USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1913-1915 > Part 3
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Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis ") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia ; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc , Carcinoma, Sar- coma, etc., of. (name origin: "Cancer" is less definite; avoid use of " Tumor" for malignant neoplasms) ; Measles; Whooping cough ; Chronic valvular heart disease ; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," " Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," " Inanition," "Marasmus," " Old age," "Shock," "Uraemia," " Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
(No ... 35 Mermaid Csc
Ward)
Winthrop (City or town.) [if death occurred in a hospital or institution, give its NAME instead of street and number.]
OK
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
3 SEX Female White
6 DATE OF BIRTH
January
(Month)
(Day)
1
, 1880
17
(Year)
If LESS than
1 day,.
hrs.
or
min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Housewife
(b) General nature of industry,
business, or establishment in
which employed (or employer).
9 BIRTHPLACE
(State or country)
Boston Mais
10 NAME OF FATHER
Maurice Healy
11 BIRTHPLACE OF FATHER (State or country)
Dicland
12 MAIDEN NAME OF MOTHER Ellen Collins
13 BIRTHPLACE OF MOTHER (State or country) Ireland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Ihave tro "Connell
(Address)
1428 Blue Will are. B.
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
January
QMonth)
10
(Day)
, 191.3
(Year)
I HEREBY CERTIFY that I attended deceased from
January
1918
, to January 10, 1913.
that | last saw h.
alive on Summary 18
., 1917,
and that death occurred, on the date stated above, at.
1:5 7am.
The CAUSE OF DEATH* was as follows :
Rheumatic Lever Pericarditis acute bilitation f
the Heart
.. (Duration) .
9
yrs.
mos.
ds.
Contributory
(SECONDARY)
,
Pleurisy
(Duration) .
yrs.
mos.
.ds.
(Signed)
Letitia Douglasadams
M.D.
Jam, 10, 193
(Address).
) 189 Cliff ane, Winthrop
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death ..
yrs. .
.mos.
ds.
State
In the
yrs.
mos.
ds.
Where was disease contracted, If not at place of death ?.
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL It Benedict
DATE OF BURIAL
Jan 13. 1913
20 UNDERTAKER holm FQ Dnaley
ADDRESS
119 Atlanticul
2 FULL NAME
Catherine A Dickenellavix
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 35 mermaid Che
Albert J. Bichenell Healy.
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
1) Married
7 AGE 33
yrs.
mos.
10
ds.
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
PARENTS
Filed .. 191 ..
Jan. 10, 1913
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As cxamples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery ; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," " Foreman," " Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of .. (name origin: "Cancer" is less definite ; avoid use of " Tumor" for malignant neoplasms) ; Measles ; Whooping cough ; Chronic valvular heart disease ; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " All- aemia " (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," " Inanition," "Marasmus," " Old age," "Shock," " Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deathis of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Winthrop (No. 308, Shirley
....
Winthrop (City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME mary ann White [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 308 Stiley St- Withrop
Wife of anthony nee Mc Quaid
PERSONAL AND STATISTICAL PARTICULARS
3 SEX J-
4 COLOR OR RACE
6 SINGLE,
MARRIED,
manud
WIDOWED,
OR DIVORCED
(Write the word)
6 DATE OF BIRTH
(Month) (Day)
(Year)
7 AGE
If LESS than
1 day, ........ hrs.
47 .yrs. .mos. ds. or ........ min. ?
8 OCCUPATION
.
(a) Trade, profession, or
particular kind of work
(b) General nature of industry, business, or establishment in which employed (or employer)
9 BIRTHPLACE
(State or country)
Bastion mass
Contributory
(SECONDARY)
(Duration)
yrs.
mos. .ds.
(Signed) Lesz Burgers Magrath,
Casa 130
, 1913 (Address)
M.D.
3 16 0
MEDICAL EXAMINER
* State the DISEASE CAUSING DEATH, or, in deaths from VIOLENT CAUSES, state (1) MEANS of INJURY; and (2) whether ACCIDENTAL, SUICIDAL or HOMICIDAL.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death.
