Town of Winthrop : Record of Deaths 1922-1924, Part 142

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 142

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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he

shall forthwith go to the place where the body lies and take charge of the same .. . . Gen. Laws, Chap. 38, Sec. 6.

. He shall in all cases certify to the town clerk or regis- trar in the place where the deceased died his name and resi- dence, if known; otherwise a description as full as may be, with the cause and manner of death. - General 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 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 in- jury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

STATEMENT OF CAUSE OF DEATH

Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homi- cidal." "Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."

If investigation shows the death to have been due to dis- ease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"

DESCRIPTION (for unknown person)

Leia, 28.1924

NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained. - Gen. Laws, Chap. 38, Sec. 14.

THIS CERTIFICATE CONSTITUTES SUCH PERMIT

R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Whittrop BOSTON (City or town)

County City or Town Beton

Suffolk

State. Massachusetts

Registered No.

St.,

Ward

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

2 FULL NAME

annie

14 Coral Que

Sherman

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

St.,

. Ward.

Withings

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

mooths days

PERSONAL AND STATISTICAL PARTICULARS

14 COLOR OR RACE

Hemale White

5 SINGLE MARRIED WIDOWED, OR

DIVORCED (write the word)

Widow

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

David

Months

Days

If LESS thao

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

If STILLBORN, eoter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, professioo, or

particular kind of work

8 BIRTHPLACE (City)

Quetria

(State or country

9 NAME OF

FATHER

Nathan Stecker

10 BIRTHPLACE OF

FATHER (City)

austria

(State or country )

11 MAIDEN NAME OF MOTHER

Mumie Cannotbe

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

austria

1423

(Month) (Day) 1 {Year)

18 PLACE OF BURIAL CREMATION, OR REMOVAL (UD)0 Betty abraham Cem. 1

DATE OF BURIAL

(Cemetery) (City or town)

19 UNDERTAKER Manuel Stantelu

Jay. 3 1924

ADDRESS Boston Permit

20 I HEREBY CERTIFY that a satisfactory stao- dard certificate of death was filed with me BEFORE the burial or traosit permit was issued.

K. C. Daniel

Official

Date of Health Office 5 permil, 12/31/23. No. 665

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from Dec 29 1923 to. Dec 31 , 19. 23 that I last saw her alive on Dec 31 . 1923 and that death occurred, on the date stated above, at 2:20 A

m. The CAUSE OF DEATH was as follows : .

Chronic Myocarditis Diabetes mellitus

(duration)

yrs ...

mos.

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs ...

mos ...

.. ds.

17 Where was disease contracted

if not at place of death ?

FOR WHAT ?

Did an operation precede death ?

Date of ..

Was there an autopsy ?

What test confirmed diagnosis ?....

(Signed)

Q. OS. Parken

, M.D.

(Address)

Date Que

Wat Bruntshet

6 Millod cd. Breton

14 Jan-5, 1924 Filed (Month) (Day) ( Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

Dec

3 1

1923

(a) Residence.

(Usual place of abode)

Length of residence in city or town where death occurred years

months

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

3 SEX PARENTS 13 Informant (Address) 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 (b) Name of employer

1 PLACE OF DEATH

Within.

No. 14 Coral

Que

M. 0. 3567.

6 AGE 70 Years

Dec. 31. 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. Tho 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 inany 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) 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 spe- cifically the occupations of persens engaged in domestic service for wages, as Servant, Cook, Hlousemaid, 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 discasc. Examples: Cerc- 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, ete., 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 (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mcre symptoms or terminal conditions, such 89 "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," ete.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Wcakness," 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.

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: Abortlon, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- rlage, 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, scen 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 interinent, by a satisfactory certi- ficate of the attending physician, if any, as required by law, or in licu 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 physl- 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 certl- ficate. . .. The person to whom the permit is so given and the physi- cian certifying the cause of deathi 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. 38, Scc. 6.

