USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 71
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If so, specify.
CL Clay
M. D
(Address)
Mass , Gen era.1 .... Hosmate.
10-159.
6
Winthrop Cem-Winthrop Mass.
-
Place of Burial or Cremation (City or Town) DATE OF BURIAL Oct.17/53 19
21
Informant
(Address)
Mrs A Whitehead
A TRUE COPY
copy arles A. Machie
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Oct. 19/53
.19
V
25m-(b)-11-49-900,475
m.S.
(Registrar of City or Town where deceased resided)
WPARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
England ............
19 MAIDEN NAME
OF MOTHER
Ellen Bowdoin
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
7 NAME OF
FUNERAL DIRECTOR
M W Kirby
Winthrop
ADDRESS
Received and filed. OCT 26 :53 19
of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
No.
Mass. General Hospt.
Mark A Whitehead
(Month)
(Day)
(Year)
19
53
10a If married, widowed, or divorced
HUSBAND of.
Anna .C ... Sullivan
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
heart
Yrs
13 Usual
Occupation:
Collector
(Kind of work done during most of working life)
14 Industry
or Business:
First Nat Bank
15 Social Security No.
None
FATHER
Mark A Whitehead
(Signed)
(Was deceased a
U. S. War Veteran,
if so specify WAR).
(If nonresident, give city or town and State)
6
OCT26 AM
R-301A 1
PLACE OF DEATH
Suffolk
(County) Winthrop (City or Town) ·Winthrop Community Hoop
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.
220
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)
none
(If deceased is a married, widowed or divorced woman, give also maiden name.) 133 Giver old. Winthrop St. (If nonresident, give city or town and State)
Length of stay: In place of death .years .. months. 21 days. In place of residence. 6 .years .. .months .. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
October 18 1983
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, Get 15 19 53
That I
Set
attended deceased from
1953
7
-
I last saw h.
vialive on
les 17
1953
, death is said to
have occurred on the date stated above, at 1 30 A .. m.
DISEASE OR CONDITION CarcinomaTosis
DIRECTLY LEADING cinomatosis
TO DEATH (a)
INTERVAL BE- TWEEN ONSET AND DEATH 3ms
11 IF STILLBORN, enter that fact here.
12
AGE.
51 Years
Months
.Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
Foreman
(Kind of work done during most of working life)
14 Industry
or Business:
Hathaway Baker
15 Social Security No.
16 BIRTHPLACE (City) (State or country) Quasia
17 NAME OF
FATHER
nathan alpert
18 BIRTHPLACE OF FATHER (City). (State or country)
Busia
19 MAIDEN NAME
OF MOTHER
Besser (unknown)
20 BIRTHPLACE OF MOTHER (City) (State or country) Russian
21 Informantdamals alpert (Address) 133 River St. Winthomp
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Walter A. Lakers
(Signature of Agent of Board of Health or other)
Received and filed. OCT2-0-1953
...... 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR OR RACE
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
maril
(Fox) 10a If married, widowed, or divorced HUSBAND of. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
ANTE CEDENT (b) CAUSES
Due To
..
focus Primary focus vutum
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Carcinoma toria
Date of operation eat 9-53
.Was autopsy performed? no
What test confirmed diagnosis?
0
5 Was disease or injury in any way related to occupation of deceased? No
no
If so, specify.
(Signed) $500
(Address) +47 Shirley t wirthump Date Gef 18
1953
M. D.
6 guidon Tefile
West. Ref.
Place of Burial or Cremation
(City of Town)
DATE OF BURIAL Oct.22 1953
7 NAME OF
Erwinf. Levine
FUNERAL DIRECTOR. ADDRESS 470 Harvard Sr. Brookline
50M-5-52-907046
X
2 FULL NAME,
Mr. Israel albert
(a) Residence. No (Usual place of abode)
UCTIONS OR CERTIFICATE
iving F DEATH t enter han one or each ) and (c)
oes not mean f dying, such ure, asthenia, s the disease. tions which
conditions, g rise to the (a) stating ying cause
ons contrib- death but not e disease or using death.
Mistkan Terita
M.s.
Thealth Officer 10.20.53 (Official Designation) (Date of Issue of Permit)
PARENTS
to.
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 ninetcen hundred and seventecn. G. L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original inter- ment, by a satisfactory certificate of the attending physician. if any, as required by law. or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by, section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
f. 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.
Na 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.
ChapuI14, Sec. 46, G. L., (Tercentenary Edition).
