)
10a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Peripheral vascular collapse
12 Hrs
Due To
(b)
Carcinoma of the colon
generalized carcino stoais-
Due To
(c)
6 Mos
Date of operation
Was autopsy performed?g
What test confirmed diagnosis? autocar
PARENTS
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