Town of Winthrop : Record of Deaths 1953, Part 8

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 8


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HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


11 IF STILLBORN. enter that fact here.


12


61


AGE


Years


- Months.


Days


If under 24 hours


Hours . . Minutes


13 Usual


Occupation :.


Labor ~~- (Kind of work done during most of working life)


14 Industry or Business:


15 Social Security No.


16 BIRTHPLACE (City).


(State or country)


17 NAME OF


FATHER


Unknown ) Uguccione


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Maria ( Pollato)


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


21 Informant (Address)


Wife


7 NAME OF


FUNERAL DIRECTOR


William E. Pepi


ADDRESS


971 Saratoga St. E.B.


Received and filed


FEB 1 6 1953


19


(Registrar)


19. 53


1957


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)


peritinitio


DIVERTICULITIS


ANTE


Due To


Questa divertualetes - a


CEDENT (b)


CAUSES


abscessed - raptured.


day


Due To (c) ANUCÍA


OTHER


anuria - lost 24 hrs.


SIGNIFICANT


CONDITIONS


divecticolain


SIGHOYD


Major findings:


perforated alsoned Aventuras sugar


Date of operat


FEB 1,1953


What test confirmed diagnosis ?.


Was autopsy performed? no labinotam test


5 Was disease or injury in any way related to occupation of deceased?


If so, specify.


(Signed).


21 Bread LA Date File 15.


1953


M. D.


(Address)


Holy Cross Cemetery


Malden


-


6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL.


Feb. 16, 1953


19


PARENTS


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


He although


fiche


2.16.53


(Official Designation) (Date of Issue of Permit)


UCTIONS 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) stating lying cause


lions contrib- death but not he disease or ausing death.


50M (B).1.51 903586


R-301A 1


Registered No.


f(If death occurred in a hospital or institution,


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


10 SINGLE


(write the word)


4 I HEREBY CERTIFY,


That I attended deceased


from


20 19


53


to


Fele 13


last saw h.


alive on


Fel 13


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


Winthron Community Hos ital


2 FULL NAME


PERSONAL AND STATISTICAL PARTICULARS


days.


Italy


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 onc, 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 comphì 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, b& 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 seventeend10 G. L. Chap. 46, Sec. 10.


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 other than the receiving tomb to another in the same cemetery, until he } 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 r the funeral is to be hekl, or from a person appointed to have the care of the 1.7 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- ing rules,of practice:


Attending physicians will certify to such deaths only as those of persons whom they have given bedside care during a last illness from disease unrelated


to any form of injury.


No undertaker or other person shall bury or otherwise dispose of a human body -(?), Board of Health physicians will certify to such deathsonly as those of in a town, or remove therefrom a human body which has not been buried, untilbe : " 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 remove it from a town, from one cemetery to another, or from one grave or B ( 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


after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-305 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


25m-(c)-11-49-900.475


PLACE OF DEATH


Plymouth (County)


Plymouth


(City or Town)


No. Cliff


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH


Plymouth


(City or town making return)


Registered No. 29


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


2 FULL NAME.


David Noel Brewer


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


(Was deceased a


U. S. War Veteran,


if so specify WAR)


no


(a) Residence. No.


7 Faun Bar Ave.


St.


Winthrop, Mass


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death


......


.years


months.


1


days. In place of residence.


.....


.years.


7


months


22 days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


February


14,


1953


DEATH


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Death by aspiration of


... vomi tus


PERSONAL AND STATISTICAL PARTICULARS


9 SEX


Male


10 COLOR OR RACE


White


11 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Single


11a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


12 IF STILLBORN. enter that fact here.


13


AGE


0


Years ..


7 Months.


23 Days


If under 24 hours


Hours


Minutes


14 Usual


Occupation :.


none


(Kind of work done during most of working life)


15 Industry


or Business:


16 Social Security No ....


none


17 BIRTHPLACE (City).


(State or country)


Mass.


18 NAME OF


FATHER


David L. Brewer


19 BIRTHPLACE OF


FATHER (City).


Plymouth


1


(State or country)


Mass.


20 MAIDEN NAME


OF MOTHER


Dorothy E. Nowell


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Mass.


Brighton


7 Chiltonville Plymouth


Place of Burial, or Cremation.


