USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1959 > Part 16
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for specify WAR)
lass .
(a) Residence. No ...
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years.
months.
7
.days. In place of residence
Years.
months.
......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April 8, 1959
(Day)
(Year)
4 | HEREBY CERTIFY,
That I attended deceased from
Apr. 6
59
Apr. 8
59
I last saw heralive on
Apr ..
8
19 .... 59 death is said to
have occurred on the date stated above, at
3.45 p.m.
INTERVAL
BETWEEN
ONSET AND
DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Acute myocardial
infarction
15 hrs 61
12
AGE
Years ..
-Months ............ Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Housework
(Kind of work done during most of working life)
own home
14 Industry
or Business :
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country)
Winthrop,
Mass
17 NAME OF
FATHER
Thomas Sheerin
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Julia
--
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21
Informant.
Rita Mattos
(Address)
564 Union st.
A TRUE COPY Charles W Deary
ATTEST :
(Registrar of (Wyer Town where deathfoccurred)
DATE FILED
Apr. 10, 1959 (
19
v.b.v 1
FRAALL VAL AVAAV ULACA INA - THIS IS A FERMARENI KELUKŲ
at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c)
50M.11-55.916145
2 FULL NAME
(Month)
19
Due To
(b)
OTHER
SIGNIFICANT
CONDITIONS
(Address)
resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
What test confirmed diagnosis ?.
7 NAME OF
FUNERAL DIRECTOR
Was autopsy performed?
yes
autopsy
5 Was disease or injury in any way related to occupation of deceased? no If so, specify.
(Signed)
John U. Gardner
M. D.
New Bedford
Date
4-8-5919
Holy Cross Cemetery, Malden, Mass 6
.
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL. Apr 11 195919
O'Malley Funeral Home
ADDRESS. Winthrop, Mass
Received and filed. MAY 1959 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F
9 COLOR
W
10 SINGLE
(write the word)
MARRIED
WIDOWED
Widowed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Francis P. O'Connor
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
PARENTS
MIS.
402
PLACE OF DEATH
Bristol (County)
Registered No.
§(If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
61
19
to
RECEIVED
TOW:
71 12. 1
9
CLERK
8
1
6:
1
6
5
MAY -* /1959 AM
X PLACE OF DEATH
Suffolk
Winthrop
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. 50
2 FULL NAME Buono, Baby Boy
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 258 E. Eagle St.,
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
3 DATE OF
DEATH
April
3
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
19
to
19
I last saw h ....... alive on
19
death is said to
have occurred on the date stated above, at
m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Prolapsed Cord
(a)
INTERVAL
BETWEEN
ONSET AND
DEATH
11 IF STILLBORN, enter that fact here.
Still Born
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 ..
16 BIRTHPLACE (City)
(State or country)
Mass
Suffolk
17 NAME OF
FATHER
Buono, Gerald
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mass.
Suffolk
19 MAIDEN NAME
OF MOTHER
Fusi, Janice
Winthrop
20 BIRTHPLACE OF
MOTHER (City)
(State or country) Mass.
Suffolk
21
Buono Gerald
Informant
(Address)
258 E. Eagle St. E. Boston
7 NAME OF FUNERAL DIRECTOR Vincent Rapino
ADDRESS
Chelsea St., E. Boston
Mass.
Received and filed APR 7 1957 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
No
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify.
(Signed)
(Address) 241 Main St.,
Date.
4-3-59
19
Holy Cross
6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 7, 1959
19
PARENTS
I HEREBY CERTIFY that a satisfactory standard certificate of death was fijed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
C Healthe Schicke
4/7/59
(Official Designation) (Date of Issue of Permit) /
UCTIONS FOR CERTIFICATE giving OF DEATH t enter than one for each b) and (c)
pes not mean of dying, heart failure, tc. It means or compli- hich caused
s, if any, i've rise to ause (a). the ause under- last.
ons contrib- cath but not the terminal dition given
Chapter 137, 154, requires s to print or cause death on :ficates.
