Town of Winthrop : Record of Deaths 1925-1927, Part 10

Author: Winthrop (Mass.)
Publication date: 1925
Publisher:
Number of Pages: 1340

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1925-1927 > Part 10

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As terial worked on may form part of the econd statement. Never return "Laborer," " Foreman," "Manager," " Dealer," etc., withcut more precise specification, as Day laborer, Farm laborer, Laborer-Coul mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, O" .16 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 indi- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death. - Name, first, the DISEASE CAUS- ING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefi- nite); Tuberculosis of lungs, meninges, peritonaeum, etc., Car- cinoma, Sarcoma, etc., of (name origin; “Can- cer" is less definite; avoid use of " Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The con- tributory (secondary or intercurrent) affection necd not be stated unless important. Example : Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal condi- tions, such as "Asthenia," "Anaemia" ( merely symptom-

atic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inani- tion," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascer- tained as the cause. Always qualify all diseases result- ing from childbirth or miscarriage, as "PUERPERAL septi- chaemia," "PUERPERAL peritonitis," etc. State eause for which surgical operation was undertaken. For VIOLENT DEATHS state MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, Or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train-accident; Revolver wound of head- homicide ; Poisoned by carbolic acid-probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may be stated under the head of "Contributory." (Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Association.)

NOTE .- Individual offices may add to abovo list of undesirable terms and refuse to accept certificates containing them. Thus tho form in use in New York City states: "Certificates will be returned for additional information which give any of tho following discases, without explanation, as the sole cause of death: Ahortion, cellulitis, childbirth, convulsions; haemorrhage, gangrene, gastritis, erysipelas, meningitis, misearriage, necrosis, peritonitis, phlebitis, pyaemia, septichaemia, tetanus." But general adoption of the minimum list suggested will work vast improvement, and its scope ean be extended at a later date.

11-3184

ORM R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Northrop (City or town)

1 PLACE OF DEATH

County

Hinthrop

Suffolke

State maro.

Registered No.

St7,

Ward

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

(Bernard.

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

(a) Residence. No

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

St.

Ward.

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

months days

PERSONAL AND STATISTICAL PARTICULARS

City or Town

2 FULL NAME

3 SEX

4 COLOR OR RACE

White

trinale

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

If STILLBORN, enter that fect here

7 OCCUPATION OF DECEASED

(a) Trada, profession, or

particular kind of work

8 BIRTHPLACE (City)

(State or country)

PARENTS

( Address)

21 Taylor St.

Filed

should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH

(b) Nema of amployer

Months

(Month)

(Day) (Year)

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

(State or country)

mass.

at Home.

East Boston.

9 NAME OF

FATHER

George Wright

10 BIRTHPLACE OF

FATHER (City)

Scotland.

11 MAIDEN NAME

OF MOTHER

Helen nichols.

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Scotland.

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

16 I HEREBY CERTIFY, That I attended deceased from 1925, to Mc-10 19

25.

that I last saw h

alive on

and that death occurred, on the date stated above, at 2A m. The CAUSE OF DEATH was as follows:

hotel Requisititon

(duration) -yr's. 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?

(Signod)

M. D.

(Address)

1925

Data

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION OR REMOVAL

Woodlawn

Everett

DATE OF BURIAL Feb. 12. 1925

(Cemetery) (City or town)

19 UNDERTAKER

Partes P. Reunion

ADDRESS

Hurthrop

20 | HEREBY CERTIFY that a satisfactory stan- dard certificata of death was liled with me BEFORE the burial or transit permit was issued f. O. Daniele

Officlal position.

Data ol issua 2/

NO 125 Permil 665

13 Margaret M. West (site) Informant

REGISTRAR

No. 21 Taylor St.

Mary Cenu

21 Taylor

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Widowed.

frederick J. Bernard

Days

If LESS than 1 dey ._ hrs. Of __ min.

MARCIN ALOLAYL

1000

days.

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

years

(Day)

1923 (Year)

1920 ..

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, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, etc. But in many cases, especially in industrial employmente, 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," "Fore- man," "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 household only (not paid Housekeepers who receive a definite salary), may be entered as House- wife, Housework, or At home, and children, not gainfully employed, ae At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, ae Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion 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. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, meninges, 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 intercurrent) 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," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "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 "PUERPERAL 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 "primary"; 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, miscarriage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

EXTRACT

FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forth- with, 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 registra- tion a standard certificate of death, stating to the best of his knowl- edge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death .. ..- Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall bury a human body. .. until he has received a permit from the board of health or its agent. .. or. from the clerk of the town where the person died ;. . . No such permit shall be issued until there shall have been delivered to such board, agent or clerk. .. a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate 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 pur- pose, or is insufficient, a physician 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 certificate. . . The person to whom the permit is so given and the physician 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 re- quire .- 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; otherwise 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 bedeide care during a last illness from disease unrelated to any form of injury.

