Town of Winthrop : Record of Deaths 1925-1927, Part 25

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 25

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).

(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 Pianter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, etc. But in many cases, especially in industrial employ ments, 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.

ORM R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS I PLACE OF DEATH County

The Commonmealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Suffolk

State_Massachusetts

ZRegistered No. Clifton Park N. Y.

St., Ward

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

2 FULL NAME

Edward 1. Murphy

(If in the Army of 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

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

., to

that I last saw h

alive on

,19

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

The CAUSE OF DEATH was as follows:

M STILLBORN, autor that fact boru

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Driller

8 BIRTHPLACE (City)

(State or country)

Charlestown

maso

CONTRIBUTORY.

(SECONDARY)

(duration)

.yrs.

.mos.

17 Where was disease contracted

if not at place of death?

FOR WHAT

Did an operation precede death?

Date of.

Was there an autopsy ?.

What test confirmed diagnosis?

(Signed) M. D.

(Address)

Date

(Month)

(Day) (Year)

18, PLACE DE, BURIAL, CREMATION OR REMOVAL'

Holy Ciao. Malden

(Cemetery)

(City or town)

DATE OF BURIAL

5- 3-25

19 UNDERTAKER

Freak A. magrath.

ADDRESS

Sant Porta

20 | HEREBY CERTIFY that a satisfactory stan-

dard certificate of death was liled with ne

BEFORE the burial or tronsd permit was issued

Official position

of permit

MAY 3 1025 Parmit 6945

ZUM

-23-200,000

3 SEX

male

6 AGE

PARENTS

Informant

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

(b) Name of employer

4 COLOR OR RACE

White

SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Single

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

Years

Months

Days

If LESS than 1 day ._.__ hrs. or ____ min.

(duration)

-yrs ..

.mos.

.ds.

9 NAME OF

FATHER

Eugene

10 BIRTHPLACE OF

FATHER (City)

Leunentang

(State or country)

11 MAIDEN NAME

OF MOTHER

mary J. Garrity

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Berlin

maro

13 Mr. E. Murphy

( Address)

Plement H Whether/2

Flled

may 16/25

(Month) (Day) (Year)

REGISTRAR

BOSTON (City or town)

City or Town

Boston

No.

Pleasant of Munkavle

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

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 smployments, 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 mors 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. Nevsr report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," ctc.), "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.

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 ssen alive by the physician or officer and the dats 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 certificats 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 ot only such persons as are supposed to have died by violence .- Gen. Laws, Chap. 38, Sec. 6.

... Hs 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 bs, with the cause and manner of death .- Gen. Laws, Chap. $8, 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.

(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, ths sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

7-16-24-10.000 (21-431)

TRANSIT PERMIT

Form VS No. 62

NEW YORK STATE DEPARTMENT OF HEALTH ALBANY

A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead body transported by a common carrier .- Rule 1.

"Always write legibly, with durable black ink

UNDERTAKER'S CERTIFICATE

1 bereby Certify that the accompanying dead body of.

Edward

& Murphy

who died in the. Vischer Ferry of

Clifton Park

County of. Saratoga

State of New York, on

(City, Village or Towny april 18

1920, Sex Male

Color or race While

Age .. 34 .. years. 2

months. 1 days, and Cause of

Death. accidental Drowning

has been prepared for transportation

strictly in accordance with RULE. 4 as printed with this blank. Date of shipment May 2

(State number of Rule)

Point of

shipment Hoy, n. 4

(Signature of Undertaker)

Brower Van Cranken

Dated

man 2

1925.

Address.

Vischer Ferry Ny

PERMIT OF LOCAL REGISTRAR

Dist. No. 43-5-2

Registered No. 7

Date of issuance. May 2 nd. 192.5-

A satisfactory Certificate of Death for above decedent having been filed and recorded in) my office, PERMISSION IS HEREBY GRANTED FOR THE REMOVAL AND SHIPMENT OF THE BODY.

(Signature of Local Registrar) .. Mary E. Pecle

Local Registrar of the ..

Town

of Clifton Parle, County Tof Sarato-gal

(City, Village or Town)

State of New York.