SOM-5-56-917573
No ..
Winthrop Community Hospital
[(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
East Boston
(Usual place of abode)
(County) 22 0/5001 5-7-59
[ R-301A 1
.. , M. D.
Malden
Winthrop
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 belicf the name of the deceased, his supposed age, the disease of which he dicd, 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 ninetcen hundred and seventcen. 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).
7 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 forin 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 ng Donly deathe 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)
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. 51
No .. Winthrop Community Hospital
Guy Hatch -- Guy Phineas Hatch
(If deceased is a married, widowed or divorced woman, give also maiden name.)
30 Pleasant Park Road St.
(a) Residence. No .. (Usual place of abode) 27 hours after admission
(If nonresident, give city or town and State)
Length of stay: In place of death .years months days. In place of residence
5 0years
.months
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
8
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, That I attended deceased from
to.
May 21
55
April 8
19.
5.9
I last saw himffalive on
April 8
59
death is said to
have occurred on the date stated above, at
2:45 Pm.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Massive Cerebral Hemorr-
(a)
lage
INTERVAL
BETWEEN
ONSET AND
DEATH
27 Hr
11 IF STILLBORN, enter that fact here.
SAGE77 Years 10Months . 1 9Days
If under 24 hours
Hours .... Minutes
13 Usual
retired engineer
Occupation :
(Kind of work done during most of working life)
EVITE BOSCHTRYSIL
14 Industry
or Business
Boston, Lynn & Revere N. G. R.R.
15 Social Security No ...
023-10-6820-A
16 BIRTHPLACE (City)
Charlestown
(State or country)
New Hampshire
17 NAME OF
FATHER
John Hatch
18 BIRTHPLACE OF
FATHER (City)
Charlestown
(State or country)
New Hampshire
19 MAIDEN NAME
OF MOTHER Edna Elizabeth Smith
20 BIRTHPLACE OF
Charlestown
MOTHER (City)
(State or country)
New Hampshire
21
Informant.
Mrs. Lulu. B. Nott
Address) 30 Pleasant Park Road
I HEREBY CERTIFY that a satisfactory standard. certificate of death was filed with me BEFORE the burial or transit permit was issued:
Mass. Talle C. pereanny. f- (Signature of Agent of Board of Health or other)
Health Price
(Official Designation)
(Date of Issue of Permit)
4/9/59
V.B.V
UCTIONS :OR CERTIFICATE
giving OF DEATH ot enter than one for each b) and (c)
Does not mean of dying, heart failure, tc. It means or compli- hich caused
s, if any, ve rise to ause (a), the under- lause last.
ons contrib- eath but not the terminal dition given
Chapter 137, 54, requires s to print or cause or death on
ificates.
(Signed).
Dorothy Cheney appleton
M. D.
(Address) 197 Woodse de Fire
Date
april 8
1959
6
Winthrop Cemetery Winthrop, Mass. Place of Burial or Cremation (City or Town)
DATE OF BURIAL April 10, 1959
19
7 NAME OF
FUNERAL DIRECTOR
Cured 13. Marsle
ADDRESS
174 Winthrop St. Winthrop,
Received and filed APR 9 1959 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
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)
Due To
Arteriosclerosis
(b)
5 Yrs
Due To (c)
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
PARENTS
SOM-5-56-917573
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,
(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 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 dicd, 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 immc- 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, ninetcen hundred and two, and the Mexican border service of nineteen hundred and sixtcen and ninetcen hundred and seventecn. 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 casc 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 inanner 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'dfed; 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 Chapl 632. Sec. 4, Acts of 1945,
No undertaker or other persons shall bund 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 aperson anpointed to have the care of the cemetery or burial ground in which the intervient 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 fileaths 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
<
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.Winthrop Comm.
.... Hosp
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
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