USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1959 > Part 47
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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. Chấp. 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 eare 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 tules 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.
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 andAUG(3), Medical Examiners will investigate and certify to all deaths supposably remove it from a town, from one cemetery to another, or from one grave or tomb 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. 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 Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death. 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 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. 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
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
·
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 STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
NoWinthrop Convalescent Home 142 Pleasant St. Charles I. Kelley
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
997 Shirley St.
St
(If nonresident, give city or town and State)
Length of stay: In place of death
years
X
5
months.
X
days. In place of residence.
40,
.X
months
Xdays.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
August 22
1959
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, That I attended deceased from
19.59
5/26/55
19_55. to.8/22/
I last saw h
Lalive on
August 21, , 19 59, death is said to
have occurred on the date stated above, at
1:00A.m.
INTERVAL BETWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE 91 Years.
6
Months
21 Days
If under 24 hours
Hours ...... Minutes
13 Usual
Occupation :
Salesman & Manager
(Kind of work done during most of working life)
14 Industry
or Business:
Dairy Products
15 Social Security No.
Morex 072-14-0042
16 BIRTHPLACE (City)
Rockville
(State or country)
Nova Scotia
17 NAME OF
FATHER
Daniel Kelley
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Rockville
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Katherine Hilton
20 BIRTHPLACE OF
Rockville
MOTHER (City)
(State or country)
Nova Scotia
21
Informant.
Percey G. Kelley
(Address) 94 Porter St., Melrose
7 NAME OF
FUNERAL DIRECTOR
RICHARDSON'S FUNERAL HOME
ADDRESS
48. LAFAYETTE PARK, LYNN
AUG 24 1959
Received and filed 19
(Registrar)
8 SEX
M
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED'
Widowed
10a If married, widowed, or divorced
HUSBAND of
Essie Daley
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Broncho pneumonia left
three days
Due To
Arterio sclerotic & hyper-
(b)
tensive heart disease. 5 yrs
Due To
(c)
Benign prostatic hypertrophy
3 yrs.
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
No
What test confirmed diagnosis?
Clinical & Lab.
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify
(Signed).
Mi Traunstein
, M. D.
(Address) 73 Bartlett Rd. Date. August22 59
Puritan Lawn Cemetery, W. Peabody 6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
August 24
159
50M-1-58-921876
R-301A 1
UCTIONS OR CERTIFICATE iving OF DEATH t enter than one for each b) and (c)
es not mean of dying, heart failure, tc. It means , or compli- hich caused
s, if any, ve rise to ause (a), the under- ause
last.
ons contrib- - eath but not the terminal dition given
Chapter 137, 954, requires s to print or cause of death on ificates.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Valku C. Pereannyit. (Signature of Agent of Board of Health or /other)
Readthe pieces
8/24/59
(Official Designation) (Date of Issue of Permit)
Registered No.
153
[(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)
(Usual place of abode)
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 hy 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 hoard 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 bne 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 he 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 he 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.
w. To 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 he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
. ): Chap. TIN, 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
Attending physicians will certify to such deaths only as those of persons to whomthey 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 toinjury: These include not only deaths caused directly or indirectly by luding 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 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 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
Registered No.
[(If death occurred in a hospital or institution,
St. (give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
34 Sydney St
St.
Somerville
(If nonresident, give city or town and State)
Length of stay: In place of death.
.years
months.
days. In place of residence 6
years.
months.
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
8
26
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
7/23
59
8/26/
19.
19
59
I last saw
imalive on
8/26/
19.
59
death is said to
have occurred on the date stated above, at
m.
INTERVAL
BETWEEN
ONSET AND
DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Anaplastic Carcinoma
of
Gall Bladder Transverse Colon2 mos
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
No
What test confirmed diagnosis? Lab. & Surgery
5 Was disease or injury in any way related to occupation of deceased ?N.O. If so, specify. Elarlas Palmas F M. D.
(Signed)
342 Hanover St Bomtok/26/59
Holy Cross Cemetery, Malden 6
Place of Burial or Cremation
DATE OF BURIAL
August 29
19.59
7 NAME OF
FUNERAL DIRECTOR
ADDRESS 2.
11
Received and filed AUG 26 1959 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR
white
10 SINGLE
(write the word)
Married
MARRIED
WIDOWED
or DIVORCED
10a If married,
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
60
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:
Cambridge, Mass.
15 Social Security No ..
031-01-4978
16 BIRTHPLACE (City)
(State or country)
Italy
17 NAME OF
FATHER
Joseph Schipani
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Marrianna Grande
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
21 Informant Angelina Schipani (Address) 34 Sydney St, Somerville, Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death wag filed with me BEFORE the burial or transit permit was issued: Machen e. f ereanung (Signature of Agent of Board of Health or other)
( Health Hacer
8/26/59
(Official Designation) (Date of Issue of Permit)
X
R-301A 1
CTIONS
ERTIFICATE ving
F DEATH enter an one or each ) and (c)
's not mean of dying, art failure, .. It means or compli- ich caused
, if any, De rise to use
(a), he under- last. use
ns contrib- ath but not the terminal dition given
hapter 137, 54, requires to print or cause or death on ficates.
PARENTS
To be filled for burial permit with Board of Health or its Agent.
Winthrop Community Hospital
No. Anthony Schipani
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence.
No ..
(Usual place of abode)
4:50 A
50M-1-58-921876
(City or Town)
Machine Operator
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 deccased, 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, ninetcen 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 shalt 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 issuc 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.
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