USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1925-1927 > Part 222
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:
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 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 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 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 poison), thermal, or electrical agents, and deaths following abortion, 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. -
AR-301
The Commonwealth of Massachusetts
STANDARD CERTIFICATE. OF DEATH
(City or town)
Registered No.
City or Town.
Winthrop
State
No.
125 Herman
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2FULL NAME
Marc A. Mc Donowak
(If U, S. War Veteran, specify WAR)
Ka) Residence. No.
(Usual place of abode)
Length of residence in city or town where death occurred 0 years
months
days.
How long in U. S., if of foreign birth?
years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE_
1
5 SINGLE, MARRIED, WIOOWEO, OR
DIVORCEO (write the word)
Married
5a If married, widowed or divorced
HUSBAND of
(or) WIFE of
James Mc. Donough
6 AGE
Years
Months
Oays
IF LESS than
1 day ......... hrs.
Or ........ min.
IF STILLBORN, enter that fact here
7 OCCUPATION OF OECEASEO
(a) Trade, profession, or
particular kind of work
(b) Name of employer
None
8 BIRTHPLACE (City)
(State or country)
JUV. B.
9 NAME OF
FATHER
Thomas Fr. Welch
horas
1O BIRTHPLACE OF FATHER (City) (State or country)
:30 Johna
11.15.
1 1 MAIOEN NAME
OF MOTHER
Alice Banker.
12 BIRTHPLACE OF
MOTHER (City)
(State or country)
13
Informant Nellie R. Malik
( Ad
Filed CU.2 24/27 (Month) (Day) (Year)
REGISTRAR
20 | HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued
W.D. Childers
Official position
Oate of Issue of permit Health Officer Luces 8/18/27
Permit No. 1287.
9.13.9 - . -
MEDICAL CERTIFICATE OF DEATH
15 OATE OF DEATH
Any 16-
(Month)
(Day)
1927 (Year)
16 I HEREBY CERTIFY , That I attended deceased from pan 101, 192/to ang, 15 _, 19_
that I last saw h. alive on
and that death occurred, on the date stated above, at The CAUSE OF DEATH was as follows: (State fm))
6
.m.
bolitis
CONTRIBUTORY
(Secondary)
(duration).
yrs.
mos
ds.
1 7 Where was disease contracted
if not at place of death.
Oid an operation precede death
For what
Oate of operation
Was there an autopsy
NO
What test confirmed diagno Oblinie
(Signed)
M. D.
(Address)
Ireland Oate 4 1924
18 PLACE OF BURIAL, CREMATION, OR REMOVAL Calvary Korbury
OATE OF BURIAL Aug 19-27
(Cemetery)
(City or town)
19 UNDERTAKER F. H. Franc
AODRESS Reare
14
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS 1 PLACE OF DEATH County Suffolk
2 00,000. 9-26. NO. 6373
Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. plied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified.
125 Herman
St.
Ward,
Winthrop
(If non-resident give city or town and state)
192
675
PARENTS
REVISED UNITED STATESSTANDARD CERTIFICATE OF DEATH
(Approved by U. S. Census and American Public Health Association)
Statement of occupation .-- Precisc 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, irrc- spective of age. For many occupations a single word or term on the first line will be sufficient, c. g., Farmer or Planter, 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 "Laborer," "Fore- man," "Manager," "Dealer," ctc., without more precise specification, as Day laborer, Farm laborer, Laborer-Coal mine, etc. Women at bome, who are engaged in the duties of the bousehold onty (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 be indicated thus: Farmer (retired, 6 yrs.). For persons who bave 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 terin-for- the- same disease. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic ecrebrospinal 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); Mcasles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. Tbe 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," "Ancmia" (merely symp- tomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Scnile," etc.), "Dropsy," "Exbaustion," "Hcart failure," "Hemorrhage," "Inanition," "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 "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, menin- gitis, miscarriage, 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 sball fortb- with, after the death of a person whom he has attended during bis 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 scen alive by the physician or officer and the date of his death ..... Gen. Laws, Chap. 46, See. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove tberefrom a buman body which has not been buried, until be has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, or from one cemetery to another, until be has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit sball be issued until there shall have been delivered to such board, agent or clerk, as the case may be, 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 licu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be ob- tained early enough for the purpose, 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 ecrtificate. If the death certi- ficate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon tbe permit. The board of health or its agent, upon receipt of such statement and certificate, shall forthwith counter- sign it and transmit it to the elerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death sball tbcreafter 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 .- Chap. 114, Sec. 45, G. L., as amended.
Medical examiners shall make examination upon the view of tbe 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. SS, Sec. 7.
No undertaker or other person shall bury a human body or tbe ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have tbe care of the cemetery or burial ground in which the interment is made .-- Chap. 114, See. 46, G. L., as amended.
RM R-301
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
Winthrop
I PLACE OF DEATH
County
Suffolk
City or Town
Winthrop
ONo.
Winthrop Community Jak talst.
