Town of Winthrop : Record of Deaths 1922-1924, Part 216

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 216

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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, convuisions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis. peritonitis, phlebitis, pyemia, septicemia, tetanus.

..... .-

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 samo was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of liis 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 obtainod 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. 38, Sec. 6.

. . . He shall in all cases certify to the town clerk or registrar in the place where tho 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 wlio, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from homo when tho 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.

IR-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS 1 PLACE OF DEATH

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON (City or town)

State Massachusetts

Registered No.

St .. Ward

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

Sereal Goldsteini

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

(a) Residence. No.

164 Pauline

(Usual place of abode)

Length of residence in city or town wbere death occurred

years

mooths

days.

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

(If non- resident give ci

years

moorbs

days

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH.

(Month)

October

1924

( Year)

(Day)

I HEREBY CERTIFY, That I attended deceased from

Oct 27

1924 to

to Oct B2.

192.4

that I last saw him alive on

Oct 31

19.24

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

R. m. The CAUSE OF DEATH was as follows : Lobar prieumonia

(duration)

yrs.

mos ..

ds.

CONTRIBUTORY.

Mitral stenosis

(SECONDARY)

(duration)

.. yrs

mos ds.

17 Where was disease contracted

if not at placc of death ?

Did an operation precede death ?

Date of

Was there an autopsy ?

What test confirmed diagnosis ? Horace & Soule

(Signed)

( Address).

180 Uruthrop St Mintha

Date

November

(Month)

L, CREMATION, OR REM

(Day)

1924

( Year)

Beth Joseph Con oben

(Cemetery)

(City or town)

19 UNDERTAKER Manuel Staneteky

DATE OF BURIAL NOV-2-1924

ADDRESS

Boston

Permit

UN 24

No. 823

If STILLBORN, enter that fact bere

7 OCCUPATION OF DECEASED

(a) Trade, professioo, or

particular kind of work

Junk-Pedler

8 BIRTHPLACE (City)

Russia

Kopel Goldstein

10 BIRTHPLACE OF

FATHER (City)

Russia

leamed

11 MAIDEN NAME

OF MOTHER

Rebecca Cannotbe

(State or country)

Russia

13 Sarah Goldstein

(Address)

164 Pauline It.

ed Nov. 61924

(Month) (Day) (Year)

REGISTRAR -

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

A.C. Daniele

Official

position

Health officers

Dale of

XM.

,000. 3567.

City or Town.

2 FULL NAME

3 SEX

male

6 AGE

Years

(b) Name of employer

(State or country

9 NAME OF

FATHER

12 BIRTHPLACE OF

PARENTS

MOTHER (City)

Informant

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

instructions and extracts from the laws on back of certificate.

N. B .- WHITE PLAINLT, WITH ONFADING DLAGR INA - THIS IS A PERMANENT NEVUND. Every item of Information

(State or country)

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

white

DIVORCED ( write the word)

married

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Sarah

Months

Days

If LESS thao 1 day ........ brs. or ........ miR.

County .. Suffolk W throp

Boston

No.

164 Pauline

St.,

Ward.

Winthrop

or town and State)

FOR WHAT ?

REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

LApproved 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 engineer, Civilengineer, Stationary fireman, etc. But in many cascs, 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 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: 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: Mcasles (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," ete.), "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 wiii 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 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 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 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- fieate 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 shali make such corti- 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 namo 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.

R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

Revere notified

The Commonwealth of Massachusetts

Winthrop

BOSTON (City or town)

1 PLACE OF DEATH County.

Suffolk

Massachusetts + Community Registered No.

hospital St

Ward

(If death occurred in a hospitalor institution, give its /NAME instead of street and number) Slotes

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

(a) Residence. No.

(Usual place of abode)

5/ Monitor

St.,

Ward.

Length of residence in city or town where death occurred

years

mooths

days.

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

years

months

days

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

( Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from

,19

., 19

that I last saw h ..

alive on

, 19

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

JA ..

The CAUSE OF DEATH was as follows :

still born

(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 ?..... www Date of

Was there an autopsy ?

What test confirmed diagnosis ?

(Signed)

, M.D.

( Address)

Date

Der.

11224

(Year)

(Month)

(Day)

13 4. Sloter

Informant

5/Thornton Pd.

(Address)

Severe

14 Filed 200. 6.1924 (Month) (Day) ( Year)

REGISTRAR

XM.

00. 3567.

20 I HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or trans't permit was issued.

H.C. Daniel

Official position

Health Office of permail

DATE OF BURIAL Det. 31 1924

19, UNDERTAKER

Manuel Stanthely

ADDRESS

Permit

Date of issoe 6/31/245 No. 822,

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

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country )

11 MAIDEN NAME

OF MOTHER

Rose Mark

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Russia

Beth areal Con veress

(Cemetery)

"(City or town)

1924

3 SEX

Male white

4 COLOR OR RACE

5 SINGLE MARRIED, WIDOWED, OR

DIVORCED (write the word)

Single

5a if married, widowed, or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

7Months

Days

If LESS thao

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

.. min.

If STILLBORN, enter that fact here Stillborn

7 OCCUPATION OF DECEASED (a) Trade, professioo, or particular kind of work (h) Name of employer

8 BIRTHPLACE (City)

Winthrop, Maso

(State or country

9 NAME OF

FATHER

Julio States

STANDARD CERTIFICATE OF DEATH

(State .. Winthrop

City or Town

No. Boston Winthrop Babi Slags

2 FULL NAME

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

PERSONAL AND STATISTICAL PARTICULARS

9,10,

02.01.1724 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

LApproved 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. Tbe 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 laborcr, Laborer - Coal mine, etc. Women at bome, who are engaged in the duties of the house- hold only (not paid Housekeepers wbo 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 bas 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 bave 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 tbe 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, etc. Tbe 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," "Sbock," "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 forthwitb, after the death of a person wbom he has attended during his last illness, at the request of an undertakeror otber 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 wbicb he died, defined as re- quired by section one, wbere same was contracted, the duration of his Jast illness, when last seen alive by the physician or officer and the date of bis 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 bealth 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 eerti- ficate of the attending physician, if any, as required by law, or in lieu thercof 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 deatb, which the clerk or registrar may require. - Gen. Laws, Chap. 114, Scc. 45.

Medical examiners shall make examination upon tbe 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 tbe 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 deatb. - 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 wbo, 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 direetly or indirectly by traumatism (including resulting septicemia), and by tbe action of chemical (drugs or poisons), thermal, or electrical agents, and deatbs following abortion, but also deatbs from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persona found dead.

M R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

STANDARD CERTIFICATE OF, DEATH

Winthrop (City or Town)

1 PLACE OF DEATH

Suffolk

. State Mais

Registered No.

......

„St.,

Ward

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

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Town of Winthrop : Record of Deaths 1922-1924, Part 216

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

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