.yrs.
In the
mos.
ds.
State.
yrs.
.mos.
ds.
Where was disease contracted, If not at place of death ?.
Former or usual residence.
19 PLAGE OF BURIAL OR REMOVAL Italy Cross
DATE OF BURIAL
10.30
Jan /6. 1913
20 UNDERTAKER
ADDRESS
Filed ., 191
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH Jan. 13, 1913 (Year)
(Month)
(Day)
17 I HEREBY CERTIFY that I have investigated the death of the deceased.
The CAUSE OF DEATH* was as follows : Internal injuries and
asphyxice caused by an accidental fall downislams.
(Duration)
.yrs.
mos.
ds.
10 NAME OF FATHER Unknown Volte
PARENTS
11 BIRTHPLACE OF FATHER (State or country) Svil and
12 MAIDEN NAME OF MOTHER Margaret- White
13 BIRTHPLACE OF MOTHER (State or country) Ireland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
anthony Nohitan
(Address)
308 Shirley St.
St. ;... Ward)
Registered No.
Jan. 13, 1 3 1913
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Preciso statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return " Laborer," "Foreman,"" Manager,""Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer -- Coalmine, etc. Wonen at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: C'erebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of " Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia ; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sur- coma, etc., of. (name origin: "Cancer" is less definite; avoid use of "Tumor " for malignant neoplasms) ; Measles ; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy," " Exhaustion," "Heart failure," " Haemorrhage," " Inanition," "Marasmus," " Old age," "Shock," " Uraemia," " Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS state MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, Or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train - accident ; Revolver wound of head -homicide ; Poisoned by curbolic acid - prob- ably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis tetanus) may be stated under the head of "Contributory."
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1913.
CITY OF BOSTON.
FULL NAME
Neil A.McKenna
Registered No.
477
Place of Death Ì
Boston
City Hospt.
and Residence
Date of Death
Jan. 13
1913.
Age
50
. years
months .days.
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
Maiden Name
IS
E
R
Husband's Name
Ireland
Birthplace
Name of William McKenna
Father.
Birthplace
Ireland
of Father
Maiden Name
Margaret Doherty
of Mother
Birthplace of Mother
Ireland
Occupation.
Clerk
Informant.
Place of Burial Malden (Holy Cross)
or removal
Undertaker
Timothy F. Callahan
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
1913,
from 1913, to that to the best of my knowledge and belief death occurred, on the date stated above, and that the CAUSE OF DEATH was as follows :
RAR'S
T PATRIENS, SIT D
Primary. (Duration)
Myocarditis
IFICE:
yrs.
ATA A.1.2%
N. MASS. Contributory · 2 (Duration)
Bronchitis (Acute)
ds.
(Signed)
J. W.Manary
M.D.
Jan. 13
1913
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Admitted to Hospt. Jan. 1,1913.
Usual Residence
" Winthrop " 112 Locust St.
Filed ......
Jan. 16
1913.
A true copy.
Attest :
Registrar.
MARGIN RESERVED FOR BINDING.
G
CITY
TVTTA
TONTITAA
731.
ATISREGIM
BO'STO
r
Jan. 13, 1913
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1913.
CITY OF BOSTON.
FULL NAME
Edwin G.Judkins
Registered No.
601
Place of Death )
Boston
Grace Hospt.
and Residence S
Date of Death
Jan. 16
1913
Age.
63
years
.. months. .. days .
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
M
W
M
Maiden Name
S
Husband's Name
Meredith N.H.
Birthplace
Name of
John D. Judkins
Father
Birthplace of Father
Sanbornton N.H.
Contributory : {
Cerebral Hemorrhage 2 ds.
(Duration)
Maiden Name Mahala P.Dolloff
of Mother ...
Birthplace Warren N.H.
of Mother.
Occupation Belt maker
Informant.
Place of Burial
Lawrence
Usual Residence .
" Winthrop " 66 Plummer St.
or removal
Undertaker J. S. Waterman & Sons
Jan. 22
Filed .. 1913.