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Baby 1)
41 Gage
St.,
Ward.
Reve
(If non-resident give city or town and state)
months deys
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
15 DATE OF DEATH ang 20
(Month)
(Day)
7727 (Year)
19 16 I HEREBY CERTIFY, That I attended deceased from Cing 11 Z. to 19
that I last saw h&
alive on
aux 19
19
22
and that death occurred, on the date stated above, at.
The CAUSE OF DEATH was as follows:
Primative Buts
(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?
(Signed) What test confirmed diagnosis? I aux 7 Sandler
M. D.
(Address)
21
1927
Date
(Month
(Day)
(Year)
18 PLACE OF BURIAL, CREMATION DR REMOVAL
Woodlawn Everett
(Cemetery)
(City or town)
DATE OF BURIAL
Guy. 23
ADDRESS
14 Le pt 2/29
Filed _- (Month) ' (Day) (Year)
REGISTRAR
20 | HEREBY CERTIFY that e satisfactory stan- dard certificate of death was hled with me BEFORE the burial or transit permit was asued
W.D. Gulduso
Official position
Healthe Office
Date of issue of permit 8/23/27
Pormi NO. 1288
៛
6 AGE
Years
Months
Days
If LESS than
1 day, __ hrs.
or __ min.
M STILLBORN, enter that fact bere
7 OCCUPATION OF DECEASED
(*) Trade, profession, or
particular kind of work
(b) Name of employer
8 BIRTHPLACE (City)
(State or country)
Winther
Community Hospital
9 NAME OF
FATHER
Domenica Lungio
10 BIRTHPLACE OF FATHER (City) togia
(State or country)
11 MAIDEN NAME
OF MOTHER
Rona Fuels
12 BIRTHPLACE OFMY MOTHER (City) (State or country)
13 Domenico Drenaggio
Informant
(Address)
Revery
notified
State Mary
(City or town)
Registered No.
miso Terenzio
(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
ysarı
months
days.
How long in U. S., if of foreign birth?
years
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
PARENTS
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 classified. Exact statement of OCCUPATION is very important. See
·23-200,000
9.13.9.
19 UNDERTAKER
JIQuanfiglio
4.308 m.
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 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," "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, 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 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.
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 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 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 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 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-303
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
The Commonwealth of Massachusetts
Medical Examiner's Certificate of Death
15.885 Boston
City or town)
1 PLACE OF DEATH
(ISSUED UNDER THE PROVISIONS OF GENERAL LAWS, CHAPTER 38) Mass.
County
Suffolk
State
City or Town Winthrop: Winthrop No Community Hospital
Registered No.
1162
St., . Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number) Theresa Having to
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence. No. Winthrop 17 Culter
(Usual place of abode)
.St.y.
.Ward.
(If non-resident, give city or town and state)
Length of residence In city or town where death occurred
1 Bars
months
days
How long In U. S., If of foreign birth? 25
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Married
Francis F. Harrington
Days
If less than
1 day, ..... hrs.
or ..... min.
2 FULL NAME
Quna.
4 COLOR OR RACE
White
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 AGE
Years
Months
43
IF STILLBORN, enter that tact here
7 OCCUPATION OF DECEASED
(a) Trade, profession, or
particular kind ot work
At Home
8 BIRTHPLACE (City)
(State or country)
Ireland
10 BIRTHPLACE OF
FATHER (City)
12 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Death. See reverse side for extracts from the laws relative to the return of certificates of death.
(State or country)
Ireland
MEDICAL CERTIFICATE OF DEATH
15 DATE OF DEATH
au
T20
1927
(Month )
(Day)
(Year)
16 HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows :
natural Causes: presumably
cardiovascular disease.)
(Die Suddenly.)
(See reverse side for description for unknown person)
17 Where was injury sustained
if not at place of death ?
(Signed)
M. D.
(Address)
Medical Examiner tor.
Suffle
22
Date
(Month)
(Day)
(Year)
18 PLACE OF BURIAL, CREMATION, OF REMOVAL
DATE OF BURIAL
Holy Cross
Malden
.Aug .24.1927
(Month) (Day) (Year)
14
Jung 25/27
Filed
(Month) (Day) (Year)
REGISTRAR
19 UNDERTAKER ADDRESS Richard & Kirby East Boston.
Permit
20 Burtal permit issued by.
Official position
21 Date of issue AUG 29 1927 No.
MARGIN REOENYED FOR BINDING
3 SEX Female PARENTS 13 DEATH in plain terms, so that it may be properly classified under the International Classification of Causes of information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (b) Name of employer
Informant
Francis F. Harrington
(Address)
705 Bennington Street E.B
(Cemetery)
(City or town)
1937
9 NAME OF
FATHER
John McDonaldon
11 MAIDEN NAME
OF MOTHER
Unknown
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shali forthwith, after the death of a person whom he has at- tended during his last iliness, at the request of an under- taker 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 clas- sified under the international ciassification of causes of death), where same was contracted, the duration of his last iliness, 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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