Town of Winthrop : Record of Deaths 1922-1924, Part 54

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 54

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If STILLBORN, enter that fact bere

8 OCCUPATION OF DECEASED

(a) Trade, profession, or particular kind of work.

(b) Name of employer

9 BIRTHPLACE (city or town).

LEESVILLE CONN

(State or country)

10 NAME OF FATHER JOSEPH WHITMORE

PARENTS

11 BIRTHPLACE OF FATHER (city or town)

UNKNOWN

(State or country) CONN.

12 MAIDEN NAME OF MOTHER ELECTRA UNKNOWN

13 BIRTHPLACE OF MOTHER (city or town)

(State or country)

UNKNOWN CONN.

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?

NONE

(Signed)

FRANCES X. CORR

, 19 22 (Address)

215 NEPONSET AVE.

M.D.

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

NORWICH CONN SEPT.26

DATE OF BURIAL

19 22

(Address)

231 COURT RD, WINTHROP

Filed SEP. 2719 22.

ENMSlenen

Registrar of city or town where death occurred

Filed ....

1922_

Registrar of city or town where deceased resided

0,000.

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

of certificate.

Informant

A. N. UPHAM

(duration)

... yrs ..............

mos ........

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

.yrs.

mos.

ds.

20 UNDERTAKER

J. E. WATERMAN & SONS

ADDRESS

BOSTON

1 PLACE OF DEATH

City or Town

Boston

No.

11,No MONROE TER

16 DATE OF DEATH (month, day, and year)SEPT . 24

19 22 .

I HEREBY CERTIFY, That I attended deceased from

AUG.

19.2.2 ... to.

SEPT. 24

19.22

that I last saw h ... E.R .... alive on

SEPT, 23

19.22

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

The CAUSE OF DEATH* was as follows :

VALVULAR HEART DISEASE

AORTIC & MITRAL

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, 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. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," ete., 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 spc- cifically the occupations of persons engaged in domestie 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 tho same disease. Examples: Cere- brospinal fever (the only definite synonym is "Epidemie cercbrospinal 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 sym tomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Lebility" ("Congenital,""Senilc," 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.)

Bronchepneumonia: 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 certificato of death, stating to the best of his knowledge and belicf the name of the deceased, his supposed age, the disease of which he died, defined as rc- 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 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 tho 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 thercafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manucr or cause of tho death, which the clerk or registrar may requirc. - 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 havo died by violence. - Gen. Laws, Chap. 38, Sec. 6.

. . . Hle 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 tho 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.

302

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

BOSTON (City or town) Registered No8.1.94 (Place of death)

1 PLACE OF DEATH

County

Suffolk

State

Massachusetts

Registered No ...

1.37

(Place of residence)

St.,

Ward

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

2 FULL NAME

HENRY JOSEPH STONE

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

(a) Residence.

State

MAS.S ...

City or Town

WINTHROP

No.

236 LINCOLN

(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?

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

MALE

4 COLOR OR RACE

WHITE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

MARRIED

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE ALMA ELIZABETH GRAHAM

6 DATE OF BIRTH (month, day, and 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

particular kind of work

MACHINIST

(b) Name of employer

.. (duration)

yrs.

mos.

ds.

CONTRIBUTORY

STAPHYLOCOCCUS

(SECONDARY)

SEPTICEMIA

(duration)

yrs.

mos

da.

10 NAME OF FATHER

NEWELL STONE

18 Where was disease contracted

if not at place of death ?

Was there an autopsy ?.

12 MAIDEN NAME OF MOTHERLARA L. HARRINGTONWhat test confirmed diagnosis ?. LABORATORY

(Signed) .

EDWIN R, LEWIS ASST. SUPT.

M.D.

, 19 22 (Address)

PETER B. BRIGHAM HOSP.

Informant

ALMA E. STONE

(Address)

236 LINCOLE ST. WINTHROP MASS

15 SEP.27 19 19 22 ENMYlenew Filed

Registrar of city or town where death occurred

Filed Oct 25, 192%

Registrar of city or town where deceased resided

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

SWAMPSCOTT CEM.

DATE OF BURIAL

SEPT27 19 22

20 UNDERTAKER

C. R. BENNISON

ADDRESS

WINTHROP

MASS.

0,000

of certificate.

PARENTS

11 BIRTHPLACE OF FATHER (city or town)

(State or country)

MASS

SWAMPSCOTT Did an operation precede death ?.

Date of

13 BIRTHPLACE OF MOTHER (city or town)

(State or country )

EAST BOSTON

MEDICAL CERTIFICATE OF DEATH

19 22

16 DATE OF DEATH (month, day, and year SEPT. 25

-- HEREBY CERTIFY, That ? attended deceased from

SEPT ....... 23

1922, to SEPT. 25

19.22

that I last saw h

alive on

SEPT. 25

19.22

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

2:50 Am.

The CAUSE OF DEATH* was as follows :

ACUTE MASTORDITIS

PURULENT MENINGITIS

9 BIRTHPLACE (city or town)

CHELSEA

(State or country) MASS

Boston

NO.PETER B BRIGHAM HOSP

City or Town

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 healthfulncss 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 fircman, 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, ete. 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 (discase causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma,""Convulsions," "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.

EXTRACIS

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 deceascd, 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 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 heu 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.

. . . 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.

-302

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

(City or town) 298

1 PLACE OF DEATHSCY

County

Lanver .........

State Janvary state hospital Registered No.

City or Town

No.

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

2 FULL NAME

Louis S. Day

Lass.

City or Town

St.

Length of residence in city or town where death occurred

years

months

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

male

4 COLOR OR RACE

white

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

married

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Martha Day

6 AGE

37 Years

Months

Days

If LESS than

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

or ........ min.

If STILLBORN, enter that fact here

General Paralysis of the Insane

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

Concrete worker

particular kind of work

(b) Name of employer

8 BIRTHPLACE (city or town)

Laine

(State or country)

9 NAME OF

FATHER

frank Lay

PARENTS

10 BIRTHPLACE OF

FATHER (city or town)

(State or country)

Maine

11 MAIDEN NAME

OF MOTHER

Manule Could

12 BIRTHPLACE OF

MOTHER (city or town)

(State or country)

Laine

13 Custis Roch

Informant

Hatlorne

(Address)

Filed

10-9-220

Registrar of city or town where death occurred

Filed

Out. 10, 1922

Registrar of city or town where deceased resided

18 PLACE OF BURIAL. CREMATION, OR REMOVAL

Camden, Camden, +e.

DATE OF BURIAL

19/2/2210

19 UNDERTAKER

J. H. Logue

ADDRESS

Boston .

carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,

of certificate.

so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back

Registered No.

(Place of death) 135

(Place of residence) St., Ward

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

(a) Residence.

State.

(Usual place of abode)

MEDICAL CERTIFICATE OF DEATH

Dep. 29, 1922.

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

hug.

sep. 29,

19 ...... ........

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

JeD.

29,

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

11.05.

The CAUSE OF DEATH wes as follows :

(duration)

...... yrs ................

mos.

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs.

mos.

ds.

17 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)

Guy C. Randall

M.D.

/7/20. (Address)

Hathorne, Lass.

15 DATE OF DEATH

(Month)

winthrop

No.

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, 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. 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 Ilousewife, 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 CAUSINO 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 discase. 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 neopiasms); 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,""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, " etc.

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Town of Winthrop : Record of Deaths 1922-1924, Part 54

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

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