Town of Winthrop : Record of Deaths 1922-1924, Part 19

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 19

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).

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, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipeias, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

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 dicd, 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 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 violence, the medical examiner shail 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:

(i) 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 eertify 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 discase resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

M R-301

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

19. 50,000.

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Winthrop (City or Town)

1 PLACE OF DEATH

State

County

City of Town Winthrop

.No.

67 Thornton Pk

Registered No.

St.,

.. Ward

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

2 FULL NAME

Charles O Brawn

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

(a) Residence.

No.

( Usual place of abode)

67 Dhaintouch St.

.Ward.

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

Length of residence in city or town where death occurred

years

months

days.

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

years

mouths days

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH

(Month)

(Day)

(Year)

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Tractie m.

6 DATE OF BIRTH

march 29 1860

(Month)

(Day)

(Year)

7 AGE

Years

Months

Days

If LESS thao

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

or ....... mio.

If STILLBORN, enter that fact here

8 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Railroad afectar

(h) Name of employer

Rockland

9 BIRTHPLACE (City)

(State or country)

10 NAME OF

FATHER

Orlando E Browse

11 BIRTHPLACE OF

FATHER (City ) ...

Lincolnville

(State or country)

maine

12 MAIDEN NAME

OF MOTHER

mary 6. Wiggin

13 BIRTHPLACE OF

MOTHER (City)

Rockland

(State or country)

mane

Inform

(Address )

6% Chariton Ste.

Filed Mar 281922

(Month) (Day) (Year)

REGISTRAR

Official position ..

Hent Ome

Date of issoe of permit. Mch 20 No. 413

Permit

21 I HEREBY CERTIFY that a satisfactory stan-

dard certificate of death was filed with me

BEFORE the burial or transit permit was issued

Pure. Hattie In. Brown Winchrofe Whenchop

DATE OF BURIAL Mar 26 1922

(Cemetery) (City or town)

M.D.

(Address).

Date

Mich

2 34

(Month)

(Day)

1922

( Year)

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

Date of.

Was there an autopsy ?

(duration)

.yrs.

.. mos ..

ds.

18 Where was disease contracted

if not at place of death ?

Did an operation precede death ?

that I last saw h

alive on

1922,

and that death occurred, on the date stated above, at

7.45 6

The CAUSE OF DEATH was as follows :

Chrome Endo carditis nutrial

values, cheim's myocarditis

(duration)

yrs ...

.mos ..

.ds.

CONTRIBUTORY

(SECONDARY)

PARENTS

3 SEX

Male

4 COLOR OR RACE

Whiten

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

I HEREBY CERTIFY, That I attended deceased from

1 year

19.20

Ich 22

to.

1922

What test confirmed diagnosis ?

(Signed)

20 UNDERTAKER

ADDRESS

Frank 6. Brown 6, Boston

Charles

march 2 2. 1922 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 singlo word or term on the first line will be sufficient, e. g., Former or Plonter, Physicion, Compositor, Architect, Locomotive engineer, Civilengineer, Stotionory firemon, etc. But in many cases, especially in industrial employments, it is necessary to know (0) 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 foctory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Doy laborer, Farm loborer, Loborer - Cool mine, etc. Women at home, who are engaged in tho 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 Servont, 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 bo indicated thus: Former (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death. - Name, first, the DISEASE CAUSING DEATn (the primary affection with respect to time and causation), using always the same accepted terni for the same disease. Examples: Cere- brospinol fever (the only definite synonym is "Epidemic cerebrospinal meningitis''); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobor pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Corcinoma, Sarcoma, etc., of .......... (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic volvular hcort disease; Chronic interstitiol nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Meosles (discase 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,""Dcbility" ("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 seplicemio," "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, erysipeias, meningitis, miscar- riage, necrosis, peritonitis, phiebitis, pyemia, septicemia, tetanus.

EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH

A physician 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 discase of which he died [defined so that it can be classified under the international classification of causes of death], where contracted, the duration of his last illness, when last seen alive by the physician, and the date of his death. . . . - Revised Lows, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chop. 322.

