Town of Winthrop : Record of Deaths 1954, Part 79

Author: Winthrop (Mass.)
Publication date: 1954
Publisher:
Number of Pages: 566

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 79

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Norfolk

(County) Needham

(City or Town) 384 Webster No.

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

"fordham

(City or town making return)

Registered No. 236

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

Eva Mf. (Toatty)

Merritt

2 FULL NAME

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

51 Dirch

Road

Winthrop

St.

(a) Residence. No.

(Usual place of abode)

(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

November

4 1954

8 SEX

9 COLOR OR RACE

White

10 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY,

Sept.19

That

11/1

to ...

I last saw H.

alive on

Oct.29

death is said to

have occurred on the date stated above,

24:20

INTERVAL BE-

(Husband's name in full)

DISEASE OR CONDITION

DIRECTLY LEADINGCoronary occlusion

TO DEATH (a)

TWEEN ONSET AND DEATH 5 mân

11 IF STILLBORN, enter that fact here.

12 20

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:

homo

15 Social Security No ...

none

16 BIRTHPLACE (City)

(State or country)

England

17 NAME OF

FATHER

Fotert Toatty

18 BIRTHPLACE OF

FATHER (City).

(State or country)

19 MAIDEN NAME

OF MOTHER

Unable to Obtain

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

England

Informant

Robert Merritt

(Address)

A TRUE COPY

ATTEST:

Marian & Peterson

ADDRESS

Received and filed

11-10-54

.19

(Registrar of City or Town where deceased resided)

PARENTS

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

(Signed),*

.... Dicks.

M3 D.

(Address)'

non com.

Abbington, Lass.

Place of Burial or Cremation,

(City or Town)

DATE OF BURIAL.

Nov.

7 NAME OF

FUNERAL DIRECTOR

winthrop, hass.

Howard S. Reynolds

DATE FILED

(Registrar of City or Town where death occurred) November 9,

ANTE CEDENT (b)- CAUSES

Due Tostoriosclerosis

5 yrs.

Due To (c)

OTHER SIGNIFICANT CONDITIONS

Major findings:

Of operations.

Date of operation

.. Was autopsy performed ?.

What test confirmed diagnosis?

physical Exam

25M-3-53-909098

PLACE OF DEATH

M R-302 1

WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD

(Was deceased a

U. S. War Veteran,

if so specify WAR)

attended deceased from

1922

10a If married, widowed, or divorced

HUSBAND of.

(Give maiden name of wife in full)

(or) WIFE of

Percy D. Nosmitt

Housewife

England

RECEIVEI

1.OV10

PLACE OF DEATH

X Suffolk (County) Winthrop (City or Town) Mayflower Nursing 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 burlal -permit with Board of Health or Its Agent.

237

2 FULL NAME ..

Lennie Baker

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

105 Washington Qui

(a) Residence.

No.

(Usual place of abode)

Length of stay: In place of death

years

months.

days. In place of residence

.years.

.months

2 days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

Female

9 COLOR OR RACE

White

10 SINGLE

(write the word)

MARRIED Vidlowend

WIDOWED

or DIVORCED

4 I HEREBY CERTIFY,

That

attended deceased from

June

19 323.

to ..

Nov.5

1954

I last saw h.C.Y ...... alive on

Nov. 5

1957, death is said to

have occurred on the date stated above, at

8:00 P. m.

INTERVAL BE- TWEEN ONSET AND DEATH 1gr.

11 IF STILLBORN, enter that fact here.

Months

Days

If under 24 hours

Hours .. . Minutes

13 Usual

Occupation:

Acusiniti

(Kind of work done during most of working life)

14 Industry

or Business :.

contiene

15 Social Security No.

Tion

16 BIRTHPLACE (City)

(State or country)

Ruscio

17 NAME OF

FATHER

David Pavid

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Russia

19 MAIDEN NAME

OF MOTHER

Golda (C.B.L)

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Russia

21 mas Sidnes m. Craft

(Address) ILS Washington Wee Nenttrans

7 NAME OF

FUNERAL DIRECTOR

Hyman 2. Jest

ADDRESS

Til Washington de Chulara

Received and filed

NOV 8 1964

(Registrar)

10a If married, widowed, or divorced

HUSBAND of ..

Sam Give me

(or) WIFE of

(Give maiden name of wife in full)

el Baker

(Husband's name in full)

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH (a)

SENILITY

ANTE

Due To

NONE

CEDENT (b)

CAUSES

Due To (c)

OTHER

SIGNIFICANT

CONDITIONS

NONE.

