Town of Winthrop : Record of Deaths 1922-1924, Part 119

Author: Winthrop (Mass.)
Publication date: 1922
Publisher:
Number of Pages: 1202

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1922-1924 > Part 119

Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).

Date of issoe

Permit

10,000.

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

Juez

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from

19.2.3 .... ,.

If LESS thao that I last saw be .. alive oo

11:457 m. The CAUSE OF DEATH was as follows :

Interstitial Pregnancy

... (duratioo)

.yrs ..

.. mos ..

.ds.

CONTRIBUTORY ..

Surgical stock following

5 hours .

(SECONDARY)

Celerator

(duration)

17 Where was disease contracted

if oot at place of death ?.

at home

Did an operation precede death? Yes

Date of

July 2/ 1923

Was there an autopsy?

und.

What test confirmed diagnosis ? Personal Gebranntin

(Signed)

Q. B. Parken

., M.D.

(Address) ..

mars

Date

Jug

1923

"(Month)

(Day)

(Year)

18 PLACE OF BURIAL. CREMATION, OR REMOVAL

DATE OF BURIAL

July 24-23

(Cemetery)

(City or town)

Official - Health Officer

7.24. 22 No. 2, 3

1923.

and that death occurred, on the date stated above,

.yrs ....

mos ..

ds.

PARENTS

N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH

1 PLACE OF DEATH

(Usual place of abode)

Regenalk. H. Cross.

1923

July 21, 1923 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

[Approved by U. S. Census and American Public Health Association]

, Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits ean 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, Locomotive engineer, Civilengineer, 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 tho latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," ete., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who aro engaged in the duties of the house- hold only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- eifieally the occupations of persons engaged in domestie 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 faet 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: Cere- brospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified. is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, 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, ete. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatie), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""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.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)

Bronchopneumonia: If primary cause, write the word "pri- mary " ; if secondary, give primary cause.

Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

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 re- quired 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 a human body . . . until he has received a permit from the board of health or its agent .. . or ... from the clerk of the town where the person died; . .. No such permit shall be issued until thereshall have been delivered to such board, agent or clerk ... a satisfactory 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 eerti- ficate 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 physi- cian 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 certi- ficate. ... The person to whom the permit is so given and the physi- cian 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. - Gen. Laws, Chap. 114, Sec. 45.

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. 88, 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; other- wise a description as full as may be, with the cause and manner of death. -Gen. Laws, Chap. 38, Sec. 7.

RULES OF PRACTICE

The fulfilment 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 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 sup- posably 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.

R - 301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

STANDARD CERTIFICATE OF DEATH

1 PLACE OF DEATH

County.

Suffolk

State

(City or town) Registered No. 123.

No.

may Kapital St.

Ward

(If death occurred in a hospital or institution, give its NAME instead of street and number)

2 FULL NAME.

Frances . tilly

(If in the Army or Navy of the United States, give rank, organization, etc.)

(a) Residence.

No.

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

.St.

Ward.

(If non resident give city or town and State )

days. How long in U. S., if of foreign hurth ? years

months

days

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

July

(Month)

I HEREBY CERTIFY, That I attended deceased from

July

19.2.3 ... , to

July 22, 1923.

.. , 19.2 3,

If LESS than

that I last saw h IN alive on

July

and that death occurred, on the date stated above, at 12.30 P.m.

The CAUSE OF DEATH was as follows :

& Evalual It anuvor lage.

... (duration)

yrs ..

... mos ....

.ds.

CONTRIBUTORY

(SECONDARY)

( duration)

.yrs

mos .ds.

17 Where was disease contracted

if not at place of death ?

Did an operation precede death?

Date of

Was there an autopsy ?

130

What test confirmed diagnosis ? NONE

(Signed)

Edward J. Franger

Irwin Str. West ling

(Address)

19 23 .

Date

July

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

(Cemetery) (City or town)

19 UNDERTAKER

C. R. Bennon

ADDRESS

Filed .......

(Month) (Day) (Year)

REGISTRAR

20 I HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the borial or transit permit was issued. I. T. Maury

Official position ...

Health oficer

Date of issue of permit 7/24 23

Permit

No.

612

000.

City or Town

3 SEX

Female

6 AGE

Years

(h) Name of employer

8 BIRTHPLACE (City).

(State or country

9 NAME OF

FATHER

10 BIRTHPLACE OF

FATHER (City)

11 MAIDEN NAME

OF MOTHER

PARENTS

Informant

should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH

instructions and extracts from the laws on back of certificate.

in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See

N. B .- WHITE PLAINLY, WITH UNFADING DLAUN INN THIS IS A PERMANENT ACCORD. Every Rem of Information

(State or country)

newark

M. J.

Thomas. Haigh

England

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

England

13 Helen Morris

(Address)

15 Olurgãos 1/

1 day, ....... hrs. or ........ min.

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

1923

( Day)

(Year)

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Berk. La Verty

Months

Days

15 Llagas

The Commonwealth of Massachusetts

DATE OF BURIAL 7/25Ts.

., M.D.

