Town of Winthrop : Record of Deaths 1922-1924, Part 72

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 72

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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 . . . by a satis- factory certificate of the attending physician, if any, as re- quired 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 phy- sician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for regis- tration 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. - General 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. If a medical examiner has notice that there is within his county the body of such a person, he

shall forthwith go to the place where the body lies and take charge of the same. . . . Gen. Laws, Chap. 38, Sec. 6.

. . He shall in all cases certify to the town clerk or regis- · trar in the place where the deceased died his name and resi- dence, if known; otherwise a description as full as may be, with the cause and manner of death. - General 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 supposably 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 in- jury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

STATEMENT OF CAUSE OF DEATH

Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homi- cidal." "Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."

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)

Jan. 3. 1923

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

R - 301

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

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

BOSTON (City or town)

County

Suffolk

State Massachusetts

Registered No.

St.,

Ward

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

2 FULL NAME

useppe Skano

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

(a) Residence.

No.

( Usual place of abodey

Length of residence in city or town where death occurred

years

months

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Male White

4 COLOR OR KACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED " write the word)

Single

5a /f married, widowed, or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

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.

(h) Name of employer

8 BIRTHPLACE (City) (State or country

Winthrop Mass

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country

Concetta Conte

11 MAIDEN NAME

OF MOTHER

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

Italy

Informant

Father

(Address)

7 Sturgis et

14 Filed:11 /1/1923

(Month) (Day) ( Year)

REGISTRAR

19 UNDERTAKER

Los, a. Lanyone

APDRESS

City

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

Albert S. Smith

Official position.

Secretary

Date of issue of permit .. 1/6/23

Permit

No. 512

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

should be 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 and extracts from the laws on back of certificate.

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

I HEREBY CERTIFY, That I attended deceased from

Dec

1922

, to

Jan

, 1923

that I last saw he

alive on

, 1923

and that death occurred, on the date stated above, at 10 !!

The CAUSE OF DEATH was as follows :

Bronchial

(duration)

.. yrs ....

mos ..

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs ...

.mos.

.ds.

17 Where was disease contracted

Ifhrot at place of death ?

FOR WHAT?

Did an operation precede death ? ?

Date of

Was there an autopsy ?

What test c

(Signed)

(Address)

Date

(Month)

(Day)

Winthrop

1923

( Year )

M.D.

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

HolyCross Cem.

(Cemetery)

(City or town)

DATE OF BURIAL Jan 1993

XM. ,000.

Boston Winther 7 Iturais et .

City or Town

7 Sturgis st

St.,

Ward.

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

1993

(Year)

( Day)

yes

9 NAME OF

FATHER

Giovanni

LEDED UNITED STATES DIANDARD CERTIFICATE OF 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 (c) 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, Es 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," 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, pyemla, septicemia, tetanus.

EXTR TRACTS

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

A physician or registered hospital medical officer shall forthwith, afterthe death of a person whom he has attended during his last illness, at the request of an undertakeror other authorized person or of any member of the family of the deccased, 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 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 tho 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 phys1- 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 physiclans 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 clectrical agents, and deaths following abortion, but also deaths from disease resulting from Injury or infectlon related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persone found dead.

R - 301 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

1 PLACE OF DEATH

County.

Suffolk

State. mass.

Registered No.

City or Town

uchoturch

No.

178 Circuit Rd

St., .. Ward

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

2 FULL NAME

Douglas Kent Remby

(a) Residence.

No.

(Usual place of abode)

178 Curent Bood Vard.

Length of residence in city or town where death occurred

years

mooths

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

moo!hs days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

male

4 COLOR OR RACE

white

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 ......... hrs.

or ........ min.

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, professioo, or

particular kind of work.

(b) Name of employer

8 BIRTHPLACE (City)

winthrop

(State or country

mass

9 NAME OF

FATHER

William & Remby

10 BIRTHPLACE OF

FATHER (City)

(State or country)

mass.

11 MAIDEN NAME

OF MOTHER

mildred Kent

Boston

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

Informant William & Remby

(Address)

178 Eurauf Road

winthro29 UNDERTAKER

14 Filed Jan 10.1920 (Month) (Day) (Year)

REGISTRAR

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

Albert I smitte

Official position ...

Secretary

Date of issue of permit 1/4/23

Permit

No. 511

.....

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

9 am

1923

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

Dec 13

1922

Jan

19.23

that I last saw h.k.xx .... alive on

Jan

19.23

and that death occurred, on the date stated above, at .... 4 A

m. The CAUSE OF DEATH was as follows :

Infections Entrin

(duration)

yrs.

mos .. 7 ds.

CONTRIBUTORY

Simple Meningitis

(SECONDARY)

(duration)

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

........... mos .. 2. .ds.

17 Where was disease contracted

ifnot at place of death ?.

yes

Did an operation precede death ? no

Date of C

Was there an autopsy ?

What test confirmed diagnosis 2

Paranal Observation

(Signed)

., M.D.

(Address)

Writeop Man

Date

Jan

1923.

(Year)

(Month)

(Day)

48 PLACE OF BURIAL, CREMATION, OR REMOVAL

DATE OF BURIAL Jan 4. 1923

(Cemetery)

(City or town)

ADDRESS e R Bennison Wrathof

00.

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

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

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

(City or toww)

ACIDOED UNITED STATES SIA

ANDARD CERTIFICATE OF OF DEATH

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

, Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can he known. The question applies to each and every person, 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 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 "Lahorer," "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 ouly (not paid Housekeepers who receive a definite salary), may he entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should he taken to report spc- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has heen changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from husincss, 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 "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, ete., of .. .. (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant ncoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ete. 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," "Ancmia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Dehility" ("Congenital," "Senile," cte.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite disease can he ascertained as the cause. Always qualify all diseases resulting from childhirth 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 soie 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 undertaker or other authorized person or of any mem her of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledgo and belief the name of the deceased, his supposed agc, 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 hody . . . until he has received a permit from the hoard 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, hy 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 thercafter furnish for registration any other necessary information which can be ohtained 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 hodies of only such persons as are supposed to have died by violenco. - 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, Sec. 7.

RULES OF PRACTICE

The fulfilment of the purpose of these laws calls for the ohser vance 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 ahsent 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 ahortion, 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

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Town of Winthrop : Record of Deaths 1922-1924, Part 72

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

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