Town of Winthrop : Record of Deaths 1922-1924, Part 71

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 71

Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).

If investigation shows the death to have been due to dis- ease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal ganglia) (found dead in bed)." " "Heart disease, presumably coronary sclerosis. (Sudden death.)"

DESCRIPTION (for unknown person)

Dec. 30. 1922.

NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- Gen. Laws, Chap. 38, Sec. 14.

THIS CERTIFICATE CONSTITUTES SUCH PERMIT

M R-301

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

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

(City or town)

County

support

State

mass

Registered No.

City or Town

winthrop

132 Pauline st.

St.,

Ward

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

2 FULL NAME

George Harding

Poster

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

(a) Residence.

No. 13 masline st.

(Usual place of abode)

Length of residence in city or town wbere death occurred

years

months

days.

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

years

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

male

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Months

Days

If LESS than

1 day ......... brs.

or ........ min.

If STILLBORN, enter that fact bere

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work.

(b) Name of employer

8 BIRTHPLACE (City)

55 west × 3d st

(State or country

n.y.

PARENTS

9 NAME OF

FATHER

George james lister

10 BIRTHPLACE OF

FATHER (City)

(State or country)

mars.

11 MAIDEN NAME

OF MOTHER

male Fosta

george james Post-

Informant

(Address)

13 2 P.

14 Filed ..... 10 1195 (Month) (Day) (Year)

REGISTRAR

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

DATE OF BURIAL

Jon 4. 1923.

(Cemetery)

W (City of town)

19 UNDERTAKER

ADDRESS

wir th

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

TheyS. Smith

Official .... position ..

Secretary

Date of issue of permit. 1/7, 23

Permit No. 5/-

1923

( Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

Dec 29

1922

1923

that I last saw b

.alive on

19.2.3.

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

5.30 A

The CAUSE OF DEATH was as follows :

Bronchial Premi

(duration)

yrs.

mos.

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs

.mos

ds.

17 Where was disease contracted

if not at place of death ?

yes .

Did an operation precede death ?

Ono

Date of

Was there an autopsy ?

What test confirmed diagnosis?

Personal Observation

...

(Signed)

B Parken

M.D.

(Address)

145 Whathoop St Winthrop

1423

Date

(Month)

(Day) (Year)

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH.

(Month)

Jan

to.

Jan

months days

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

St.,

Ward.

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

0,000.

REVISED UN UNITED STATES STANDARD CE

CERTIFICATE OF DEAID

[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. Tho 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 Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING' DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cere- brospinal fever (the only definite synonym is "Epidemie cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified. is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of ... ... (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, 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," ete.

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, mlscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

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

A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an 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 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 permlt 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.

. . . 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 thoss 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.

R-301 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commomuralth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON

(City or Town)

1 PLACE OF DEATH

County

Suffolk

State

Massachusetts

Registered No. 2'

City or Towh

No.

46 chestic are

St ..........

.Ward

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

2 FULL NAME

Horton N.

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

(a) Residence.

No. 45 Chester Ave

St.

.Ward.

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

Leogth of residence in city or town wbere death occorred

years

mooths

days.

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

years

mooths

days

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

Mente

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

married

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Rheta m. Chamberlain

6 DATE OF BIRTH

June

(Month)

(Day)

(Year)

Years

Months

Days

If LESS thao

1 day, ........ brs.

or ....... min.

If STILLBORN, enter that fact bere

8 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Salesmanager

(State or country)

N. B. Chamberlain

11 BIRTHPLACE OF

FATHER (City)

madison

(State or country)

mane

12 MAIDEN NAME

OF MOTHER

Lida I. le hamberlam

13 BIRTHPLACE OF

MOTHER+(City)

Boston

(State or country)

mass

Informant.

Elve Chamberlain

(Address)

45 Chester Ave

Filed

2. 10. 423

(Month) (Day) (Year)

REGISTRAR

20 UNDERTAKER

E. l. Burke

ADDRESS Jamaica Plain

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

albert J. Smith position

Official Secretary

Date of issoe of permit 1/3/23 No 529

Permit

TXM. ,000

MEDICAL CERTIFICATE OF DEATH

16 DATE OF DEATH.

4 am

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

Lec 9

19.