Major findings:

Of operations.

Date of operation

.Was autopsy performed?

What test confirmed diagnosis ?.

Clinical.

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

If so, specify

(Signed)

(Address)

Lundimed Maso Date 11/6/

M. D.

6 Beth Jaraul of Mobilen N. Reading Place of Burial or Cremation (City or Town)

DATE OF BURIAL

22-7

19-1

50M-10-52-908091

R-301A 1

TIONS R RTIFICATE ing DEATH enter an one each and (c)

s not mean lying, such e, asthenia, - the disease, ons which

conditions, rise to the a) stating ng cause

is contrib- ath but not disease or sing death.

PARENTS

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Valter & Bakes (Signature of Agent of Board of Fearlow or other)

(Date of Issue of Perpit) 11/6/54

(Official Designation)

Registered No.

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)

St.

(If nonresident, give city or town and State)

3 DATE OF

DEATH

hos.

(Month)

(Day)'

1954

(Year)

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 helief 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., (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 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:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness fron disease unrelated to any form of injury. "

(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled-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)

No.

Winthrop Community Hospital

Baby Boy D' Ambrosio

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

160 Favwood Ave.

St.

S. Postow, Mes5.

(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

3 DATE OF

DEATH

11-

14-54

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY.

11/13/54

to ..

11/14

195X

I last saw hat

alive on.

11/13

195 / death is said to

have occurred on the date stated above, at

10%

.. m.

INTERVAL BE- TWEEN ONSET AND DEATH

ANTE

Due To

CEDENT (b)

CAUSES

Due To (c)

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?

If so, specify

(Signed)

(Address)

235 Maverik 2 Date

11/15 1954

........ , M. D.

Holy CROSS

5.13

Place of Burial or Cremation

(City or Town)

DATE OF BURIAL

Nov . .. 17 ,

Informant

(Address)

Joseph D' Ambrosio

160 Faywood Ave, (Father)

7 NAME OF

FUNERAL DIRECTOR

William E. Peni

ADDRESS

971 Saratoga St. F.B.

Received and filed. NOV 2: 1904 ........ 19

(Registrar)

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

Male

9 COLOR OR RACE

White

10 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

Single

10a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGE

Years

Months

Days

If under 24 hours

Hours 55 Minutes

13 Usual

Occupation :

None

(Kind of work done during most of working life)

14 Industry

or Business:

None

15 Social Security No.

None

16 BIRTHPLACE (City)

(State or country)

Winthrop

17 NAME OF

FATHER

Josenh D' Ambrosio

PARENTS

18 BIRTHPLACE OF

FATHER (City)

East Boston

(State or country)

Mass

19 MAIDEN NAME

OF MOTHER

Josephine D'Ambrosio

20 BIRTHPLACE OF

Keene

MOTHER (City)

(State or country)

N.H,

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

Thealth Office

11/17/54

(Official Designation)

(Date of Issue of Permit}

100M-10-53-910621

Boston 12-7.54

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.

238

J(If death occurred in a hospital or institution.

St. [ give its NAME instead of street and number)

PHYSICIAN - IMPORTANT

2 FULL NAME

UCTIONS OR CERTIFICATE iving OF DEATH t enter han one For 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.

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH (a)

PREMATURE

( 5 1/2 Mas,)

That I attended deceased from

(Was deceased a

U. S. War Veteran,

(if so specify WAR)

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

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.

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 fontihjfry Qr 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 in which the interment is made.

1 ;. {Q-Chap 114. Sec 46, G. L., (Tercentenary Edition).

RULES OF PRACTICE

- The Ifullmest of the purpose of these laws calls for the observance of the follow- ing fules of

(1). Attendingiphysicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness front disease unrelated to any form of injury. (2) Board of Health physicians will certify to such deaths only as those of though disabled by recognized disease unrelated to any form of pers fine lied without tudent 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

PLACE OF DEATH

Suffolk (County)

Winthrop

(City or Town)

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. 239

2 FULL NAME

Harry Lawton Smith

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

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Town of Winthrop : Record of Deaths 1954, Part 79

Author: Winthrop (Mass.) Publication date: 1954 Publisher: Number of Pages: 566

Author: Winthrop (Mass.)
Publication date: 1954
Publisher:
Number of Pages: 566