USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1959 > Part 27
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\ physician or officer furnishing a certificate of death as required by the ceding section or by section forty-five of chapter one hundred and four- n, shall. if the deceased, to the best of his knowledge and belief, served in the y, navy or marine corps of the United States in any war in which it has been aged, insert in the certificate a recital to that effect, specifying the war, and 11 also certify in such certificate both the primary and the secondary or imme- te cause of death as nearly as he can state the same. For neglect to comply h any provision of this section, such physician or officer, shall forfeit ten dollars. · the purposes of this section and of sections forty-five, forty-six and forty-seven aid chapter one hundred and fourteen, the word "war" shall include the China ef expedition and the Philippine insurrection, which shall, for said purposes, be med to have taken place between February fourteenth, eighteen hundred and ety-eight and July fourth, nineteen hundred and two, and the Mexican border vice of nineteen hundred and sixteen and nineteen hundred and seventeen. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body town, or remove therefrom a human body which has not been buried, until he received a permit from the board of health, or its agent appointed to issue h permits, or if there is no such board, from the clerk of the town where the son died; and no undertaker or other person shall exhume a human body and love it from a town, from one cemetery to another, or from one grave or tomb er than the receiving tomb to another in the same cemetery, until he has eived a permit from the board of health or its agent aforesaid or from the clerk the town where the body is buried. No such permit shall be issued until there ll have been delivered to such board, agent or clerk, as the case may be, satisfactory written statement containing the facts required by law to be urned and recorded, which shall be accompanied, in case of an original inter- nt, by a satisfactory certificate of the attending physician, if any, as required by , or in lieu thereof a certificate as hereinafter provided. If there is no attending ysician, or if, for sufficient reasons, his certificate cannot be obtained early ough for the purpose, or is insufficient, a physician who is a member of the board health, or employed by it or by the selectmen for the purpose, shall upon plication make the certificate required of the attending physician. If death is used by violence, the medical examiner shall make such certificate. If such a rmit for the removal of a human body, not previously interred, from one town another within the commonwealth cannot be obtained early enough for the rpose, the certificate of death made as above provided and in the possession of e undertaker desiring to make such removal shall constitute a permit for such noval; provided, that such body shall be returned to the town from which it was moved within thirty-six hours after such removal, unless a permit in the usual rm 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 recentimedical 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.
PACE FOR ADDITIONAL INFORMATION
ATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
ANK, RATING
ORGANIZATION AND OUTFIT
ERVICE NUMBER
M R-303 A 1
X PLACE OF DEATH
Suffolk (County)
.Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH Registered No. Winthrop S(If death occurred in a hospital or institution,
To be filed for burial permit with Board of Health or its Agent.
Waters of Cottage Park Beach No.
St. ¿ give its NAME instead of street and number)
2 FULL NAME
STEPHANIE BRIANA
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No .... Seymour Street
(Usual place of abode)
St
Winthrop,
Massachusetts
(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
May
22
1.9.5.9.
(Month)
(Day)
(Year)
4 I 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.)
11a If married, widowed, or divorced
HUSBAND of
...
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
4
AGE
Years ....
-
Months
13
.Days
.Hours ........
.. Minutes
5 Accident, suicide, or homicide (specify) Accident
Date and hour of injury
5/22 .19.59
Where did
Winthrop, Mass
Injury occur ?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in
public place ?
Public beach
(Specify type of place)
Manner
Slipped from log into water,
(How did injury occur?)
.......
While at work?
Was autopsy performed? No
6 Was disease or injury in any way related to bebapation of deceased?
(Address) Boston, Mass. .Date .... 5/22 19 .. 59
Winthrop Cemetery, Winthrop 7
Place of Burial, or Cremation. (City or Town)
May 25,
19.59
DATE OF BURIAL
8 NAME OF
Ernest C. Caggiano
FUNERAL DIRECTOR
ADDRESS 147 Winthrop St., Winthrop
Received and filed
19
(Registrar)
PARENTS
19 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
Mass.
20 MAIDEN NAME
OF MOTHER
Norma DeStefano
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
22 Richard W. Briana
Informant
(Address)
19 Seymour St. , Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with nye BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
Healthy Affecté 5/25/59
(Official Designation)
(Date of Issue of Permit)
If under 24 hours .......
