Town of Winthrop : Record of Deaths 1922-1924, Part 85

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 85

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).

(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)

, M.D.

(Address)

218 Inarri Fr

Date

July 24

( Month)

( Dav)

1923

( Year)

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Wenchenot

(Cemetery)

(City or town)

DATE OF BURIAL

2/25-1923

19 UNDERTAKER

ADDRESS

Wundert

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

Official position

Date of issue of permit. 2/24/23

Permit

Mo.

538

0,000.

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

13 miss Ella abbott

Informant

(Address)

51 College Park Road

Filed ..

Was 6 1923

(Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

July

1923

(Year)

I HEREBY CERTIFY, That I attended deceased from

1919, to

July 23

, 1923 ,

July 22

. 1923,

If STILLBORN, eater that fact bere

-2

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

at- Home

(b) Name of employer

8 BIRTHPLACE (City).

Lowell

(State or country

Maso

PARENTS

9 NAME OF

FATHER

Oliver Pearl

10 BIRTHPLACE OF

FATHER (City).

unable to obtain

(State or country)

11 MAIDEN NAME

OF MOTHER

Con maria. King

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

after- To

2 FULL NAME

51 Collage lack R 8.0l

Ward.

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

(Day)

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 agc. 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," "Dealcr," 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, Hlousework, 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, ctc. 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 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 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.

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 as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . ..- Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall bury a human body . . . until he has received a permit from the board of health or its agent . . . or ... from the clerk of the town where the person died; . . . No such permit shall beissued until thereshall have been delivered to such board, agent or clerk ... a satisfactory written statement containing the facts required by law to be returned and recorded, which shall 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 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.

M 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

Massachusetts

Registered No 36

St., Ward

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

2 FULL NAME

Marie H. DE Cormack

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

(a) Residence.

(Usual place of abode)

Length of residence in city or town where death occurred

years

mooths

days.

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

years

Feb.

192.3

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

Feb

19.

-1

Feb 24

, 3

If LESS thao

that I last saw her alive on

Feb. 24

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

P ?

The CAUSE OF DEATH was as follows :

Jeterms of The new born

(duration)

yrs ..

mos.

6 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 ?

Color of ram-mecare

(Signed)

albert astrin

, M.D.

(Address)

32 Wave Way hof , including

Date

Fel.

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Holy Cross Malden of

(Cemetery)

(City or town)

DATE OF BURIAL Feb 211923

19 UNDERTAKER

Richard laterby

ADDRESS E. Boston

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

Official

cretary of permil

Date of issue 2.22/23

Permit . No. 5.10

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.

PARENTS

10 BIRTHPLACE OF

FATHER (City).

(State or country)

P.E. P. Source

11 MAIDEN NAME

OF MOTHER

Cose Bloom

East Boston

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

13 Feather

Informant (Address) 16 Forent St Winthrop

14 1/13. 6.1923 Filed. (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

3 SEX

Female White

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

€1

Single

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

6 AGE Years

Months

Days

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

If STILLBORN, eoter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work.

At Home

(b) Name of employer

Winthrop

8 BIRTHPLACE (City).

(State or country

9 NAME OF

FATHER

ER Daniel AMCormack

XXM. 0,000.

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

lo. 16 Forest &t

St.,

.Ward.

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

months days

PERSONAL AND STATISTICAL PARTICULARS

15 DATE OF DEATH

(Month)

L3.

...

FOR WHAT?

City or Town

.. State. No 16 Honest St

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 healthifulness of various pursuits can be known. The question applies to each and every person, irrespective of age. l'or many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engincer, Civilengineer, Stationary fireman, cte. 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 inore precise specification, as Day laborer, Farm laborer, Laborer - Coal minc, 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. Carc 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," "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.

33 Way Have A

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 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 seetion 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 elerk of the town where the person died; . .. No such permit shall beissued until there shall have been deliverod 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 momber 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- fleate. ... 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, Scc. 6.

. . . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residenee, if known; other- wise a description as full as may be, with the cause and manner of death. -Gen. Laws, Chap. 38, Sec. 7.

RULES OF PRACTICE

The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they havo given bedside care during a last illness from disease unrelated to any form of injury.

RM R-301

should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classifled. Exact statement of OCCUPATION is very important. See

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

(City or town)

Registered No. 37

City or Town

No.

573 Pleasant St

St.,

Ward

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

2 FULL NAME

Sarah ackroyd,

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

(a) Residence.

No.

573 Pleasant

St.

Ward.

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

Length of residence in city or town where death occurred

years

months

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

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

white

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed or divorced HUSBAND of (on) WIFE of

of Timeon ackroyd

6 AGE

Years

Months

Days

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

If STILLBORN, ester that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work.

(b) Name of employer

8 BIRTHPLACE (City).

Bruntal

(State or country

England

9 NAME OF

FATHER

William Frather

10 BIRTHPLACE OF

FATHER (City)

(State or country)

England

11 MAIDEN NAME

OF MOTHER

Unable to obtain

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

13 Chis. N. ackroyd

Informant

(Address)

523 Pleasant St

Filed Mau, 61923

(Month) (Day) (Year)

REGISTRAR

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

DATE OF BURIAL 2/27-23

(Cemetery)

Mica

(City or town)

19 UNDERTAKER

ADDRESS Wiechert

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

Official Secretary

Date of isse of permit. 2/27/23

Permit No. 541

100,000.

MEDICAL CERTIFICATE OF DEATH

Fieb

1923

(Year)

I HEREBY CERTIFY, That I attended deceased from

1923

, to 76 25

, 1923

If LESS than

that I last saw her alive on

Zub 25

. 19 2.3

and that death occurred, on the date stated above, at 11 0% P. m.

The CAUSE OF DEATH was as follows :

Braccial Precummorad

1 week

.(duration)

.. yrs ..

.. mos ... ds.

CONTRIBUTORY

(SECONDARY)

(duration)

... yrs ..

.. mos ...

.ds.

Did an operation precede death ?..

.. .... Date of

Was there an autopsy ?

Personal Coloration

What test confirmed diagnosis ?..

(Signed)

M.D.

(Address)

148 Wanting LT

1923

Date

(Month)

(Day)

(Year)

PARENTS

1 PLACE OF DEATH

County

State

Mars

....

17 Where was disease contracted

if not at place of death ?

15 DATE OF DEATH

(Month)

(Day)

(Usual place of abode)

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 relativo healthfulness of various pursuits can bo known. The question applies to each and every person, irrespectivo of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter. Physician, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary fireman, 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 cxamples: (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," "Forcman," "Manager," "Dealer," ctc., without moro preciso 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 reccivo 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 tho occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, ctc. 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 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 neoplasms); Measles; Whooping cough; Chronic valvular heort 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 ascertaincd as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.

Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.

Town of Winthrop : Record of Deaths 1922-1924, Part 85

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

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