Town of Winthrop : Record of Deaths 1958, Part 25

Author: Winthrop (Mass.)
Publication date: 1958
Publisher:
Number of Pages: 566


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 25


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death certificate contains a recital, as required by. seetion 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 eause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).


Medieal 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 heldi, 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 medieal 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 supposahly 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 ean 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 oceupation 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


X Suffolk 7(County) Winthrop (City or Town)


4.7.50


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


CERTIFICATE OF DEATH


Registered No.


50


Mayflower Nursing Home


DONOHUE


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


322 Euclid ave.


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


Length of stay: In place of death.


2


.years.


9


months.


days. In place of residence ...


... years.


months.


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


F.


9 COLOR


White


10 SINGLE


(write the word)


widowed


MARRIED


WIDOWED


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(Give manden mame o Awife in full) Jeremiah & Donohue


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


Years


12


ACE 85,


8


Months.


15 Days


If under 24 hours


Hours ....


Minutes


13 Usual


Occupation:


(Kind of work done during most of working life)


14 Industry


or Business:


Janice Shoe Co.


15 Social Security No ..


034-03-0810


16 BIRTHPLACE (City)


(State or country)


Barton Vermont


17 NAME OF


FATHER


Michael Fontaine


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Vermont


19 MAIDEN NAME


OF MOTHER


Victoria Boucher


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Vermont


21 William F Teler


Informant


(Address)


20 Holyoke St Lyand


I HIEREBY CERTIFY that a satisfactory standard certificateof death was filed with me BEFORE the burial or transit permit was issued: Falu . Jereanuso


(Signature of Agent of Board of Ilcalth or other) fractie, Fici


(Official Designation)


(Date of Issue of Permit)


X


-301A 1


TIDNS


RTIFICATE ing DEATH enter in one r each and (c)


not mean of dying, rt failure, It means of compli- ch caused


if any, rise to se (a). under- se


last.


Due To (c)


OTHER


SIGNIFICANT


ististes


CONDITIONS


Was autopsy performed?


no


What test confirmed diagnosis? Physical examination


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


(Signed)


Vincent Butts


, M. D.


(Address) 244 meridian X 3-31 1958


6 St mary's


Place of Burial or Cremation


DATE OF BURIAL apr 1 1958


7 NAME OF


FUNERAL DIRECTOR


Walter & ahern


ADDRESS 567 Boston St Lynn


Received and filed MAR 31 1958 19


(Registrar)


1958


(Year)


(Month)


(Day)


That I attended deceased from


4 I HEREBY CERTIFY


8-6


19


55 to


3.28 -


1958


I last saw h


..... alive on


March 28, 1958, death is said to


have occurred on the date stated above, at


1.30 Am.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Bronchop neumoung


(a)


audunlysten of the Heart


(b)


Due To


Old age-infection


INTERVAL BETWEEN ONSET AND DEATH


50M-5-57-920345


PLACE OF DEATH


(Caroline) 2 FULL NAME.


No. CLARA


[(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)


Mars


no.


St.


Lynn


(If nonresident, give city or town and State)


3 DATE OF


DEATH


march


29


Lynn (City of/Town)


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


PARENTS


(or) WIFE of


Packer


s contrib -- > th but not e terminal tion given


apter 137, 1, requires to print or cause or death on cates.


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, eightcen 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 sooncr 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 derk 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


X


R-302 1


PLACE OF DEATH


Suffolk


(County)


Revere


(City or Town)


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


Revere


(City or town making return)


Registered No. ........ .60


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


2 FULL NAME (Baby Boy) Martello (If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence. No. 169 Pauline St.


Winthrop


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.


......


... years.


.months.


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March


30,


1958


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


19 ..


19


to.


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.


Stillborn


12


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:


15 Social Security No.


Revere


16 BIRTHPLACE (City).


(State or country)


Mass.


17 NAME OF


FATHER


Ernest Martello


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Boston


19 MAIDEN NAME


OF MOTHER


Josephine Melucci


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy.


