Town of Winthrop : Record of Deaths 1922-1924, Part 220

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 220

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Stato 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, eryslpelas, meningitis, miscar- rlage, necrosis. peritonitis, phlebitis, pyemla, septicemia. tetanus.

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

A physiclan 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 namo of the deceased, his supposed age, the disease of which he died, defincd as re- quired by section one, whero samo 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 dellvered 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 caso of an original interment, by a satisfactory certi- ficate of the attending physician, if any, as required by law, or iu licu thercof 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- clan 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 physiclan. If death is caused by vlolence, 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, See. 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.

(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. Theso 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.

M R-301 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON (City or town)

I PLACE OF DEATH County Suffolk

. State Massachusetts

Registered No.

City or Town

Boston

No .. 171 Shore Drie

St.

Ward

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

2 FULL NAME

171 Shore Drive

St.,

Ward. Winthrop

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

Length of residenca in city or town where death occurred

years

months

days.

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

years

months days

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

white

SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Married

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

Sarah

Years

Months

Days

If LESS than

1 day, __ hrs.

of __ min.

If STILLBORN, anter that fact hero

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

Builder

particular kind of work

8 BIRTHPLACE (City)

Russia

(State or country)

9 NAME OF

FATHER

Nathan Backin

10 BIRTHPLACE OF

FATHER (City)

Queria

(State or country)

11 MAIDEN NAME

OF MOTHER

Esther Cannot be

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Russia

MEDICAL CERTIFICATE OF DEATH

1924.

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

march

hun 23

1924.

that I last saw him alive on

nov. 23.

1924 ..

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

VIA

The CAUSE OF DEATH was as follows:

Carcinoma of Intestines

(duration) -2

yrs .mos. ds.

CONTRIBUTORY (SECONDARY)

(duration)

yrs.

.mos. ds

17 Where was disease contracted

if not at place of death?

FOR WHAT?

not known

Did an operation precede death?

Date of

Was there an autopsy?

If Under One Year. Was Baby Breast Fed

What test confirmed diagnosis?

teamed)

(Signed)

albert astrin

M. D.

(Address)

150 Short Drive, Winthings

Date

(Month)

25/1924

(Year)

Informant

Mrs.S. Bockin

(Address)

171 Shore Drive

Filed.

Dec 3/24

(Month)

(Day)/ (Year)

REGISTRAR

-23-20M -100000

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

H.C. Daniele

Official position

Date of issue 11/20/24-NO.

DATE OF BURIAL

18 PLACE OF BURIAL, CREMATION OR REMOVAL

Adath Jareal Cem

(Cemetery!

(City of town)

ay w · Rox

18 UNDERTAKER Manuel Stanetaky Doctors

Nov. 201924 ADDRESS

Permit 830

3 SEX male 6 AGE 44 PARENTS 13 14 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 (b) Name of employer

Winthrop Darrd Backin

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

(a) Residence. No.

(Usual place of abode)

15 DATE OF DEATH har. 25,

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 he known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first lins will be sufficient, e. g., Farmer or Pianter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, 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 ths husiness or industry, and therefore an additional line is provided for the latter statement; it should he used only when nesdsd. examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the sscond statement. Never return "Lahorer," "Fore- man," "Manager," "Dsaler," etc., without more prsciss specification, as Day laborer, Farm laborer, Laborer-Coal mine, stc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may he entersd as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has hesn changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion at hsginning of illness. If retired from husiness, that fact may he indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, writs 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 acceptsd term for the same disease. Exam- ples: Cerebrospinal fever (the only definite synonyma is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualifisd, is indefinite) ; Tuberculosis of lungs, meninges, 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 intercurrent) affection need not he 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," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Ursmia,". "Weakness," etc., when a definite disease can he ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUERPERAL septicemia," "PUERPERAL peritonitis," stc.

State cause for which surgical operation was undertaken.

