Town of Winthrop : Record of Deaths 1922-1924, Part 27

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 27

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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 certificato of death, stating to the best of his knowledge and belicf tho name of the deceased, his supposed age, tho diseasc 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 beissued 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 he 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 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 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 bodics 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 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 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.

(3) Medical examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

M R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON

1 PLACE OF DEATH

Suffolk

State

46 Hawthorne Que

St.,

Ward

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

2 FULL NAME

Lenne nath

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

Ward. Winthrop

(If non-resident give cit dor town and State)

Length of residence ia 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

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH.

(Month)

april

(Day)

(Year)

HEREBY CERTIFY, That I attended deceased from 1 Mar 11

that I last saw h

alive on

apr 23

022

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

6.30 A.m.

The CAUSE OF DEATH was as follows : Chronic Heptoutes

.(duration).

mos.

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs ..

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 ?

200

What test confirmed dagnosis ?

(Signed)

Louis

Skimball

M.D.

( Address).

13 Habart Cur R

Levere

Date

Cemil

22/1

( fonth)

(Day)

(Year)

Informant

B. Rothburg

(Address)

46 hawthorne Que

Filed

1922

(Month) (Day) (Year)

REGISTRAR

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

ItMorning

Official position.

Heath Off

Date of issue of permit ..

DATE OF BURIAL april 231922

ADDRESS

Boston

Permet

-XXM.

00.000

County

3 SEX

Female

7 AGE

(b) Name of employer

10 NAME OF

FATHER

PARENTS

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

N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD. Every item of information

( State or country)

4 COLOR OR RACE

white

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Widow

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Samuel

6 DATE OF BIRTH

( Month)

(Day)

(Year)

Years

Months

Days

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

If STILLBORN, enter that fact here

8 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work.

Housework

9 BIRTHPLACE (City)

austria

Jacob Dober

11 BIRTHPLACE OF

FATHER (City ).

austria

(State or country)

learned

12 MAIDEN NAME

OF MOTHER

Rebecca Cannotbe

13 BIRTHPLACE OF

MOTHER (City)

austria

(State or country)

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

Austrian Cem. Wobum

(Cemetery)

(City or town)

20 UNDERTAKER

Manuel Stanetaky

Massachusetts

(City or Town)

Registered No.

City or Town

Boston Winthrop No ...

46 Hawthorne Que.

(a) Residence. No.

( Usual place of abode)

1922

19.

Cyp 23

artenon sclerosis

Aluzical Ligris

april 23% 1/27

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 Planter, Physician, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) tbe 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 wben 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., witbout more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, wbo are engaged in the duties of the bouse- bold 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 bas been changed or given up on account of the DISEASE CAUSINO DEATH, state occupation at beginning of illness. If retired from business, tbat fact may be indicated tbus: Farmer (retired, 6 yrs.). For persons wbo have no occupation whatever, write None.

Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (tbe 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 "Typboid 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., wben a definite disease can be ascertained as tbe cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.

State cause for which surgical operatlon 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, 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 wbom he has attended during his last illness, at the request of an undertaker or otber authorized person or of any meniber 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, bis supposed age, the disease of which he died, defined as re- quired by section one, where same was contraeted, 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 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 pbysi- 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 tbe place where the deceased died bis name and residenee, 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 witbout 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, tbe 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

(City or Town) 1.68

With Registered No.

No.

70 Somenel Que.

St .... .. Ward

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

freeh's Woodbridge (ukine)

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

No. Tra omerael ien Str.

Ward.

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

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Sa If married, widowed, or divorced ana Crowley Partition

HUSBAND of

(or) WIFE of

(Year)

If LESS than

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

or ....... min.

8 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(h) Name of employer

Histo dealing

Patina 4mm

Portemouth

ansio B. Moody

Informant

(Address)

To Somenach are

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH

(Month)

I HEREBY CERTIFY, That I attended deceased from

april 221

1922

april 24

1922

.............

that I last saw hAM alive on

aprill

19 22

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

. m.

The CAUSE OF DEATH was as follows :

Cerebral Hemorrhage

arterio sclerosis chami

Qbrmc interstitial nephritis

( duration)

.yrs.

mos. 3

ds.

CONTRIBUTORY.

(SECONDARY)

.(duration)

yrs.

mos ..

.ds.

18 Where was disease contracted

if not at place of death ?

Did an operation precede death ?

Date of.

Was there an autopsy ?

What test confirmed diagnosis ?

clinical diagnosis

(Sigoed)

Biomed calf Chary B M M. M.D.

( Address).

Date

aford

251

( Month)

(Day)

(Year)

19 BLAGE OF BURIAL, CREMATION, OR REMOVAL

Winthrop

(Cemetery)

(City or town)

Winthrop

DATE OF BURIAL 4/26/212

20 UNDERTAKER

Char. R.l Dennison

ADDRESS

Winthrop

Permit

00,000

21 ! HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued S. a. Maury

Official position ..

Health officer

Date of issue

of permit. 4.2.5 22 No. 4315

april

1922

(Day)

(Year)

City or Town

2 FULL NAME

(a) Residence.

(Usual place of abode)

Length of resideoce io city or towa where death occorred

years

months

3 SEX

male

4 COLOR OR RACE

2hits

6 DATE OF BIRTH

nov. 1615.62

(Day)

( Month)

7 AGE

Years

Days

Months

If STILLBORN, enter that fact here

10 NAME OF

FATHER

Unable to Obtain

11 BIRTHPLACE OF

FATHER (City)

(State or country)

12 MAIDEN NAME

OF MOTHER

Unable to Obtain

13 BIRTHPLACE OF

MOTHER (City)

PARENTS

(State or country)

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

Filed

(Month) (Day) (Year)

N. B. - WRITE PLAINLY, WITH ONFADING BLACK INK -THIS IS A PERMANENT RECORD. Every Item of Information

9 BIRTHPLACE (City)

(State or country)

W. A.

1 PLACE OF DEATH of Suffolk County

KCVISEU UNILEU SIAIES SIANVAKU CEKILFILALL OF DEATH

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

Statement of occupation. - Precise statement of occupation is very important, so that tho relativo healthfulness of various pursuits can be known. The question applies to each and every person, irrespectivo 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, ete. But in many cascs, especially in industrial employments, it is necessary to know (a) tho 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, ete. Women at home, who are engaged in the duties of the house- hold only (not paid Ilousekeepers 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 "Epidemio 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 (sccondary or inter- current) affection need not be stated unless important. Example: Measles (discase causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (mercly symptomatic), "Atrophy," "Col- lapsc,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," ete.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclaturo 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 undertakeror otherauthorized 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 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 perinit 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, Scc. 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 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, Scc. 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.

M R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

Winthrop

BOSTON (City or Town)

Ward

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

Baby

Colaque

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

(a) Residence. No

( Usual place of abode)

Length of residence io city or town where death occurred

years

months

days.

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

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Town of Winthrop : Record of Deaths 1922-1924, Part 27

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

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