Town of Winthrop : Record of Deaths 1956, Part 74

Author: Winthrop (Mass.)
Publication date: 1956
Publisher:
Number of Pages: 534


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1956 > Part 74


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PLACE OF DEATH -


R-302 1 -


No ..


Beth El Nursing Home


(Was deceased a


U. S. War Veteran,


if so specify WAR)


no


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


INTERVAL BETWEEN ONSET AND DEATH


(b)


Arteriosclerosis


50M.11-55-916145


(Signed)


1734 Beacon Street


R-302 1


PLACE OF DEATH


(County)


(City or Town)


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


POSTON


(City or Town making this return)


9571 210


§ (If death occurred in a hospital or institution,


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


2 FULL NAME Ernest Bedard


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


703 Fast 4th


St


South Boston,


(If nonresident, give city or town and State)


Length of stay: In place of death


11years.


11


months.


days. In place of residence.


.years


months.


.days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


October 2.5 19.5.6. (Year)


(Month)


(Day)


4 I HEREBY CERTIFY,


That I attended deceased from


Sept


26, 1956


to


Oct.


25, 1955


I last saw h ........ alive on


19


death is said to


have occurred on the date stated above, at


7:55₽


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) Fatty Nutritional Cirrhosis in Decompensation


INTERVAL BETWEEN ONSET AND DEATH


Due To


Arteriosclerotic Heart


(b)


Disease


yrs


Due To


(c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


Yes


What test confirmed diagnosis?


Autopsy


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


(Signed) Ilerlis M. D.


(Address)


Foston City Hospt 10-26 19


56


6


Winthrop .Com Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


Oct 29 195


7 NAME OF


FUNERAL DIRECTOR


AJ StLaurent


ADDRESS.


Received and filed. DEC 1- 1958


19


(Registrar of City or Town where deceased resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Married


10a If married, widowed,


HUSBAND of.


CHEFlotte Peterson


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


69


Ionths.


16


Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


Heel Shaver


retired


(Kind of work done during most of working life)


14 Industry or Business :


15 Social Security No.


013-14-1955


16 BIRTHPLACE (City)


(State or country)


Canada


17 NAME OF


FATHER


Adolphe Bedard


PARENTS


18 BIRTHPLACE OF FATHER (City) (State or country) Canada


19 MAIDEN NAME OF MOTHER Hermine LaBrie


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Canada


21 Informant (Address)


A TRUE COPY


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


Oct 30


19.56


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town resided as soon as possible, after the close of the month in which the death occurred. (Scc Chap. 46, Sec. 12, G. L .. ) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased


No.


Boston City Hospt


Registered No.


(Was deceased a


U. S. War Veteran,


w/W


I


if so specify WAR).


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


50M.1 :. 56-916145


Winthrop


Wife


yrs


AGE


Years


10


4-29-18 5-8-19 Pvt. Co. I 306th Inf. 2720523


100M-11-55-916145


7 NAME OF


FUNERAL DIRECTOR


alfred-B. March


ADDRESS 774 Winthrop St. Winthrop, Mass.


Received and filed NOV - 5 1956 19


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


10 SINGLE


(write the word)


MARRIEDmarried


WIDOWED


or DIVORCED


female


white


10a If married, widowed, or divorced


HUSBAND of ......


(Give maiden name of wife in full)


(or) WIFE of John William Fielding


11 IF STILLBORN, enter that fact here.


12


AGE57 Years 6


.Months22 ... Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


Rifauf An toffeduring most of working life)


14 Industry


or Business :..


own home


15 Social Security No.


none


16 BIRTHPLACE (City)


(State or country)


England


17 NAME OF FATHER


18 BIRTHPL


George Edward Cross


FATHER (City)


(State or country)


England


19 MAIDEN NAME


20 BIRTHPLACE OF


MOTHER (City).


(State or country)


England


21 Informant John-W. Fielding


(Address)


62 washington ved termicate to


I HEREBY CERTIFY that a satisfactory standars was, filed with me BEFORE the batjal or transit perput was issued: Waller Allaluce Vaughan (Signature of Agent of Board of/ Health or other) 11/1/3/56


(Official Designation ) (Date of Issue of Permit) Rainved. 11.4-56 V.1.


-


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


November 2, 1956


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


2/10


19.


