USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1959 > Part 18
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(c)
years
Registered No.
[(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
PHYSICIAN - IMPORTANT -
(Was deceased a
Spanish
U. S. War Veteran,
if so specify WAR) American
2 FULL NAME
IR-301A 1
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 ninetcen 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 recogniren disease; Arttdlated to any form of injury, have died without recent medical litendance of jubose 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
Enlisted N.V.@ - SUTREVaKOXX
DATE OF ENTERING MILITARY SERVICE
April 13, 1898
DATE OF DISCHARGE
1. 121901
RANK, RATING
RT.
ORGANIZATION AND OUTFIT
89th Coast AR 1.
SERVICE NUMBER
ยท C.2317783
X PLACE OF DEATH
Suffolk
(County)
Winthrop Mass (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filled for burial permit with Board of Health or its Agent.
Registered No. 55
[(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
2 FULL NAME.
Stanley Malvarosa
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Fleet Street
St.
Boston Mass
(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
13 -
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Cyq.
1958
to april 13 959
I last saw 'hilalive on
April 13, 1959 death is said to
have occurred on the date stated above, at
49. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Leute congestive heart failure
INTERVAL BETWEEN ONSET AND DEATH 5 days
1 year
14 Industry
or Business:
15 Social Security No. 033-26-5912
16 BIRTHPLACE (City)
(State or country)
Italy
17 NAME OF
FATHER
Michelangelo Malvarosa
18 BIRTHPLACE OF
Ttaly
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Nunziata Angrisano
20 BIRTHPLACE OF
MOTHER (City) _.
(State or country)
Italy
6
Place of Burial or Cremation (City or Town)
DATE OF BURIAL April 17 TO50 19
7 NAME OF
FUNERAL DIRECTOR
ciro Cincotti
ADDRESS
3 North Sq Boston, Mass
Received and filed APR 16 1959 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Marr
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
60 years 6
Years.
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Florist
Due To
arteriosclerotic heart disease
(b)
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed ?
no.
What test confirmed diagnosis?
Climail
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify.
(Signed)
Charles Meloni
, M. D.
305 Have Su 210 Date april 13 1959
(Address)
St. Michael Cemetery Foston, Press
21
Informant
Nep Dora Malvarosa
(Address)
20 Fleet St Boston Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
CHealthe Officer
4/16/59
(Official Designation)
(Date of Issue of Permit)
UCTIONS FOR A CERTIFICATE
Ggiving OF DEATH ot enter nthan one I for each ), b) and (c)
soes not mean of dying, s heart failure, , tc. It means 67, or compli- phich caused
bis, if any, ve rise to ause (a), the ause under- last.
ons contrib-> o cath but not the terminal edition given
Chapter 137, 154, requires s to print or cause or death on ifcates.
50M-1-58-921870
IR-301A 1
ThisTown 5V
Winthrop Community Hospital No ..
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR).
(a) Residence. No.
(Usual place of abode)
Dora Romano
(Kind of work done during most of working life)
PARENTS
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registercd 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 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 mjury, 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
IR-301A 1
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
oes not mean of dying, heart failure, tc. It means . or compli- phich caused
Pas, if any, ave rise to ause (a). the under- ause
ons contrib- 'cath but not t the terminal sdition given
Chapter 137, 154, requires is to print or cause or death on
Ifcates.
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 filled for burial permit with Board of Health or its Agent.
No. 51 Ingleside Avenue
[(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
2 FULL NAME Amelia Mary Louise Jenkins Swift)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
51 Ingleside Avenue
St
(If nonresident, give city or town and State)
(Usual place of abode)
Length of stay: In place of death
years
months
5 days. In place of residence ... years.
months.
. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
18
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
That I attended deceased from
19
Nov 22
,
to APRIL 18
I last saw h 2 alive on
APRIL 17, 1997, death is said t
have occurred on the date stated above, at
9:45 A.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) CONGESTIVE HEART FAILURE
INTERVAL BETWEEN ONSET AND DEATH
Due To
ARTERIOSCLERATIC HEART
(b)
10 YRS
DISEASE
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
PULMONARY FIBROSIS
KyRS
Was autopsy performed?
No
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased ? 16 If so, specify
(Signed).
Dorothy Cheney appleton, M. D.
197 woodlands aventi
(Address)
6 Winthrop Cemetery
Winthrop, Mass
Place of Burial or Cremation (City or Town)
DATE OF BURIAL il A.1959- 19
7 NAME OF
FUNERAL DIRECTOR
FOR Cefreit B. Manske
ADDRESS
174 inthron St. Winthrop,I
Received and filed APR 27-1959 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
10 SINGLE
(write the word)
female
white
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
Gerald Jerking
Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
2019
AGE
87Years.5 Months 1 7 Days
If under 24 hours
-
_Hours ____ Minutes
13 Usual
Occupation :
housework
(Kind of work done during most of working life)
14 Industry
or Business :.... ovm home
15 Social Security No. none
16 BIRTHPLACE (City)
West Derby
(State or country Lancashire co. England
17 NAME OF
FATHER
Thomas Swift
18 BIRTHPLACE OF
FATHER (City)
(State or country)
England
19 MAIDEN NAME
OF MOTHER
Mary Anne Lowe
20 BIRTHPLACE OF
MOTHER (City).
(State or country)
England
21
Informant
George H. Jenkins
(Address)
51 Ingleside Avenue
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Lass. palpa C. Jerrantes (Signature of, Agent of Board of Health or other)
4/21/59
(Official Designation)
(Date of Issue of Permit>
V BV
PARENTS
Date 4/20
1953
60M-1-58-921876
Registered No. 56
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
NO.
MARRIED
WIDOWEDWidowed
or DIVORCED
last.
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
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