USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 23
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MAR 23 1955
19
(Registrar)
I PARENTS
18 NAME OF
FATHER
Thomas Joseph Healey
19 BIRTHPLACE OF
FATHER (City).
Pawtucket
(State or country)
Rhode Island
20 MAIDEN NAME
OF MOTHER
Margaret Wood
21 BIRTHPLACE OF
MOTHER (City)
Cambridge
(State or country)
Massachusetts
Informant
Mrs ........ James .............. Healey
(Address) 736 Somerset Ave Vinthron
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
3/22 156
(Official Designation)
(Date of Issue of Permit)/
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. place?
ORM R-303 A 1
N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of MARGIN RESERVED FOR BINDING
of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
50M- 10-53-910621
11.5.
PLACE OF DEATH
(City or Town)
RightTo left Coronary Sclerosis
-
14 Usual
Occupation :..
Fire Fighter
(Kind of work done during most of working life)
15 Industry
or Business:
Winthrop ... FireDepartment
16 Social Security No.
023-09-4211
17 BIRTHPLACE (City).
(State or country)
Rhode Island
Pawtucket
Manner of
Collapsed a deed quickly
10 COLOR OR RACE
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, ( if so specify WAR) NO.
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. See. 45. G. L. as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.
No undertaker or other person 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., as amended.
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.
\. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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 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 alshideaths 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steain railway accident.""Pistol shot wound of the chest with associated hemorrhage, hom- icidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1)Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING .....
ORGANIZATION AND OUTFIT
SERVICE NUMBER
.........
PLACE OF DEATH
.... Suffolk (County)
ORM R-301 1 Winthrop (City or Town)
No.
73 Chester Avenue
[(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME. Isabella Greer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 73 Chester Avenue .......
St.
(If nonresident, give city or town and State)
Length of stay: In place of death 1.1years ... 6
.months. .. days. In place of residence 11
.. years
6
.months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
.March
2.6.
19.5.5
(Month)
(Day)
(Year)
female
white
MARRIED
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
Nov. 10
1953
to MARCH 26
19
55
I last saw hE R alive on
MARCH 25 1954, death is said to
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
GENERALIZED
TWEEN ONSET AND DEATH 8 MOS
11 IF STILLBORN, enter that fact here.
12
AGE.9.] Years ... 1.1. Months ..
0
.Days
If under 24 hours
Hours ....
Minutes
13 Usual
Occupation:
housework
(Kind of work done during most of working life)
14 Industry
or Business:
own home
15 Social Security No.
none
16 BIRTHPLACE (City)
(State or country)
Nass
East .... Boston
ENERALIZED
SYRS
Major findings:
Of operations.
Date of operation
HOME
Was autopsy performed ?. NO
What test confirmed diagnosis ?.
CANICAL + LAB.
5 Was disease or injury in any way related to occupation of deceased? No.
If so, specify
M. D.
(Signed) . Transfer for
(Address) AGESHIRLEYM,WHDay/MAR261955
Forest Hills Cemetery , Boston, Mass. 6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL March 28 1955 ho
7 NAME OF
FUNERAL DIRECTOR
Alfred 2. March
ADDRESS
774 Vinthron St. Vinthron Mass.
Received and filed.
MAR 28-1955
19
A TRUE COPY ATTEST:
(Registrar)
PARENTS
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21 Mr.S. John Maw Sr.
Informant (Address) 73 Chester Avenue, Winthro
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Watter & Baker
(Signature of Agent of Board of Health or other)
caffe 3/28/35
(Official Designation)
(Date of Issue of Permit)
X
V
STRUCTIONS FOR AL CERTIFICATE In giving E OF DEATH o not enter re than one use for each ), (b) and (c)
his does not mean le of dying, such failure, asthenia, means the disease, plications which death.
forbid conditions, giving rise to the ause (a) stating derlying cause
onditions contrib- the death but not to the disease or n causing death.
50M.(A) -11-51-905807
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Winthrop (City or town making return)
64
Registered No.
(Was deceased a U. S. War Veteran, if so specify WAR)
NO.
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
single
have occurred on the date stated above, at.
6:45 A
m.
INTERVAL BE-
TO DEATH (a)
CARCINOMATOSIS
Due To
CARCINOMA OF IT.