22, to Jan

1872

that I last saw han

alive on

Cham

19.23

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

1:30 A

The CAUSE OF DEATH was as follows :

Chrome nstretitial heplerit's

Chronic Myocardini

(duration)

.. yrs.

mos.

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

.ds.

CONTRIBUTORY

( SECONDARY)

(duration)

yrs

mos.

ds.

18 Where was disease contracted

-if not at place of death ?

FOR WHAT?

yes.

Did an operation precede death ?

Date of

Was there an autopsy ?

What test confirmed diagnosis ?.

Personal Observation

(Sigoed)

raymond B. Parker, M.D.

(Address)

Date

Jan

1923.

( fear)

( Month)

(Day)

19 PLACE OF BURIAL, CREMATION, OR REMOVAL

Forest Stills

(Cemetery)

(City or town)

DATE OF BURIAL Jan 4, 1923

3 SEX male 7 AGE 10 NAME OF FATHER PARENTS 14 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

9 BIRTHPLACE (City)

gamarca Plan

mais

1923

(Usual place of abode)

[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 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 (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.

State cause for which surgical operation was undertaken.

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

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

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

CATRAGI

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

A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where 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 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.

(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.

RM R-303

MARGIN RESERVED FOR BINDING

N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information for extracts from the laws relative to the return of certificates of death. so that it may be properly classified under the International Classification of Causes of Death. See reverse side should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF DEATH in plain terms,

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

MEDICAL EXAMINER'S CERTIFICATE OF DEATH

Medfield (Cty or town)

: Registered No.

# 3

County

The field

City or Town

No.

State Hospital

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, ctc.)

St.

Ward.

Winthrop mass

(a) Residence. No.

(Usual place of abode)

Length of residence in city or lowa where death occurred

years

days

months

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

years

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

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

male

4 COLOR OR, RACE

White

5 SINGLE, MARRIED, WIDOWED OR

DIVORCED (write the word)

Vingle

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Whout 42

Months

Days

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

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Farm Land

(b) Name of employer

8 BIRTHPLACE (City)

Brooklyn

(State or country)

Aw york

9 NAME OF

FATHER

michael murphy

10 BIRTHPLACE OF

FATHER (City)

Ireland

(State or country)

11 MAIDEN NAME OF MOTHER Rachel Invarian

12 BIRTHPLACE OF MOTHER (City) (State or country)

England

Informant:

Hospital Records

(Address) Medfield maso

14 Filed Der 6 925 William Everett (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

kan.

(Day)

1923

(Year)

16 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows : ,

Organic HeartDisease

(Cortic requigitation, specific cortitio, and aneurysm of the first part of descending aortic)

Sudden death

(See reverse side for description for unknown person)

17 Where was injury sustained if not at place of death ?! John H Wyman (Sigoed)

Landdress)

3 Samford SV Mediay

Jan

(Month)

(Day)

17th Norfolk Thatret

Medical Examiner for.

11923

(Year)

18 PLACE OF BURIAL, CREMATION, or REMOVAL

DATE OF BURIAL Une Take mechteld 1/15/23 (Cemetery) (City or town)

(Month) (Day (Year)

19 UNDERTAKER-

Josefiva Roberts Medfield

21 Date of issue ..

Permit No ...

20 Burial permit issued by

Official position.

Norfolk

State

2 FULL NAME

arthur w. Murphy

(ISSUED UNDER THE PROVISIONS OF GENERAL LAWS, CHAPTER 38)

1 PLACE OF DEATH

PARENTS

, M.D.

Date ..

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 certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died (defined so that it can be classified under the inter- national classification of causes of death), 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. . . . - General Laws, Chapter 46, Section 9.

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Town of Winthrop : Record of Deaths 1922-1924, Part 71

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

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