Town of Winthrop : Record of Deaths 1922-1924, Part 48

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 48

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. . . 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. 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.

A R-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)

County Suffolk

State ... Massachusetts

Registered No. 117

St. Ward

Winthrop

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

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

.Ward. Winthrop

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

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Hernale

4 COLOR OR RACE

white

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (prite the word)

Wadout

5a If married, widowed, or diverted

HUSBAND of

(or) WIFE of

Samuel

6 DATE OF BIRTH

not Kenarun

( Month)

(Day)

(Year)

7 AGE

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

particolar kind of work

Housework

(b) Name of employer

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 ?

(Signed)

(Address)

174 Wrethy within our

Date

(Month)

(Day)

(Year)

Informant ..

n. Spector

37 Buldin It. Wol.

(Address)

Filed Sept. 1.1922

AMonth) (Day) (Year).

REGISTRAR

20 UNDERTAKER

Manuel Stanetoku

ADDRESS

Bator

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

Official position ...

, Date of issue men of permit.

08-26.2 No 470?

Permit

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

11 BIRTHPLACE OF

FATHER (City ) ...

Russia

(State or country)

12 MAIDEN NAME

OF MOTHER

Sarah Cannot be

teamed

13 BIRTHPLACE OF

MOTHER (City)

(State or country)

Russia

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH

any

(Nonth)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

1921

any

1922

that I last saw bir

alive on

19 2.3

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

10 %.

.m.

The CAUSE OF DEATH was as follows : uran

Chimie Sin de cardenas

(duration)

....... yrs.

.. mos.

ds.

9 BIRTHPLACE (City)

(State or country)

Russia

10 NAME OF

FATHER

Nathan Glazer

FOR WHAT?

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

Pride of Boston Con

(Cemetery)

Wolny

(City of town)

DATE OF BURIAL Rug. 28 1922

2 FULL NAME

52 Trident Que

(a) Residence. No.

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

days.

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

16 years

1922

XM. 0,000

City or Town

Boston

No ..

52 Trident

REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

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

Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "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 "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of .. ... .. (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Dobility" ("Congenital,""Senile," etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite diseaso can be ascertained as the cause. Always qualify all discases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," ctc.

State cause for which surgical operation was undertaken.

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

Bronchopneumonia: If primary cause, write the word "pri- mary" ; if secondary, give primary cause.

Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, totanus.

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 memberof 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 dicd; ... 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 licu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the 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 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. - 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.

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.

-302

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Rutland (City or town)

Registered No .....

(Place of death)

Registered No.

118

(Place of residence)

St.,

Ward

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

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

City or Town ... Winthrop

49 Bartlett Road

St.

Length of residence in city or town where death occurred

years

months

days

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

years

months

days

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH (month, day, and year)

Aug.26

9 22

I HEREBY CERTIFY, That I attended deceased from

Jan. 20

1922

Aug. 26

that I last saw h .. ].M .... alive on.

Aug. 25

19.

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

2 .

... m.

The CAUSE OF DEATH* was as follows:

Pulmonary tuberculosis

(duration)

mos.

de.

CONTRIBUTORY

None

(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?

Physical findings

What test confirmed diagnosis?

and Xitay

(Signed)

IL.C.Hubbard

M.D.

13 BIRTHPLACE OF MOTHER (city or town)Brooklyn (State or country) N. Y. Aug. P6 , 1932(Address)Rutland State Sanatorium

15 Aug. 26, 1922 Kam M. Hanft Syst: 5, 1922 Filedland

Registrar of city or town where death occurred

....

Registrar of city or town where deceased resided

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

Holy Cross,

Malden, "ass.

DATE OF BURIAL

Aug. 28, 19 22

20 UNDERTAKER

John J.Fay

ADDRESS

Woodland St.

worcester,

-ass.

20,000.

1 PLACE OF DEATH

County

Worcester

2 FULL NAME

Francis J. Grainger

(a) Residence.

State

Mass.

(Usual place of abode)

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Married

White

Nale

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Evelyn Grainger

6 DATE OF BIRTH (month, day, and year) June 25, 1893

7 AGE

Years

Months

Days

If STILLBORN, enter that fact bere

8 OCCUPATION OF DECEASED

(a) Trade, profession, or

Orderly

particular kind of work.

9 BIRTHPLACE (eity or town)

East Boston,

(State or country)

Mass.

11 BIRTHPLACE OF FATHER (city or town)

(State or country)

Ireland

12 MAIDEN NAME OF MOTHER Mary LeBlanc

PARENTS

Miss Mary E. Fitzgerald

Informant

(Address)

Rutland State Sanatorium

of certificate.

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 on back

N. B. - WRITE PLAINLY, WITH ONFADING INK - THIS IS A PERMANENT NEVUND. Every Fem Vi Imformation enoura De

(b) Name of employer

Rutland State Sanatorium

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

10 NAME OF FATHER Dr. William H. Grainge

State Mass.

City or Town

Rutland

No.

Rutland State Sanatorium

yrs.

REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

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

Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "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 "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of ..... .. (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Nevér report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Lebility" ("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," 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.

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 otherauthorized 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 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- 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, 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.

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.

301-א

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

1 PLACE OF DEATH

County

City or Town

Winthrop ...... Mass

No.

Fort ... Banks. Mass ..

St., Ward

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

2 FULL NAME

JAMES S. SHANNON.

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

(a) Residence. No.

28 Cambridge Terrace,

St.,

Ward.

Cambridge ,Mass.

(Usual place of abode)

(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 barth ?

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Male

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIYORCED (write the word)

Single

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Months

Days

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

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

Soldin

8 BIRTHPLACE (City)

(State or country

Mass

9 NAME OF

FATHER

Michael Shannon

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Ireland

11 MAIDEN NAME

OF MOTHER

Budget Mc hammer

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Juland

Informant

Gro Ht Kelly

(Address)

1 Card Combina

Filed Sept 11922

(Month) (Day) ( Year)

20 1 HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued. SAMO

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

aux

1922

(Year)

I HEREBY CERTIFY, That I attended deceased from

August 11

1922 to

Aug 27

19 ... 2.2.,

If LESS than

that I last saw

..... im .. alive on

August 27

19 .. 22 ..

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

5.30 a.m.

The CAUSE OF DEATH was as follows : General Peritonitis followed

by .pneumonia ..

Caused by

pustulated appendix

(duration)

. mos ..

14.

.ds.

CONTRIBUTORY

Oedema .... of lungs ..

(SECONDARY)

6 hrs.

(duration)

.yrs ...

.mos

ds.

17 Where was disease contracted

if not at place of death ?

Camp Devens Mas

Did an operation precede death ?

Yes

.... Date of

July 13/22

Was there an autopsy ?.

No.

What tesconfirmmed lingnosis ?

Clinical

(Sig) med m. moms

, M.D.

Date

(Address)

Captain,M.C. Fort. Banks ,Mass ..

1922

August 27/22

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Cambridgecom Masz

(Cemetery)

."(City or town)

DATE OF BURIAL fug 29

19 UNDERTAKER

George H Jcellery

ADDRESS

Camb

Official position

Wealth Ofie Date of issue / of permit

auf 27/22 No ...

Permit 471

,000.

The Sonomuralth of Massachusetts

STANDARD CERTIFICATE OF DEATH cambridge

notifica

State Ma 8 8

Registered No.

119

(City or town)

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

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Town of Winthrop : Record of Deaths 1922-1924, Part 48

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

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