6


Holy Cross Cemetery. Place of Burial or Cremation (City or Town)


DATE OF BURIAL


April


3.


.19.58


21 Informant. (Address) Ernest Martello 169 Pauline St., winthrop


A TRUE COPY


ATTEST:


....


(Registrar of City or Town where death occurred)


DATE FILED


April


8


19 58


(Registrar of City or Town where deceased resided)


8 SEX


Male


9 COLOR OR RACE


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Single


I last saw h ...........


alive on


19


death is said to


have occurred on the date stated above, at.


m.


INTERVAL BE-


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Full Term


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. Eenecchi, M. D.


(Signed).


(Address) 551 Broadway


Antero


.Date.


3/31 19 50


Malden


7 NAME OF


FUNERAL DIRECTOR


14 Proctor Ave., Revere


ADDRESS


Charles Bruno & Son


Received and filed. LAPR 10 1955 19


M. D.


PARENTS


25M (E)·6-50.902253


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


No.


Revere Memorial Hosp.


(Was deceased a


U. S. War Veteran,


No


(if so specify WAR).


X


( t 1 UUUUUU C


I t E S C P C I C S ( 1 S


T


O T


S a


r


1


d


C 1 1


T


t


I


1 1


APR 1 01950 /"


PLACE OF DEATH


X SUFFOLK (County) WINTHROP (City or Town) 10 ORLANDO No. .


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


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


61


AVLE


[(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


(a) Residence. No .. 10 OrLANdo


St AVKE


(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


(Month)


(Day)


4 I HEREBY CERTIFY,


That I attended deceased from


FEB 8,157


to


MAR, 31, 1958


I last saw hE Ralive on


MAR. 30, 1958, death is said to


have occurred on the date stated above, at


1


7Am.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


UREMIA.


Due


·ARTERIOSCLEROTIC


(b)


HEART DISEASE


Due To


CARDIAC DECUMP-


(c)


-ENSATION


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


NO


What test confirmed diagnosis ?_..


5 Was disease or injury in any way related to occupation of deceased NO If so, specify


(Signed)


a.n. Caplan


, M. D.


(Addre


19MermaidAVE Date 3-31-58


CAM bridgesop Place of Burial or Crematton


CAMbridar (City or Town)


DATE OF BURIAL APtil 2 won a miller Servie.


1958


7 NAME OF FUNERAL DIRECTOR M. Allison Burgers


27SPRUCESTWATHAM


ADDRESS


Received and filed MAR 3.1 1958 19


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX 7


9 COLOR


w


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


SINSIE


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.


12


AGE 90 Years


1


Months


4


Days


If under 24 hours


Hours ..... Minutes


13 Usual


Occupation :


At HOME.


(Kind of work done during most of working life)


14 Industry


or Business:


At HOME.


15 Social Security No.


MarStrand


17 NAME OF


FATHER


AlexANder. Anderson


18 BIRTHPLACE OF


FATHER (City).


MALSTRAND


(State or country)


Sweden.


19 MAIDEN NAME


OF MOTHER


ChristINA ANderSON


20 BIRTHPLACE OF


MALSTRAND


MOTHER (City)


(State or country)


SWEDEN


21 1 nformany Folke.F. ANDERSON (Address) 20 RUM Ford AV. WAlthAM


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


(Official Designation)


VV


3/3/58


(Date of Issue of l'ermit)


VI


-301A 1


IONS


TIFICATE


ing DEATH nter n one each and (c)


not mean f dying, t failure, It means r compli- caused


if any, rise to ¿ (a), under- last.


contrib. but not terminal ion given


apter 137, requires o print or cause or death on


cates.


50M-5-57-920345


2 FULL NAME.


ANNA, M. ANderSON


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


(Usual place of abode)


15 ye


MARCH


31,


1958


(Year)


INTERVAL BETWEEN ONSET AND DEATH 220Ks


1 YEAR


1YEAR


16 BIRTHPLACE (City).


(State or country)


SwedEN


PARENTS


Registered 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, nincteen 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).




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