14 Usual
Occupation :
(Kind of work done during most of working life)
15 Industry or Business :
16 Social Security No.
17 BIRTHPLACE (City)
(State or country)
Mass.
Winthrop
(write the word)
9 SEX
female white
10 COLOR OR RACE
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
single
Asphyxia due to drowning. ....
Injury (Signed) If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF 25M-8-57-920750 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of Nature of Injury .....
18 NAME OF
FATHER
Richard W. Briana
M. D.
Boston
PHYSICIAN - IMPORTANT
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 ath of a person whom he has attended during his last illness, at the request an undertaker or other authorized person or of any member of the family of e deceased. furnish for registration a standard certificate of death, stating to the st of his knowledge and belief the name of the deceased, his supposed age, the sease of which he died, defined as required by section one. where same was ntracted. the duration of his last illness, when last seen alive by the physician 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 receding section or by section forty-five of chapter one hundred and four- en, shall. if the deceased, to the best of his knowledge and belief, served in the my. navy or marine corps of the United States in any war in which it has been gaged, insert in the certificate a recital to that effect. specifying the war. and all also certify in such certificate both the primary and the secondary or imme- ate cause of death as nearly as he can state the same. For neglect to comply ith any provision of this section, such physician or officer, shall forfeit ten dollars. or the purposes of this section and of sections forty-five, forty-six and forty-seven said chapter one hundred and fourteen, the word "war" shall include the China lief expedition and the Philippine insurrection, which shall, for said purposes, be eemed to have taken place between February fourteenth, eighteen hundred and nety-eight and July fourth, nineteen hundred and two, and the Mexican border ervice of nineteen hundred and sixteen and nineteen hundred and seventeen. . L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body a town, or remove therefrom a human body which has not been buried, until he as received a permit from the board of health, or its agent appointed to issue ich permits, or if there is no such board, from the clerk of the town where the erson died; and no undertaker or other person shall exhume a human body and move it from a town, from one cemetery to another, or from one grave or tomb ther than the receiving tomb to another in the same cemetery, until he has ceived a permit from the board of health or its agent aforesaid or from the clerk f the town where the body is buried. No such permit shall be issued until there hall have been delivered to such board, agent or clerk, as the case may be. satisfactory written statement containing the facts required by law to be eturned and recorded, which shall be accompanied, in case of an original inter- hent, by a satisfactory certificate of the attending physician, if any, as required by aw, 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 nough for the purpose, or is insufficient, a physician who is a member of the board f health, or employed by it or by the selectmen for the purpose, shall upon pplication make the certificate required of the attending physician. If death is aused by violence, the medical examiner shall make such certificate. If such a ermit for the removal of a human body, not previously interred, from one town o 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 he undertaker desiring to make such removal shall constitute a permit for such emoval; provided, that such body shall be returned to the town from which it was emoved within thirty-six hours after such removal, unless a permit in the usual orm 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 ariny, 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, See. 45. G. L. as amended by Chap. 48, Acts of 1927 and Chap. 414. Acts of 1931.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such perinits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made ...... .Chap. 114,
Sec. 46. G. L., as amended.
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not clisabled 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 deathsonly 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.'
If disease or injury was related to occupation, sperify. If investigation shows the death to have been due to disease, specify: (1)Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
SPACE FOR ADDITIONAL INFORMATION.
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING. ORGANIZATION AND OUTFIT
SERVICE NUMBER
-
IR-301A 1
PLACE OF DEATH
X SUFFOLKY (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.
Registered No. 88
f(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.
(Usual place of abode)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 18 PLEASANT PARK RD St. (If nonresident, give city or town and State)
Length of stay: In place of death .......... years months ... 2 days. In place of residenceOyears months _._. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
MAY
23
1959
(Year)
(Month)
(Day)
4 I HEREBY CERTIFY.
That I attended deceased from
Oct25
1958
to
MAY 23
1959
I last saw
hey alive on
MAY 22, 1907, death is said to
have occurred on the date stated above, at
7:50A .m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) CEREBRAL HEMORRHAGE
Due To
(b)
HYPERTENSION
(c) Due To ARTERIOSCLEROSIS-CEREBRAL
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) ..