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

Bronchopneumonia: If primary cause, write the word "primary"; 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, miscarriage, 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 forth- with, 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 registra- tion a standard certificats of death, stating to the hest of his knowl- edge and helief the name of the deceased, his supposed age, the disease of which he diod, defned as required by ssction one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death . ... Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall hury a human hody. . . until he has received a permit from the hoard of health or its agent. .. or ... from the clerk of the town whers 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 shall he accompanied, in case of an original interment, by a satisfactory certificate 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 pur- pose, or is insufficient, a physician 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 certificate. . . The person to whom the permit is so given and the physician 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 causs of the death, which the clerk or registrar may re- quire .- Gen. Laws, Chap. 114, Sec. 45.

Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy 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; otherwise a description as full as may he, 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 hedside care during a last illness from discase 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 unre- lated to any form of injury, have died without recent medical at- tendance or whoss physician is ahsent 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 hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut 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.

M R-301

OFFICE OF THE SECRETARY OMVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop

(City or town)

Registered No.

St.

Ward

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

2 FULL NAME

Margaret 2.

Varr

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

(a) Residence. No. 263 Doudouic

(Usual place of abode)

Length of residence in city or town where death occurred

years

St.,

Ward.

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

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Female 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

15 DATE OF DEATH

november

25 1924

(Month)

(Year)

(Day)

I HEREBY CERTIFY, That I attended deceased from

19.

Nov 25 1924.

that I last saw h

alive on

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

8 P.m.

The CAUSE OF DEATH wases follows:

berebral Hemorrhage.

(duration)

-yrs.

mos.

¿. ds.

arterio Actorand.

CONTRIBUTORY

(SECONDARY)

5 yrs. 1-

_yrs ._

(duration)

.mos.

17 Where was disease contracted

if not at place of death?

Did an operation precede death ?.

Date of

Was there an autopsy?

Systolic Blood Press

What test con ymed diagnosit

Horace

&Brandon

(Signed)

.. M. D.

(Adds) 7 Central Ag EuxBoston

Date

now

19924

(Year)

mais

13 Bessie Barr

Informant

(Address)

263 Bourdain Ly

Dec. 3.1924

Filed

(Month) (Day) (Year)

REGISTRAR

ADDRESS

19 UNDERTAKER

Frank E. Brown East Hosting

20 | HEREBY CERTIFY that a satisfactory stan- dard certificate ol death was filed with me BEFORE the burial or transit permit was issued J. C. Daniels

Official position.

Wealth officer

Date of issue of permit 11/28/24

Permit NO. 831

-100.000

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

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Scotland

11 MAIDEN NAME

OF MOTHER

Jessie Davison

12 BIRTHPLACE OF

MOTHER (City)/

(State or countryy

Leochand

(Month)

(Day)

18 PLACE OF BURIAL CREMATION OR REMOVAL

Woodlawn

Everett

(Cemetery)

(City or town)

DATE OF BURIAL Nov 28-241

I STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

School Teacher

8 BIRTHPLACE (City)

(State or country)

Liverpool

Cinq.

9 NAME OF

FATHER

John Barr

6 AGE

Years

Months

Days

ff LESS than 1 day .___ hrs. or ...__ min.

MEDICAL CERTIFICATE OF DEATH

days.

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

years

months

State Mark

I PLACE OF DEATH

County

Suffolk

City or Town

No 263 Boudoir

9.95

nov. 25

, 1924.

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 he known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Pianter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, etc. But in many cases, especially in industrial employ ments, 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 "Lahorer," "Fore- man," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer-Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may he entered as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, ete. If the occupation has heen changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion 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. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite) ; Tuberculosis of lungs, meninges, 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 intercurrent) 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," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "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 "PUERPERAL 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 "primary"; if secondary, give primary cause.

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

A physician or registered hospital medical officer shall forth- with, 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 registra- tion a standard certificate of death, stating to the best of his knowl- edge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required 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 hody. .. 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 con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate 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 pur- pose, or is insufficient, a physician 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 certificate. . . The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can hejobtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- Gen. Laws, Chap. 114, Sec. 45.

Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy 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; otherwise 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 ohservance of the following rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from diseasc unrelated to any form of injury.

(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease unre- lated to any form of injury, have died without recent medical at- tendance or whose physician is ahsent 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 hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut 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.

M R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

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Town of Winthrop : Record of Deaths 1922-1924, Part 220

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

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