USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1932 > Part 1
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J. L. FAIRBANKS & CO. Stationers 43 FRANKLIN STREET -- BOSTON-
ORM R-301A
MARGIN RESERVED FOR BINDING
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 185 Woodside avest No
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No
4 8 3
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Sarah & Vogel
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No. 185 Wordsede Give St.,
(Usual place of abode)
Length of residence in city or town where death occurred / / yrs.
mot.
Ward,
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
Female White
3 SEX
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in fully 9
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE 5' Years Months Days
If less than 1 day
Hours
Minutes
OCCUPATIONĮ
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ... 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ....
10 Date deceased last worked at
this occupation (month and
year)
11 Total time (years) spent in this occupation
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Michael Holland
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Queland
(State or country)
15 MAIDEN NAME
OF MOTHER
mary Campbell
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Oreland
17 anthony & Vorge
Informant
(Address) 185 Wandade The Within
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: W mi. D- Childress (Signature of Agent of fard of Health or other)
Health Officer
1/13/32
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
yam
11
1932
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY, That I attended deceased from
,19
.. , to
19
I fast saw h ..
.alive on.
19
death is said
to have occurred on the date stated above, at.
6 A.
m.
The principal cause of death and related causes of importance in order of
onset were as follows:
Natural Causes .
Probably Auguina Pectoris
1932
Contributory causes of importance not related to principal cause:
Name of operation
None.
What test confirmed diagnosis wernhoutun
Was there an autopsy? Na
20 Was disease or injury in any way related to occupation of deceased?
If so, specify ..
(Signedy mond
., M. D.
19.3.2 ..
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Steph Boston
(Cemetery)
(City or town)
DATE OF BURIAL.
January 14
1932
22 NAME OF
UNDERTAKER
ADDRESS
867 ' leacon fr Bostal
Received and filed
JAN 21 1932
19
(Registrar)
75m-2-'50. No. 7997-a
1
Ward
(If U. S.
War Veteran,
specify WAR)
days. How long in U. S., if of foreign birth?
Dateofonset
at Store
Date of
Revised United States Standard Certificate of Death
Jan 11, 1932
Statement of occupation .- Precise statement of occupation is very important, 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 occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. 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 in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, ete. For a person who had no occupation what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," "worker." "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store,' "factory, " "mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
Distinguish carefully the different kinds of engincers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causcs, name earlier morbid conditions, if any. related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis
Date of onset
1015
Chronic interstitial nephritis
I921
Cerebral hemorrhage
July 5, 1927
Contributory causes of importance not related to principal cause:
..
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appcar in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registercd hospital medical officer shall forth- with, 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 be ief the name of the deceased, his supposed age, the disease of which he dicd, defined as required by seetion onc, 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.
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 satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, 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 cxaminer shall make such certificate. 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 state- ment and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. 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., as amended.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Sec. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.
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 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 ceme- tery or burial ground in which the interment is made .. .. Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following 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 un- related to any form of injury, have died without recent medical attend- ance 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.
ORM R-301
1 ... No. 3 SEX Female 5a If married, widowed, or divorced HUSBAND of (or) WIFE of ... 9 Industry or business in which OCCUPATION PARENTS is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION work was done, as silk mill, saw mill, bank, etc. .......
100m-11-'30. No. 605-b
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: W.m. & Childrenex (Signature of Agept of Board of Health or othery
Health Officer (Official Designation) (Date of Issue of Permit) 1/14/32
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan
12
1932
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY, That I attended deceased from
1931
193C
I last saw h
...... calive on
19 32 death is said
at 3:45Pm.
to have occurred on the date stated above, The principal canse of death and related causes of importance in order of onset were as follows:
Date of Onset
7
AGE.
63
Years
5
Months
16
.Days
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. .
House work
Own home
10 Date deceased last worked at
11 Total time (years)
this occupation (month and
year)
Nov. 1930
occupation 40yrs
12 BIRTHPLACE (City)
Portland
(State or country)
Maine.
13 NAME OF
FATHER
Edwin Higgins.
14 BIRTHPLACE OF
FATHER (City)
UNKNOWN
(State or country) Maine.
15 MAIDEN NAME
OF MOTHER
Sarah Day
16 BIRTHPLACE OF
MOTHER (City)
freeport
(State or country)
Maine.
21 PLACE OF BURIAL,
Winthrop
Winthrop
CREMATION OR REMOVAL
(Cemetery)
(City br town)
DATE OF BURIAL
January 14
1932.
22 NAME OF
UNDERTAKER
Mass
Charles R. Bennison.
ADDRESS
WinthropJAN
.
Received and filed.
19
A TRUE COPY, ATTEST:
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of MARGIN RESERVED FOR BINDING
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
PLACE OF DEATH
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No. 2.
Winthrop (City or Town) 19 Sagamore Ave. St., Ward 5 give its NAME instead of street and number) (If death occurred in a hospital or institution,
florence May (Higgins) England
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
Length of residence in city or town where death occurred 22
yrs.
19 Sagamore Ave
St., ......... Ward,
(If nonresident give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married.
(Give maiden name of wife infull)
Frederick James England
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
If less than 1 day Hours Minutes .... Curcuma Segural. ...
7
Contribntory canses of importance not related to principal cause:
Name of operation ..
What test confirmed diagnosis ?.
Was there an autopsy? 4
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
M. D.
(Address)
2 Date
1/13 193 0
17 fred K J. England.
Informant ..
(Address)
19 Sagamore Are
mos.
days. How long in U. S., if of foreign birth? yrs.
(If U. S.
War Veteran,
specify WAR)
Revised United States Standard Certificate of Death
Jan, 12, 1932
Statement of occupation .- Precise statement of occupation is ervy important, 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 occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. 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 in answer to Question 8 and own home in answer to Question 9. 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 what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store, " "factory,'
'mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis
Date of onset
...
Chronic interstitial nephritis
1021
Cerebral hemorrhage
July 5, 1927
..
...
Contributory causes of importance not related to principal cause:
...
..
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, 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 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.
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 satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, 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 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 state- ment and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. 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., as amended.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Sec. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.
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 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 ceme- tery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following 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 un- related to any form of injury, have died without recent medical attend- ance 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.
1015
ORM R-301 A
Suffolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
2378
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Iro annie Spiller
(If deceased is @married, widowed or divorced woman, give also maiden name.)
10 Locust
St.,.
Ward,
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jun
13
(Month)
(Day)
(Year)
19
HEREBY CERTIFY, That I attended deceased from
1931, to -13
1932
I last saw her alive on
death is said
to have occurred on the date stated above, at
The principal cause of death and related causes of importance in order of onset were as follows: arteriosclerosis Dateofonset
Contributory causes of importance not related to principal cause:
Chronic hijocanditi
Name of operation
Date of
What test confirmed diagnosis? Alethecom
Was there an autopsy?
20
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
de gabali
M. D.
(Signed)
1-15
1932
(Address)
Date
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
It. Bunards. Concom
(Cemetery)
DATE OF BURIAL
Jan 16
(City or town) 1932
22 NAME OF
UNDERTAKER
Richard Cluby
ADDRESS
Received and filed
JAN 21 1932
19
....
(Registrar)
1
PLACE OF DEATH
(County) Stanthrop (City or Town) 10 Locust St.,
.......
...........
.. Ward
(If U. S. War Veteran, specify WAR) 3
(a) Residence.
No.
(Usual place of abode)
Length of residence in city or town where death occurred
15 VIS.
mos.
days.
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