USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 26
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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, See. 45, G. L .. (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held or from a/person appointed to have the care of the cemetery or burial ground ty which the interment is made.
Chap. 114, Seć, GL (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these faw's calls for the observance of the follow- ing rules of practice!
(1) Attending physiciens will certify to such deaths only as those of persons to whom they have given bedade ore during a last illness from disease unrelated to any form of injury/ (2) Board of Health hans rull certify to such deaths only as those of persons who, though disabledpy recognized disease unrelated to any form of injury, have died without recentinelical 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 de not, only deaths caused directly or indirectly by traumatism (includingoresmiting septicemia"and by the action of chemical (drugs or poisons) thermal, ofelectrical 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, ete. 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. Winthrop
Community Hospital
J (If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)
Baby Boy Giovanni
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR)
(a) Residence. No. (Usual place of abode)
134 Paris St
East ... Boston 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
april
17
1953
(Year)
(Month)
(Day)
That
I attended deceased from
I last saw h.
alive on
19
death is said to
have occurred on the date stated above, at
8:50PM.
Lm.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
ANTE
Due To
CEDENT (b) CAUSES
Due To
(c)
Stell Ba
blastesis
OTHER SIGNIFICANT CONDITIONS
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?
SSSchuffa
.Date 4/17 .. M. 3
Boston
DATE OF BURIAL
April
21
1953
19
7 NAME OF
FUNERAL DIRECTOR
Vincent Rapino
ADDRESS
9 Chelsea ~t East Boston
Received and filed.
APR 21 1953
19
(Registrar)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
(write the word)
Single
MARRIED
WIDOWED
or DIVORCED
10a If married, widowed, or divorced HUSBAND of .. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here. Stillborn
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)
Winthrop
17 NAME OF
FATHER
Alfred Giovinni Tick
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy Boston
19 MAIDEN NAME
OF MOTHER
Louisi Gambino
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston
21 Alfred Giovanni
Informant (Address) 134 Paris St East Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter &Bahar, winthrop
(Signature of Agent of Board of Health or other)
H.O.
apr. 20, 1953
X
(Official Designation)
(Date of Issue of Permit)
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
d conditions. ing rise to the e (a) staling lying cause
tions contrib- death but not he disease or ausing death.
<
15015
sh. ? ' 05/7/8
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.
86
2 FULL NAME ..
(If deceased is a married, widowed or divorced woman, give also maiden name.)
4 I HEREBY CERTIFY.
19
to
19
PARENTS
(Signed)
(Address)
192
6
St. Michaels
Place of Burial or Cremation
(City or Town)
50M (B)-1-51 903586
1 R-301A 1
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 f 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 er officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9. RECEI.
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 fre 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 remove it from a town, from one cemetery to another, or from one gra ALTRE i other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health. or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4. Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or . if 'there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the epretery or burial ground in which the interment is made.
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"; Chap. 114, Sec. 46, G. L., (Tercentenary Edition). 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 RULES OF PRACTICE relief expedition and the Philippine insurrection, which shall, for said purposes, ba The fulfillment of the purpose of these laws calls for the observance of the follow- ing Yules of practice : 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 seventeenff :- (1) Attending physicians will certify to such deaths only as those of persons G L. Chap. 46. Sec. 10. 6
to whom they have given bedside care during a last illness from disease unrelated do any form of injury.
*20 Board of Health physicians will certify to such deaths only as those of Ipersons 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 muury. 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
ANK, RATING
ORGANIZATION AND OUTFIT SERVICE NUMBER
R-301A 1
PLACE OF DEATH
(City or Toyn)
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.
87
Haspentoil
J(If death occurred in a hospital or institution, St. į give its NAME instead of street and number)
Baby Boy Store
(If deceased is a harried, widowed or divorced woman, give also maiden name.)
55 wave way are winston
mais
(If nonresident, give city or town and State)
Length of stay: In place of death.
years.
months.
days. In place of residence
.. years.
.months
1
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
may
9 COLOR OR RACE
I tute
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
4 I HEREBY CERTIFY,
That I attended deceased from
ceps. 20, 153,
to
ap.20,
1953
19.
.. , death is said to
I last saw him alive. on
have occurred on the date stated above, at
12.02Am.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here Stillfaire
12
AGE
. Years
Months .. ..
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Placenta (Kind of work done during most of working life)
14 Industry
or Business:
22002.
15 Social Security No ...
16 BIRTHPLACE (City).
(State or country)
HUBERT L.
17 NAME OF
FATHER
Hoter Itori
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?
If so, specify .....
(Signed)
an carter
(Address) /6 /My celist
M. D.
Date 4-20 195 3
otras kan csal Place of Burial or Cremation (City or Town)
DATE OF BURIAL 19
5
7 NAME OF
FUNERAL DIRECTOR
it.7. 2und
ADDRESS 1615/200con St Barth-Line
Received and filed APR 2 1 1953 19
(Registrar)
PARENTS
18 BIRTHPLACE OF FATHER (City) (State or country)
19 MAIDEN NAME
OF MOTHER
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
21 Informant Address
Hirdet Stene.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter S.Baker. Winthrop, X
(Signature of Agent of Board of Health or other)
H.O Capr. 20, 1953.
(Official Designation)
(Date of Issue of Permit)
UCTIONS FOR CERTIFICATE
giving OF DEATH t enter than one for each b) and (c)
loes not mean f dying, such ure, asthenia, ns the disease, ations which h.
1 conditions, ng rise to the (a) stating lying cause
ions contrib- death but not re disease or using death.
50M (8)-1.51 903586
X Suffolk (County)
No.
2 FULL NAME ..
(a) Residence. No. (Usual place of abode)
-
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(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)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) .
G Prematanta
,
Due To romaine Sepanico CEDENT (b) CAUSES ANTE
Prolapsed OOK
Due To (c) MaceraTed
OTHER
macerated Fetus
SIGNIFICANT
CONDITIONS
of about 5 + match.
supplier of
1
:
Anita F. Dasdar
EVERETT, 7
Registered No.
3 DATE OF DEATH april 20, (Month) 1953 (Year)
(Day)
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
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.
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
best of his knowledge and belief the name of the deceased, his supposed age the" chemical, thermal or electrical agents or following abortion, or from diseases resulting fromn 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.
A physician or officer furnishing a certificate of death as required by the "No undertaker or other persons shall bury a human body or the ashes thereof 2.which have been brought into the commonwealth until he has received a permit 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 so to do from the board of health or its agent appointed to issue such permits, or army, navy of marine corps of the United States in any war in which it has been 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 engaged, insert in the certificate a recital to that effect, specifying the war, and, shall als certify in such certificate both the primary and the secondary orcimine diate cause of death as nearly as he can state the same. For neuling finansal ground in which the interment is made
Chập: 114, Sec. 46, G. L., (Tercentenary Edition).
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 Chip !!! 5 relief expedition and the Philippine insurrection, which shall. for said purposes be 6 % RULES OF PRACTICE Tra fulfillment of the purpose of these laws calls for the observance of the follow- grudes of practice: deemed to have taken place between February fourteenth, eighteen hundred and ninety-cight and July fourth, nineteen hundred and two, and the Mexican borderpod Attending physicians will certify to such deaths only as those of persons service of nineteen hundred and sixteen and nineteen hundred and seventeen G. L. Ch r. 46, Sec. 10.
to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
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