July 22 1923

REVISED UNITED STATES STANDARD' CERTIFICATE OF DEATH

[Approved by U. S. Census and American Public Health Association]

, Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of agc. F'or many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary fireman, ete. But in many eases, 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) Salesman, (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 house- hold only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spc- cifically 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 faet may be indicated thus: Farmer (rctired, 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: Cere- brospinal fever (the only definite synonym is "Epidemie cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified. is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, 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, ete. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma,""Convulsions,""Debility" ("Congenital,""Senile,". etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shoek," "Uremia,""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.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)

Bronchopneumonia: If primary cause, write the word "pri- mary" ; if secondary, give primary cause.

Certificates will be returned for additional information which give any of the following diseases, without explanation, as the soie cause of death: Abortion, celiulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, totanus.

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 undertakeror 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 discase of which he died, defined as re- quired by seetion 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 a human body . . . until ha has received a permit from the board of health or its agent . . . or . .. from the elerk of the town where the person died; . . . No such permit shall be issued until there shall have been delivered to such board, agent or clerk ... a satisfactory 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 certi- ficate 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 physi- cian 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 vioience, the medical examiner shall make such certi- ficate. ... The person to whom the permit is so given and the physi- eian certifying the cause of death shall thereafter furnish for registration any other necessary information which ean be obtained as to the deecased, or as to the manner or cause of the death, which the clerk or registrar may require. - Gen. Laws, Chap. 114, Scc. 45.

Medical examiners shall make cxamination 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 elerk or registrar in the place where the deceased died his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -Gen. Laws, Chap. 38, Sec. 7.

RULES OF PRACTICE

The fulfilment 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.

(3) Medical examiners will investigate and certify to all deaths sup- posably due to injury. These inelude 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 deatha of persons not disabled by recognized disease, and those of persons found dead.

In plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See

Instructions and extracts from the laws on back of certificate.

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Italy

Fuedela Sessa

11 MAIDEN NAME OF MOTHER

12 BIRTHPLACE OF MOTHER (City) (State or country)

Italy

13 Fiedela Sessa

Informant (Address) 254 Maria At

14 Filed Meu 31 1923

(Month) (Day) ( Year)

REGISTRAR

20 1 HEREBY CERTIFY that a satisfactory stan- dard certificate of death was Gled with me BEFORE the burial or transit permit was issued .... S.A. Mowry

Official Thatthe officer

Date of issue of permit 7/24/23

Permit No. 9,,

1.30%. m. The CAUSE OF DEATH was as follows :

Pulmonary Tuberculosis

.. (duration)

... yrs.

mos.

.ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs

mos.

......

.ds.

17 Where was disease contracted

if not at place of death ?

Did an operation precede death ?

Date of

Was there an autopsy ?

What test confirmed diagnosis ?

(Signed) Edward Grainger. ., M.D.

(Address) 7

Freuen Si.

Date

July

1923

Monthy

(Day)

( Year)

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

AJoseph Sem,

(Cemetery) Sento City of town

DATE OF BURIAL July 27, Ma

DRESS

,000. 3567.

The Commonwealth of Massachusetts

R-301 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

STANDARD CERTIFICATE OF DEATH

County

duffelle

State Mass

Registered No .. 124

St., Ward (If death occurred in a noppi al or institution, give its NAME instead of street and number)

2 FULL NAME.

254 Main It

.... St., ..

(Hin the Army or Na y of the United States, give rank, organization, etc. ) Ward.

(If non-resident give city or town and State )

days. How long in U. S., if of foreign birth ? years

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX 4 COLOROR RACE Female White

5 SINGLE, MARRIED, WIDOWED, OR DA ROLD ( write the word) Single

5a If married, widowed, or divorced HUSBAND of (or) WIFE of

6 AGE

Years 18

Months

Days

If LESS than 1 day ......... hrs. or ....... min.

If STILLBORN, erter that fact bere

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

School

(h) Name of employer

15 DATE OF DEATHA

July 251923

(Month)

( Day)

(Year)

16 I HEREBY CERTIFY, That Lattended deceased from Aug 1921 , to July 25 , 19 23 that I last saw her alive on Og gle 24 . 1923 and that death occurred, on the date stated above, at.

MEDICAL CERTIFICATE OF DEATH

(a) Residence.

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

iscono

Main It

City or Town Hinthof No. 254 Eleanor Mare 1

Hinthrof (City or town)

should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH

8 BIRTHPLACE (City Hinthrop Mass Benjamin 9 NAME OF FATHER

...

19 UNDERTAKER

July 25. 1923 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

[Approved by U. S. Census and American Public Health Association]

Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of agc. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter. Physician, Compositor, Architect, Locomotive engincer, 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) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager." "Dcaler," 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 house- hold only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, Es 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 havo 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 diseasc. Examples: Cere- brospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, 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, ete. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (sccondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Ancmia" (merely symptomatic), "Atrophy," "Col- lapse.""Coma,""Convulsions,""Debility" ("Congenital,""Senile," etc.), " Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""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," ctc.

Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.

Town of Winthrop : Record of Deaths 1922-1924, Part 119

Author: Winthrop (Mass.) Publication date: 1922 Publisher: Number of Pages: 1202

Author: Winthrop (Mass.)
Publication date: 1922
Publisher:
Number of Pages: 1202