52


to


11/2,


19 56


I last saw


He alive on


11/2


death is said to


., 19.56


have occurred on the date stated above, at 4.30 Am.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Carcinoma both


(a)


previsto


INTERVAL BETWEEN ONSET ANO DEATH


Due To


metastasis to


Brain


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


What test confirmed diagnosis ?.


Brukar


5 Was disease or injury in any way related to occupation of deceased? 10 If so, specify.


(Sig


cuithours aronStation


4M. D.


OF MOTHER


Julia Evelyn Walsh


(Address) 116 Loudou St Dar Betare East Ba .19.


6 Winthrop Cemetery Winthrop Mass


Place of Burial or Cremation (City or Town)


DATE OF BURIAL November 5 7956 19 ... / ....


X Suffolk (County )


.... Winthrop (City of 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.


211


No. 62 Washington Avonuo


§(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)


NO.


(If deceased is a marfied, widowed of divorced woman, give also maiden name.)


(a) Residence. No .... 62 Washington Avenue St


(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 45 ... years. months. .days.


CTIONS OR CERTIFICATE


iving F DEATH t enter han one for each ) and (c)


es not mean of dying, art failure, c. It means ,.or compli- hich caused


s, if any, ve rise to use (a), he under- use last.


ons contrib- cath but not the terminal dition given


Chapter 137, 954, requires s to print or :


cause or f death on tificates.


PLACE OF DEATH


R-301A 1


- (b)


1955


PARENTS


Registered No.


2 FULL NAME Grace Evelyn Fielding (Cross .. )


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 hy section forty-five of chapter one hundred and four- te"n, 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 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 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


M R-303 A 1


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 stato CAUSE AND MANNER OF SOM-10-53-910621 9. 2 N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. place?


X Sullalic XCounty)


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 permit with Board of Health or its Agent.


Registered No. .........


212


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)


WW II


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


Length of stay: In place of death. .years. .. months .. .days. In place of residence.


(If nonresident, give city or town and State)


3


.years


months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


kor - 4 - 1956


(Month)


(Day)


(Year)


9 SEX


Male


10 COLOR OR RACE


White


11 SINGLE


(write the word)


MARRIED WIDOWEDMarried or DIVORCED


4I 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 ) Hypertenzure Heart Disease


acute Cardiac Dilatation


12 IF STILLBORN, enter that fact here.


13


AGE


Years


33


Months.


Days


If under 24 hours


Hours .....


Minutes


14 Usual


Occupation:


Salesman


15 Industry


Retail Dry Goods Store


or Business:


16 Social Security No ...


Not .... Learned


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


(Specify type of place)


Manner of Closed wiele das ging wear


Injury


(How did injury occur?)


Nature of


Injury


his home ; Ried quickly


While at work?


Was autopsy performed?


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


If so, specify)


(Signed)


Im Buckley M.O.


(Address)


7


Holy Cross


Malden


Place of Burial, or Cremation.


(City of Town)


DATE OF BURIAL


Nov. 7,


1956


........


8 NAME OF


FUNERAL DIRECTOR


DiPietro & Vazza


ADDRESS


11 Henry St Fast Boston


Received and filed.


NOV 6, 1955


.....


19


(Registrar)


PARENTS


19 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


20 MAIDEN NAME


OF MOTHER


Angelina LoPilato


21 BIRTHPLACE OF MOTHER (City) (State or country) Italy


22 Paul Campo (Address) 319 Sumner St, East Boston Informant


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Analiza Confereanno.


(Signature of Agent of Board of Health or other) Thealth Ofrecer 11/6/56


(Official Designation)/ (Date of Issue of Permit),


...


11a If married, widowed, or divorced 1 Gallese.


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


5 Accident, suicide, or homicide (specify),


Date and hour of injury.


19


city-


Where did Injury occur? (City or town and State)


East Boston


17 BIRTHPLACE (City) ..


(State or country)


Mase


18 NAME OF


FATHER


Paul Campo


1


1


2 FULL NAME ..


PLACE OF DEATH


(City or Towns 65 Sagamore ano No. ... Stephen Campo


(If deceased is a married, widowed or divorced woman, give also maiden name.) 46 Sagamore are Winthrop


M. D. 1056


(Kind of work done during most of working life)


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 of 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, See. 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 hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is eaused 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. 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,


Scc. 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 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


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 steam 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."




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