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 city or town in which 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 con- taining the facts required by law to be returned and recorded, which ... shali be accompanied by a satisfactory certificate of the at- tending physician, if any, as required by law, or in lieu thereof a certifi- cate 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, the chairman of the board of heaith, if a physician, or any physician employed by said board or by the selectmen for the purpose, shail upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner only shall make such certificate. .. . The person to whom the per- mit is so given and the physician who certifies to the cause of death shall thercafter 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. - Revised Laws, Chop. 78, Sec. 38.

Medical examiners shall, in all cases, certify to the city or town clerk or to the city registrar in the place where the deccascd died, his name and residence, if known, otherwise a description of such person as full as may be, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are supposed to have come to their death by violence. - Revised Laws, Chap. 24, Sec. 8.

RULES OF PRACTICE

The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:

(1) Attending physicians wili 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 Heaith 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 disabied by recognized disease, and those of persons found dead.

M R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

BOSTON (City or Town)

1 PLACE OF DEATH

County.

Suffolk

State

Massachusetts

Registered No

Ward

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

2 FULL NAME

Bridget Sarah Thompson

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

St.,

........

.. Ward.

cithroto

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

Length of residence in city or town where death occurred

years

months

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

ten ale

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

John (ls drew thorn .2 en

6 DATE OF BIRTH

(Month)

(Day)

(Year)

7 AGE

Years

6.7

Months

Days

If LESS than

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

or ....... min.

If STILLBORN, enter that fact bere

8 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

Roston

9 BIRTHPLACE (City)

(State or country)

Унаги

10 NAME OF

FATHER

John Lyonve

PARENTS

11 BIRTHPLACE OF

FATHER (City)

(State or country)

freland

12 MAIDEN NAME

OF MOTHER

Cathrine hadden

13 BIRTHPLACE OF

MOTHER (City)

(State or country)

treland

Informant.

Coffey

(Address)

Hora ie à dieer (1), they

May 281922.

(Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH

(Month)

(Day)

(Year)

17 I HEREBY CERTIFY, That I attended deceased from

that I last saw h ........

.. alive on

Zenek 22

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

1000 .

.. m.

The CAUSE OF DEATH was as follows :

Oceny y Lungo

(duration)

.mos ............. „ds.

CONTRIBUTORY

(SECONDARY)

(duration)

.yr's~ mos ............... . ds.

18 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)

M.D.

( Address).

Date

(Month)

(Day)

1422

(Year)

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

Holy Gra

traiden

DATE OF BURIAL

harris, 1422

(Cemetery)

(City or town)

20 UNDERTAKER

L'cl. Hotline

ADDRESS

¿. Bo ton

21 [ HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued São Moura

Official

position.4

Healthy Lice"

Date of issne 3,24 22

Permit

No ..

400

instructions and extracts from the laws on back of certificate.

XM. 00,000

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 important. See

: 1."City or Town

Boston / No. 22.

St.,

(a) Residence.

No ..

22 Otis

(Usual place of abode)

march

1922

19.22

yrs ...

1854

judge march 22142 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 cach 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 Plonter, Physicion, Compositor, Architect, Locomotive engineer, Civilengineer, Stationory 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) Solesmon, (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 Doy loborer, Form laborer, Laborer - Cool 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 Servont, Cook, Housemoid, 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: Cerc- brospinal fever (the only definito synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobor 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); Meosles; Whooping cough; Chronic valvulor heart disease; Chronic interstitial nephritis, etc. Tho 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, sucif as- "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Dcbility" ("Congenital,""Senile," etc.), "Dropsy,""Exhaustion,""Heart failure,""Ilemorrhage,""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 septicemio," "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, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

EXTR RACIS

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 tho 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, Scc. 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 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 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, Chop. 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.

. . . Ilo 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, 2.

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 Dr 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.

1 R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

.......

(City or Town)

1 PLACE OF DEATH

County

Sarlfack

State

Registered No

4:11

City or Town

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

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Town of Winthrop : Record of Deaths 1922-1924, Part 19

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

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