(City or Town)


DATE OF BURIAL


February


17


19 5


8 NAME OF


FUNERAL DIRECTOR


Roy E. Beaman


ADDRESS


Plymouth Mass.


Received and filed


MAR 5 - 1953


.......... 19


(Registrar of City or Town where deceased resided)


PARENTS


Informant ...


22


Mr. David. L. Brewer


(Address) / Faun Bar Ave. Winthrop


A TRUE COPY.


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


February


17


,53


5 Accident, suicide, or homicide (specify).


Accidental


Date and hour of injury


Feb. 14


.. 19


53


8:00 p.m.


Injury occur?


Where did


Cliff St. , Plymouth , Mas s.


(City or town and State)


Did injury occur in or about home, on farm, in industrial place, or in public


place?


Home


Manner of


Injury


Aspiration of vomitus


Nature of


(How did injury occur?)


Injury


Suffocation


While at work?


no


.Was autopsy performed?


no


6 Was disease or injury in any way related to occupation of deceased? If so, specify


(Signed)


Walter E. Deacon


M. D.


(Address)


Date.


19


...


...


I R-305 1


(Specify type of place)


Winthrop,


RECEIVED


.. 1


0


1.9


TES


5


MAR-5


50M-5-52-907046


7 NAME OF


FUNERAL DIRECTOR,


Juderick Shagrant


ADDR


ss98 Havre St. & Boston


Received and filed.


REB 1 0 1905


19


(Registrar)


11 IF STILLBORN, enter that fact here.


12


57


.Years


Months


.Days


If under 24 hours


Hours


Minutes


13 Usual


Occupation :....


Housework


(Kind of work done during most of working life)


14 Industry


or Business :.


Pun home


15 Social Security No .... Provincetown


16 BIRTHPLACE (City). (State or country)]


mais.


17 NAME OF


FATHER


Joseph Johns


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Portugal


19 MAIDEN NAME


OF MOTHER Mary & Saton


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Portugal


21 Informant


Ethel Laracy


5) 10 noble Ctl East Boston


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transi) permit was issued: Walter 2, Bakery


(Signature of Agent of Board of Health or other) Health Officer 2 . 16 . 5}


(Official Designation)


(Date of Issue of Permit)


-


Nonterap Community Hospital


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


mary 9. Lalacy


(If deceased is a married, widowed or divorced woman, give also maiden name.) 10 Noble ' CV.


St.


E. Boston


(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


Feb


(Month)


14


(Day)


1953


(Year)


8 SEX


Female Site


9 COLOR OR RACE


10 SINGLE


(write the word)


MARRIED"


WIDOWED


or DIVORCEDIGweed


4 L HEREBY CERTIFY,


19.480


to ...


Feb 14


190-3


I last saw her alive on K2B


13, 1955, death is said to


0


10a If married, widowed, or divorced


HUSBAND of ......


(Give maiden name of wife in full)


Patrick a Jaracy


(or) WIFE


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


4Remia


TWEEN ONSET ANO DEATH 4/8hs


ANTE


CEDENT


CAUSES


Kong disease


Due To arterio-selerstee


(b)


(c)


· Hypertension


essential


OTHER


Chronje capsular


SIGNIFICANT


CONDITIONS


heart disease-obesity


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? no


ft so, specify.


(Signed) socjalu 227


M. D.


(Address) 20 I malungle


Date 2-11 19:3


oHoly Cross


S VintoTrop. Matelem


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL.


Feb 17


1953


Boston 3/6/5"


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.


30


Registered No.


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WARY


none


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 th.


id conditions, ing rise to the se (a) stating rlying cause


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


R-301A 1


PLACE OF DEATH Suflack (County) enteros (City or town)


2 FULL NAME ..


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


That I attended deceased


from


have occurred on the date stated above, at.


2:09 17.


.m.


INTERVAL BE-


PARENTS


Madre Islands


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.


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).


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 ør: burial ground in which the interment is made.


Chap, 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


6


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 injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.


No undertaker or other person shall bury or otherwise dispose of a human body thesons who, though disabled by recognized disease unrelated to any form of


(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


PLACE OF DEATH


Suffolk (County)


nathrop


(City or Town) 39 g No ... ....


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


MEDICAL EXAMINER'S CERTIFICATE OF DEATH


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


31.


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




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