USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 29
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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 pr infection relating to occupation, or suddenly when not disabledf 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 in which the interment is made.
i: Chapf 144. Soc.46, G. L., (Tercentenary Edition).
RULES OF PRACTICE 8 FORTHEHt'Of the purpose of these laws calls for the observance of the follow-
of Reactie drog 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 ofinjury. (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 re didd withoutcent medical attendance or whose physician is absent injewhen 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 occupi- 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
(County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
04
J(If death occurred in a hospital or institution, "St. [ give its NAME instead of street and number) No.
2 FULL NAME. Samuel ALBERT
(If deceased is a married, widowed or divorced woman, give also maiden name.)
34 Hawthorne Ave.,
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In place of death years. 10 months .days. In place of residence 36years
months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
APRIL
27
1953
(Year)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED Me
of DIVORCErried
4 I HEREBY CERTIFY.
That I attended deceased from
april 8
1953.
to
april 27
1953
I last s
his alive on april 27, 1953
death is said to
have occurred on the date stated above, at
1:15 P. m.
10a If married, widowed, or divorced
HUSBAND of ..
Rose. MYERS
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
2) Conbral Hemorrhage
INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN. enter that fact here. 10 days 12 AGE.80 Years Months Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
Salesman
(Kind of work done during most of working life)
14 Industry
or Business:
Hardware Business
15 Social Security No. none
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
c.n.b.l.
Alpert
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
c.n.b.l.
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21 Julia ... Levenson
Informant
(Address)
233 River Rd., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter &. Shaker
(Signature of Agent of Board of Health of other)
Healthe Office
4.28.57
(Official Designation)
(Date of Issue of Permu)
50M-2-19-25666
7 NAME OF
B· Schlossberg. 205
FUNERAL DIRECTOR
ADDRESS
12.72 Blue Hill Ave . , Matt.
Received and filed. APR.2.8.1953 19
(Registrar)
2 yrs
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation.
.. Was autopsy performed?
200
What test confirmed diagnosis ?.
Clinical
5 Was disease or injury in any way related to occupation of deceased? 200
If so, specie
Charles
Liberau (Signed) M. D. (Address) 238 Dove Drive Date 4/271 195-3
Netherland Society, Melrose 6
Place of Burial or Cremation (City or Town)
DATE OF BURIAL.
April 29,1953
19
/DA/VANthbthe/Até/MAYFLOWER NURSING. AIBERT HOME
-
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(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 lure, asthenia, ins the disease. cations which th.
id conditions. ing rise to the e (a) stating lying cause
tions contrib- death but not he disease or ausing death.
V
1
A R-301A 1
ANTE Cerebral Centerio-
CEDENT (b)
CAUSES
Achinasia
(write the word)
(Month)
(Day)
Registered No.
ALBERT
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 (Tercettepary Edition).
Medicalexaminers sball make examination upon the view of the dead bodies Lof persons las tare "supposed to have died by violence, or by the action of Thendeal, thorgal or electrical agents or following abortion, or from diseases resultety front idiury of infection relating to occupation, or suddenly when not aokzahle discase, or when any person is found dead. . - General Lay ro.as amended by Chap. 632, Sec. 4. Acts of 1945.
6 priother persons shall bury a human body or the ashes thereof which Has 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 eAFRD14, Sec.4BIG. L., (Tercentenary Edition). yrial ground in which the interment is made.
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 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
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
IR-301A 1
PLACE OF DEATH Auffolk /County Winthrop (City or Town)
5/6/5
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No. 95
Winthrop Community Hospital No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) PHYSICIAN - IMPORTANT
mary e mambuca
(If deceased is a married, widowed or'divorced woman, give also maiden name.)
654 Saratoga
St. .
East Boston
(If nonresident, give city or town and State)
Length of stay: In place of death ..... .. years.
.years. months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
april (Month)
27 (Day)
1953 (Year)
8 SEX
7.
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
(write the word)
4 I HEREBY CERTIFY,
That I. attended
deceased from
Jan
I last saw h alive on april 26 ... 1953. death is said to
10a If married, widowed, or divorced HUSBAND of .. ... . (or) WIFE of (Give)maiden name of wife in full) Nicholas Mambuca
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12 AGE 42 2Years
Months
Days
If under 24 hours
Hours
Minutes'
13 Usual
Occupation:
Housework HOUSEIN.X2 (Kind of work done during most of working life)
14 Industry
or Business:
Own Home
15 Social Security No. 029-05-4747
16 BIRTHPLACE (City) (State or country) Bortre Mau
17 NAME OF FATHER
Joseph Di Vingo
18 BIRTHPLACE OF FATHER (City) (State or country)
Stala
19 MAIDEN NAME OF MOTHER
Screphine arena
20 BIRTHPLACE OF MOTHER (City) (State or country)
Italy
6 Holy Cross Place of Burjal or Cremation
Walden (City or Town)
DATE OF BURIAL. april 30 1º
7 NAME OF FUNERAL DIRECTOR. Charles H. Treanor
ADDRESS East Boston
Received and filed APR 30 1950 19
(Registrar)
TWEEN ONSET AND DEATH 5 years
ANTE
Due To
Certains d tu divers
CEDENT (b) CAUSES aceites
WITH Due To (c) PYElo
OTHER
Cielo oneplantes
CONDITIONS
Major findings:
Of operations ..
Date of operation
Was autopsy performed ?.
What test confirmed diagnosis ?.
X- Ray- Lab.
5 Was disease or injury in any way related to occupation of deceased ?.
If so, specify.
(Signed)
habe J. Cataldi M. D. 4 8 hgran CHE /Bouton and 24 1953 (Address)
PARENTS
21 Informant (Address) 654 saratoga ft
E. Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit perunit was issued: Walter & Bakes (Signature of Agent of Board of Health of other) Theallle Officer 4/3/23 (Official Designation)
(Date of Issue of Permit)
UCTIONS OR CERTIFICATE iving OF DEATH t enter han one For each b) and (c)
oes not mean f dying, such ure, asthenia, as the disease, ations which
conditions. g rise to the (a) stating ying cause
ons contrib- death but not e disease or using death.
50M-2-49-25666
2 FULL NAME
(Was deceased a U. S. War Veteran, ja so specify WAR)
no
(a) Residence. No. (Usual place of abode)
3 ANKS.
months. days. In place of residence 12
to april 26
1953
have occurred on the date stated above, at
10 P .. .. m. INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADER
TO DEATH (a) Neumatic Heat
Dizemne Frage TV (IV>
7 years
To be filed for burial permit with Board of Health or its Agent.
nicholas mambuca
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-if There is no such board, from the clerk of the town where the body is to be buried 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 immer 11 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 RULES OF PRACTICE 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 "The fulfillment of the purpose of these laws calls for the observance of the follow- ing fules 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 borger,, service of nineteen hundred and sixteen and nineteen hundred and sever G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human bf 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 orfeu 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 cxaminers shall make examination upon the view of the dead bodies of persons as are supposed to have dicd 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 bri 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.
(1) .Attending physicians will certify to such deaths only as those of persons o when they have given bedside care during a last illness from disease unrelated anyform of injury.
(2) Board of Health physicians will certify to such deaths only as those of ons who, though disabled by recognized disease unrelated to any form of HERBy 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 M(including resulting septicemia), and by the action of chemical drugs or polsons) 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.
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