. .. He shall in all cases certify to the town clerk or registrar in tho 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 abertion, 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

1 PLACE OF DEATH County

City or Town

HinThat

No. 105 Grover ave

St.,

Ward

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

Carris As Read.

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

(a) Residence. No. 105

· (Usual place of abode)

Trova An

St.,

Ward.

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

Length of residence in city or town where death occurred 5 years

months

days.

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

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Female Mili

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

married

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

Boy and J. Read

Years

Months 4

Days

If LESS than

1 day, ....... hrs.

or ... . min.

If STILLBORN, ester that fact bere

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Acresce wife

(h) Name of employer

8 BIRTHPLACE (City

ity Jacenton

(State or country mais

9 NAME OF

FATHER

Chas Horton

PARENTS

(State or country )

11 MAIDEN NAME OF MOTHER

Lewica m. Read

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

north Dig hlin

13 Dayards Read

Informant:

(Address)

105 Server are Waiting

Fil 14 Jan. 16. 1924 (Month) (Day) ( Year)

REGISTRAR

20 1 HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the borial or trans't permit was issued A.C.Daniela

Official position

Weallthe officer

Date of issue 1/2/24

Permil reais No. 666.

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. Exaot statement of OCCUPATION is very important. Seer

instructions and extracts from the laws on back of certificate.

000. 3567.

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

(City or town)

State.

mais

Registered No.

days

1924

15 DATE OF DEATH

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I, attended deceased from

1014

to,

1923

that I last saw het alive on Diciembre 16, 123.

and that death occurred, on the date stated above, at 10H. m. The CAUSE OF DEATH was as follows; Sarcoma of Lungs, Camina

+ Pelois- (Original focus on TOE)

(duration)

18 yr

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.

1905-1914

Was there an autopsy ?

Hierropic c um of

What test confirmed diagnosis ?

2xelions

(Signed) ...

9'20 Cour

noncoralthe var .

(Address)

Date

(Month)

(Day)

(Year)

DATE OF BURIAL

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

6 lewood

Bradford Drie 3-24

(Cemetery)

19 UNDERTAKER G. M. allen

ADDRESS medford.

, M.D.

1923.

10 BIRTHPLACE OF

FATHER (City)

Rehabil

6 AGE

MEDICAL CERTIFICATE OF DEATH

2 FULL NAME

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 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 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," "Forcman," "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 spe- 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 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: Ceres 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, etc. 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" (mcrely 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 discase can bo ascertained as the cause. Always qualify all discases 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 deccased, his supposed age, the discase 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 datc 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 dicd; . . . 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 licu 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 medicai 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. 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; 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 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.

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Cambridge (City or_town)

1 PLACE OF DEATH

County

Middlesex

State

MASS.

Registered No.

(Place of residence)

St ..

Ward

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

2 FULL NAME

Abraham Segal

Mass .

City or Town

Length of residence in city or tuwa where death occurred

years

months

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED ( write the word)

Mar.

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Freeda

6 AGE

Years

Months

Days

If LESS than

1 day, ........ hrs.

.min.

If STILLBORN, enter that fact bere

7 OCCUPATION OF DECEASED

(a Trade, profession, or

particular kind af work

(b) Name of employer

Retired

8 BIRTHPLACE (city or town)

(State or country)

Russia

9 NAME OF

FATHER

Joseph

10 BIRTHPLACE OF

FATHER (city or town)

(State or country)

Russia

11 MAIDEN NAME

OF MOTHER

Anna ( Unkn )

12 BIRTHPLACE OF

MOTHER (city or town)

(State or country)

Russia

Informant

Jennie Roitran,

Winthrop, Mass.

(Address)

Filed Jan. 4191924.

Registrar af city or town where death occorred Filed War.7., 1924

Registrar of city ar town where deceased resided

MEDICAL CERTIFICATE OF DEATH

Jan. 2,1924

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Town of Winthrop : Record of Deaths 1922-1924, Part 142

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

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