" Only the Local Registrar (Deputy or Subregistrar) can issue a Burial, Removal or Transit Permit

" Detach here and give part above to escort or attach to waybill if shipped by express

1924-, Route of shipment. Point of destination For the Boston, Mais

april 13, 1925

ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE

was

Date of

(Interment or cremation)

(Signed)

Person in charge of

(Name of Cemetery, Crematorium, etc.)

Person in charge must return this Permit to Registrar of his District within SEVEN (7) DAYS from above date. If no person is in charge, the UNDERTAKER MUST SIGN ABOVE STATEMENT, write across the face of the Permit the words " No person in charge," and FILE PERMIT WITHIN THREE (3) DAYS with Registrar of District in which cemetery is located.

EXTRACTS FROM LAWS OF 1913, CHAPTER 619, ARTICLE 20

§ 379. Duties of undertaker. In each case the undertaker, or person having charge of the corpse, shall file the certificate of death with the registrar of the district in which the death occurred and obtain a burial or removal permit prior to any disposition of the body. * * * The undertaker shall deliver the burial permit to the person in charge of the place of burial, before interring or other- wise disposing of the body; or shall attach the removal permit to the box containing the corpse, when shipped by any transportation company; said permit to accompany said corpse to its destination, where, if within the State of New York, it shall be delivered to the person in charge of the place of burial.

"§ 380. Duties of undertakers; interment within the state. If the interment, or other disposition of the body is to be made within the state, the wording of the burial or removal permit may be limited to a statement by the registrar, and over his signature, that a satisfactory certificate of death, having been filed with him, as required by law, permission is granted to inter, remove or dispose other- wise of the body, stating the name, age, sex, cause of death, and other necessary details upon the form prescribed by the commissioner of health.

§ 381. Interments. No person in charge of any premises on which interments or cremations are made shall inter or permit the interment or other disposition of any body unless it is accompanied by a burial, cremation or transit permit, as herein provided. Such person shall endorse upon the permit, the date of interment, or cremation, over his signature, and shall return all permits so endorsed to the registrar of his district within seven days from the date of interment or cremation. He shall keep a record of all bodies interred or otherwise disposed of on the premises under his charge, in each case stating the name of each deceased person, place of death, date of burial or disposal, and name and address of the undertaker; which record shall at all times be open to official inspection, provided that the undertaker or person having charge of the corpse, when burying a body in a cemetery or burial ground having no person in charge, shall sign the burial or removal permit, giving the date of burial, and shall write across the face of the permit the words, " No person in charge," and file the burial or removal permit within three days with the registrar of the district in which the cemetery is located.

SEXTONS and UNDERTAKERS violating the law relative to the return of permits are liable to a penalty of NOT LESS THAN FIVE DOLLARS NOR MORE THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The law will be enforced. Local Registrars are required, under penalty, to report violations thereof.

ORM R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

(City or town)

State

Registered No.

City or Town

No.

Ti interior Com unity I tre. St.

Ward

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

2 FULL NAME

(a) Residence. No.

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

deys.

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

yeers

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Inale

4 COLOR OR RACE

White

SINGLE, MARRIED, WIDOWED, OR

DIVORCEO (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.

005

If STILLBORN, enter thet fact here

The CAUSE OF DEATH was as follows: amencephalus

(duration)

yı's.

mos. ds.

CONTRIBUTORY

mother has uterine Fibroids.

(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)

albert astrin

M. D.

(Address)

150 Shone Drive.

Date

april

(Month)

(Day)

14,

(92) .

(Year)

Informant

fearless Daly

(Address)

34 Veckans St

14 Filed ales, 27/25

(Month) (Day) (Year)

REGISTRAR

18 PLACE DF BURIAL, CREMATION DR REMOVAL

at Muchacha Beton

DATE OF BURIAL 4/17/25

(Cemetery)

(City or town)

19 UNDERTAKER

ADDRESS

/ include

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

A. C. Daniele

Official- position, Heath Officer

Date of Issue / 4/16/25

Permil NO.

8+95

MARGIN RESERVED FOR BINDING

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

PARENTS

11 MAIDEN NAME

OF MOTHER

telen I Dasy

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Cornasimo

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

april

14 1925

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

april 14

.19

that I last saw him

alive on

april 14

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

12 15 Am.

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

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Town of Winthrop : Record of Deaths 1925-1927, Part 25

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

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