A true copy . Attest: ErMSlenen
Registrar.
MARGIN RESERVED FOR BINDING.
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
1913,
from 1913, to. that to the best of my knowledge and belief death occurred, on the date stated above, and that the CAUSE OF DEATH was as follows:
RAR'S
PATRI
JA. SIT D Primaryo (Duration)-
Chro. Interstitial Nephritis
CITY
PTICE
and Chro.Myocarditis
GTVT
CONDITAA
1130.
HE-PONATA A.
T
N. MASS.
(Signed)
Myron F. Cutler
M.D.
Jan. 16
1913 .. .........
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
BO
BO'S TONIA D. 182 z
00 Jan . 16, 1913
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH winchent Man (No 58 Beacon S.L
St. : .. Ward)
Jordan . J. WEscott 2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 58 Beacon PL Wiehantera
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Marcel
6 DATE OF BIRTH
Sixt
(Month)
(Day)
1848
17
I HEREBY CERTIFY that I attended deceased from
1
(Year)
hace. 15.
. la.
191.2 .... , to
21.
1913;
that | last saw h.d ........ alive on
Ran
2%.
191.3.,
and that death occurred, on the date stated above, at.
119.m.
The CAUSE OF DEATH* was as follows :
(Duration)
.yrs.
7
mos.
ds.
Contributory.
(SECONDARY)
.. (Duration)
.. yrs.
.. mos.
ds.
2
(Signed)
Dr.l. Porto
M.D.
farm. 23., 19h3 (Address)
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death ..
.yrs.
„mos.
ds.
State
„yrs.
In the
mos.
.ds ..
......
Where was disease contracted, If not at place of death 7.
Former or usual residence.
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
4/23
1913.
20 UNDERTAKER
ADDRESS
/
Filed 191
REGISTRAR
16 DATE OF DEATH
9
-
(Month)
(Day)
(Year)
7 AGE
If LESS
I day, ........ hrs.
6 4 Vr.
.yrs.
5
mos.
ds.
... min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
Owner of Harduma
(b) General nature of industry,
business, or establishment in
which employed (or employer)
Hardware Bur
9 BIRTHPLACE
(State or country)
For kam me.
10 NAME OF
FATHER
Lilliani VEscott
11 BIRTHPLACE
OF FATHER
(State or country)
12 MAIDEN NAME
OF MOTHER
Marcha" X. Libby
1ª BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Clara. J. Wescott Wife
(Address)
important. See instructions on back of certificate.
PARENTS
N B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
Registered No.
4
191.3.
.
Jan. 21, 1913
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed , examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (6) Grocery", "(a) Fc; En, (b) Automobile factory. The material worked on may form part of the second statement. Never return " Laborer," "Foreman," " Manager,""Dealer," etc., without more precise specification, as Day laborer, Farm taborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of " Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia; Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of .... .. (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), "Atrophy," " Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy,""Exhaustion," "Heart failure," "Haemorrhage," " Inanition," " Marasmus," " Old age," "Shock," " Uraemia," " Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1913.
CITY OF BOSTON.
FULL NAME - Plakias
Registered No.
814
Place of Death )
Boston
Des Brisay Hospt.
and Residence S
Date of Death
Jan 22
1913.
Age .. years
........
.months days.
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
P
W
S
Maiden Name
IS
E
Husband's Name
.R
CITY
BOSTONIA
Name of
Father Thomas Plakias
5.0 8
Birthplace of Father
Greece
Contributory : (Duration)
Maiden Name
of Mother Georgia Papaiano
Birthplace of Mother.
Greece
Occupation ----
Informant ..
Place of Burial
or removal.
Mt Hope
Undertaker J S Waterman & Sons
Filed ... Jan 28 1913.
A true copy. Attest : Ermslenen
Registrar.
MARGIN RESERVED FOR BINDING.
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from 1913, to. .... .. 1913, that to the best of my knowledge and belief death occurred, on the date stated above, and that the CAUSE OF DEATH was as follows :
RAR'S
S. SIT
Primary (Duration )-S
Hemorrhagic Disease of
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