F1
6
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 torfhans Hey have given bedside care during a last illness from disease unrelated dity forht 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 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
.....
R-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town>> Bay Vue Rest Home No.
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. 230
J(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Constantino Romano (If deceased is a married, widowed or divorced woman, give also maiden name.)
69 Webster St.
St. .
East Boston (If nonresident, give city or town and State)
Length of stay: In place of death.
3
years
months days. In place of residence
50. . years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
& SEX Male
9
VALOR OR RACE
10 SINGLE
(write the word)
MARRIED WIDOWED or DIVORCED
Married
4 LHEREBY CERTIFY,
That I attended deceased from
@ et 17 19 53 to ...
Oer 18
19
53
I last saw halive on 0 ex 18, 1955 death is said to
have occurred on the date stated above, at 1100 A m.
INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.
12
1 day .79 Years AGE Months
Days
If under 24 hours
Hours .
Minutes
13 Usual
Occupation :
Laborer
(Kind of work done during most of working life)
14 Industry
or Business:
Retired
15 Social Security No.
022-09-7688
16 BIRTHPLACE (City)
(State or country)
Italy
17 NAME OF
FATHER
Ralph Romano
PARENTS
18 BIRTHPLACE OF
Italy
FATHER (City) (State or country)
19 MAIDEN NAME
OF MOTHER
Terisa (unknown)
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
6
Holy Cross
Place of Burial or Cremation
DATE OF BURIAL
October
22
(City or Town) 53
7 NAME OF
FUNERAL DIRECTOR.
Vincent Rapino
ADDRESS
9 Chelsea St. East Boston
Received and filed
OCT. 21. 1953
19
(Registrar)
& day
Due To Fractured Ciff (c) his.
OTHER
Carcenone
SIGNIFICANT
CONDITIONS
of Prostate gland
Major findings:
Of operations.
Fractured Lup
Date of operation
?
200
What test confirmed diagnosis?
Was autopsy performed?
Clinical
5 Was disease or injury in any way related to occupation of deceased? 200
If so, specify .
SACCAR
am. a. Janone
(Signed)
M. D.
1953
(Address)
6/ Request Ramme Date 10/21
Malden
Virginia Romano
21 Informant (Address) 69 Webster St East Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit pepunt was issued: Walter & takers- (Signature of agent of Board of Health of other) Health Officer 10. 21.53
(Official Designation) (Date of Issue of Permit)
CTIONS R ERTIFICATE ving DEATH enter an one r each and (c)
es not mean dying, such re, asthenia, the disease, ions which
conditions. grise to the (a) stating ing cause
ns contrib- eath but not disease or sing death.
+50M (B)-12-49-900722
ANTE CEDENT (b) CAUSES
Due To
Cerebral
Thrombosis
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Pulmonary
Edema
10a
If married, widowed, or divorced
HUSBAND of
Virginia
LaRosa
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
3 DATE OF
DEATH
October (Month)
18 (Day)
1953
(Year)
Registered No.
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran. No if so specify WAR)
(a) Residence. No. (Usual place of abode)
Bos10-20 1/4/53
3
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 eertifying 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.
RECEIVE
No undertaker or other persons shah 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, frontthe clerk of the town where the body is to be buried or the funeral is to be bekl or from a person appointed to have the care of the cemetery or burial ground in ahuh the interment is made.
Chap. 114, Sec. ,,{Tercentenary Edition).
./10.
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 gul testify 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 Heal ysicians will certify to such deaths only as those of persons who, though disafiatby 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. Utdimunle not onlt Mdeaths caused directly or indirectly by traumatism (including, fesalting 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 domestie 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
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec 12, G. L.)
25M-3-53-909096
PLACE OF DEATH
SUFFOLK (County) ROSTOU
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
9326
₡31
give its NAME instead of street and number) ( (If death occurred in a hospital or institution, No. . The Boston Floating Hospital
2 FULL NAME ..
JONATHAN L WEY
(If deceased is a married, widowed or divorced woman, give also maiden name.)
15 Bates Ave.,
(a) Residence. No. (Usual place of abode)
(If hontrestdent, give city or town and State)
Length of stay: In place of death.
......
.years.
months ..
2 ...... days. In place of residence ........... years ........... months ... 2.6.days.
26 mins
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October
2.3
1953
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
10.21
19
... ,
to ..
10-23
19 .. 53
I last saw h .... .... alive on.
-10-23.
., 19 .... 5 Zdeath is said to
have occurred on the date stated above, at 4.250 m.
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