ANTE
CEDENT (b)
CAUSES
BREAST
2 4 RS
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
ARTERIOSCLEROSIS
17 NAME OF FATHER James Greer
18 BIRTHPLACE OF FATHER (City) (State or country) Ireland
19 MAIDEN NAME
OF MOTHER
Isabella McMullen
(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 hy section one, where same was contracted, the duration of his last illness, when last seen alive hy 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 hy section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, served in the army, navy or marine corps of the United States in any war in which it has been 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,12 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 seven- teen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody 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 hoard, from the clerk of the town, where 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 br other than the receiving tomh to another in the same cemetery, until he / bas received a permit from the board of health or its agent aforesaid or from the clerk of the town where the hody 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 or HARD'S as tequived ment, hy a satisfactory certificate of the attending physician, if any, 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 hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy 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 he obtained early enough for the purpose, the certificate of death made as ahove 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 hody has been sooner obtained hereunder. If the
IN
death certificate contains a recital, as required hy 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 registration. 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 he 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 only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; ... General Laws, Chap. 38, Sec. 6.
No undertaker or other persons shall hury a human hody 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 hoard, from the clerk of the town where the body is to he buried or the funeral is to he held, or from a person appointed to have the care 1 .. 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 following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from 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 hy 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.
typy: 9(3). Medical Examiners will investigate and certify to all deaths supposahly de for injury. These include not only deaths caused directly or indirectly hy raumGiatism (including resulting septicemia), and hy the action of chemical drugs or poisons) thermal, or electrical agents, and deaths following abortion, Ut but also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
AM 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 he 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 he 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 hy 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
engaged, insert in the certificate a recital to that effect, specifying the war Canidt jof, the cemetery or burial ground in which the interment is made.
+ PLACE OF DEATH
Suffolk (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 ite Arent.
Registered No. 65
Winthrop Community Hospital No. .. Pasquale D'Avella 2 FULL NAME ..
[(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, No
(If deceased is a married, widowed or divorced woman, give also maiden name.) 490 Medford82
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years months .. days. In place of residence ... years months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(Month) (Day)
1455 (Year)
8 SEX
Male
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIED Married
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
mar 28 1955 to
19 53
I last saw ham
9mar 29
19 , death is said to
have occurred on the date stated ahove, at / 150 m.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(2) Coronary Thrombosis
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN. enter that fact here.
12 AGE 69
Years
Months
Days
If under 24 hours
Hours . . Minutes
13 Usual
Occupation:
Retired
(Kind of work done during most of working life)
14 Industry
Merchants wool East Boston
or Business:
15 Social Security No. .
011-01-3614
16 BIRTHPLACE (City)
(State or country)
Italy.
17 NAME OF
FATHER
Vincent D'Avella
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Raffaela Brogna
20 BIRTHPLACE OF MOTHER (City) (State or country)
Italy
6 St Michaels
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 2
55
19
7 NAME OF
FUNERAL DIRECTOR
Vincent Rapino
-
1. 370
ADDRESS
9 Chelsea St.East ... Boston
19
Received and filed.
(Registrar)
PARENTS
21 Informant. Margaret D'Avella (Address) 450 Medford St Walden Dass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter & Papery. (Signature of Agent of Board of Health or other) Hearthe Price H/1/55
(Official Designation)
(Date of Issue of Permity
X
INSTRUCTIONS FOR ICAL CERTIFICATE
In giving SE OF DEATH do not enter ore than one use for each (a), (b) and (c)
This does not mean ode of dying, such ri failure, asthenia .. t means the disease, mplications which i death.
forbid conditions. , giving rise to the cause (a) stating underlying cause
Conditions contrib- lo the death but not to the disease or ion causing death.
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations
Was autopsy performed? 726-
Date of operation.
What test confirmed diagnosis Cleanlara
5 Was disease or injury in any way related to occupation of deceased?Le
If so, specify ...
(Signed) Janci
Eschola
M. D.
(Address) 1953 ammm Gthe Date Mar 2.9 1955
Boston
.......
10a If married,
wargarde Riccia
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
M 25/5
ANTE Due To CEDENT (b) CAUSES
Due To (c)
50M-2-19-25666
ORM R-301A 1
(a) Residence. No. (Usual place of abode)
if so specify WAR)
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 Clercentenary Edition).
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 physiciant. 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 immer diate cause of death as nearly as he can state the same. For neglect to comply! 6 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-sever /> 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 bode service of nineteen hundred and sixteen and nineteen hundred and seventtet G. L. Chap. 46, Sec. 10.
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