(2) Board of Health Physicians will certify to euch deaths only as those of persons who, though disabled by recognized disease unre- lated to any form of injury, have died without recent medical at- tendance or whose physician is absent from home when the certificate of death is needed.

(3) Medical examiners will investigate and certify to all deathe supposably due to injury. These include not only deaths caueed directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisone), thermal, or electrical agents, and deaths following abortion, but aleo deathe from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of pereons found dead.

RM R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

STANDARD CERTIFICATE OF DEATH

1 PLACE OF DEATH

County

Juffolha

State2

mana

(City or town)

Registered No.

City or Town

Edward H. Saganey

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

Ward.

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

Length of residence in city or town where death occurred

years

months

deys.

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, DR

DIVORCED (write the word)

dunque.

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

on + el

1925, to

that I last saw h

alive on

Feb.

1925

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

6.36 p. m.

The CAUSE OF DEATH was as follows:

Broncho. Pneumonia

(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) Edward . Franzen. M. D.

(Address)

Feb.

1925

(Month)

(Day)

(Year)

Informant

H. Jagaway.

( Address)

29 dea youn QUE

Filed

(Month) (Day) (Year)

REGISTRAR

19 UNDERTAKER

Fol TO maley

ADDRESS Wineturn

20 | HEREBY CERTIFY that a satisfactory stas- darf certificate of death was liled with me BEFORE the burial or tronsit permit was issued F. C. Daniele

office

Deta ol ,issue

12/12/25

Permit NO. 8166

6 AGE

Years

Months

Days

If LESS than 1 day, __ hrs. of ___ min.

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trada, profession, or

particular kind of work

(b) Nama of amployer

Winthrop

8 BIRTHPLACE (City)

(State or country)

Mask

9 NAME OF

FATHER

Anthony

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Austria

11 MAIDEN NAME

OF MOTHER

Ann Walch

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

manas

18 PLACE OF BURIAL, CREMATION DR REMOVAL

Staly Cosas malden

(Cemetery)

(City or town)

DATE OF BURIAL 2/13/25

22 .00000

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

2 FULL NAME

(a) Residence. No.

(Usual place of abode)

29 Sea Hero Quest.

No.

Sea Hoam Que

St.,

.Ward

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

1923"

Date

The Commonwealth of Massachusetts

Feb. 11.1920

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 he known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Pianter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, 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 "Lahorer," "Fore- man," "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 household only (not paid Housekeepers who receive a definite salary), may he entered as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically 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 occupa- tion at beginning of illness. If retired from business, that fact may he indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

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 contrihutory (secondary or intercurrent) affection need not he 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," "Collapse," "Coma," "Convul- sions," "Dehility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "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 "PUERPERAL septicemia," "PUERPERAL peritonitis," etc.

State cause for which surgical operation was undertaken.

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

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

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

A physician or registered hospital medical officer shall forth- with, 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 registra- tion a standard certificate of death, stating to the best of his knowl- edge and helief the name of the deceased, his supposed age, the disease of which he died, defined as required 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 died ;. .. No such permit shall be issued until there shall have been delivered to such board, agent or clerk. .. a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall he accompanied, in case of an original interment, hy a satisfactory certificate 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 pur- pose, or is insufficient, a physician 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 certificate. .. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- 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 hy 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; otherwise a description as full as may he, 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 ohservance of the following rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside 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 disahled by recognized disease unre- lated to any form of injury, have died without recent medical at- tendance 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 hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut 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.

ORM R-301

MARGIN RESERVED FOR DINDING

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop

(City or town)

Registered No.

City or Town

Winthrop

No.

Community Hosp.

St.,

Ward

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

2 FULL NAME

Grows Lyman Crosby

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

.St.,

Ward.

(Beacon Villa)

(If non resident give eity or town and state)

months

deys.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

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Town of Winthrop : Record of Deaths 1925-1927, Part 10

Author: Winthrop (Mass.) Publication date: 1925 Publisher: Number of Pages: 1340

Author: Winthrop (Mass.)
Publication date: 1925
Publisher:
Number of Pages: 1340