Dorothy Cherry appleton
M. D.
(Address) 197 Woodside Cure Date 5/23 195 3
7 Place of Burial or Cremation
DATE OF BURIAL MAY 24 195€
7 NAME OF
FUNERAL DIRECTOR
MAURICE WITIRBY
ADDRESS WINTHROP
Received and filed
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
FEMALE WHITE
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
WIDOWED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
PATRICK SLOHN
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE Z/Years
Months.
Days
If under 24 hours
_Hours ......
. Minutes
13 Usual
BOOKERPER
(Kind of work done during most of working life)
14 Industry
or Business :
FELICE GENERAL
15 Social Security No ..
NONE
16 BIRTHPLACE (City)
(State or country)
MASS
17 NAME OF
FATHER
THOMAS
HENRY
18 BIRTHPLACE OF
FATHER (City).
IRELAND
(State or country)
19 MAIDEN NAME
OF MOTHER
BRIDGET- CONNIFF
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
IRELAND
21
Informant.
MBS DELLA THOMPSON.
(Address) IGYLEBIDON ST. MELROSE
I HEREBY CERTIFY that a satisfactory standard certificate of death was bled with me BEFORE the burial or transit permit was issued : Tallh
(Signature of Agent of Board of Health or other) Jedelto Niecer 5/25/59
(Official Designation)
(Date of Issue of Permit)
V.B.V
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 e, or compli- which caused
ns, if any, ave rise to cause (a), the under- ause
ions contrib -- leath but not the terminal ndition given
Chapter 137, 954, requires s to print or cause or death on tificates.
50M-1-58-921876
No .:
WINTHROP COM, HOSP.
2 FULL NAME
MARY J. (HENRY) SLOAN
INTERVAL BETWEEN DNSET AND DEATH
4DAYS
joyes
14R
BOSTON
Occupation :
PARENTS
ary BarBUNTARUP
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 ath of a person whom he has attended during his last illness, at the request an undertaker or other authorized person or of any member of the family of e deceased, furnish for registration a standard certificate of death, stating to the st of his knowledge and belief the name of the deceased, his supposed age, the sease of which he died, defined as required by section one, where same was ntracted, the duration of his last illness, when last seen alive by the physician 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 eceding section or by section forty-five of chapter one hundred and four- en, shall, if the deceased, to the best of his knowledge and belief, served in the my, navy or marine corps of the United States in any war in which it has been gaged, insert in the certificate a recital to that effect, specifying the war, and all also certify in such certificate both the primary and the secondary or imme- ate cause of death as nearly as he can state the same. For neglect to comply th any provision of this section, such physician or officer, shall forfeit ten dollars. or the purposes of this section and of sections forty-five, forty-six and forty-seven said chapter one hundred and fourteen, the word "war" shall include the China lief expedition and the Philippine insurrection, which shall, for said purposes, be emed to have taken place between February fourteenth, eighteen hundred and nety-eight and July fourth, nineteen hundred and two, and the Mexican border rvice of nineteen hundred and sixteen and nineteen hundred and seventeen. . L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body a town, or remove therefrom a human body which has not been buried, until he s received a permit from the board of health, or its agent appointed to issue ch permits, or if there is no such board, from the clerk of the town where the rson died; and no undertaker or other person shall exhume a human body and move it from a town. from one cemetery to another, or from one grave or tomb her than the receiving tomb to another in the same cemetery, until he has ceived a permit from the board of health or its agent aforesaid or from the clerk the town where the body is buried. No such permit shall be issued until there all have been delivered to such board, agent or clerk, as the case may be, satisfactory written statement containing the facts required by law to be turned and recorded, which shall be accompanied, in case of an original inter- ent, by a satisfactory certificate of the attending physician, if any, as required by w, or in lieu thereof a certificate as hereinafter provided. If there is no attending ysician, or if, for sufficient reasons, his certificate cannot be obtained early ough for the purpose, or is insufficient, a physician who is a member of the board health, or employed by it or by the selectmen for the purpose, shall upon pplication make the certificate required of the attending physician. If death is used by violence, the medical examiner shall make such certificate. If such a ermit for the removal of a human body, not previously interred, from one town another within the commonwealth cannot be obtained early enough for the urpose, the certificate of death made as above provided and in the possession of e undertaker desiring to make such removal shall constitute a permit for such moval; provided, that such body shall be returned to the town from which it was emoved within thirty-six hours after such removal, unless a permit in the usual orm for the removal of such body has been sooner obtained hereunder. If the
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