Town of Winthrop : Record of Deaths 1925-1927, Part 252

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 252

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Medical examiners ehall 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 eases certify to the town clerk or registrar in the place where the deceased died his name and residenee, if known; otherwise a description as full as may be, with the eause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.

No undertaker or other person shall bury a human body or the Hashes thereof which have been brought into the commonwealth until rhe 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 Melerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery oor burial ground in which the interment is made .- Chap. 114, Sec. 46, &G. L., as amended.

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits ean 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, ete. 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, ete. Women at home, who are engaged in the duties of the household onty (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 domestie service for wages, ae Scrvant, Cook, Housemaid, ete. 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.

RM R-301

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

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Mass

(City or town)

Registered No.

St. Ward

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

(If U. S. War Veteran, specify WAR)

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

3 SEX

Female

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Single

5 a If married. widowed or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Months

Days

IF LESS than

1 day, ........ hrs.

or ........ min.

IF STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

Factory felker

8 BIRTHPLACE (City)

(State or country)

Mark

9 NAME OF

FATHER

Signal Sivencen

1 O BIRTHPLACE OF FATHER (City) (State or country)

Densine Gutterson

1 2 BIRTHPLACE OF

MOTHER (City)

(State or country)

Informant(

Segnala wengen

(Address)

36 Deal St.

14 Filed pris, 3/22 (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

Hm. L. ChildrenOFis

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

27.1927

(Year)

Jimmy

I HEREBY CERTIFY , That I attended deceased from

19 27 to DEC. 27, 19.

that I last saw h

Zalive on

Die. 26. 1

, 19 2)

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

The CAUSE OF DEATH was as follows: (State fully)

5.000.

acute Pulmonary Edema

.ds.

CONTRIBUTORY

(Secondary)

Shows Hugocarditis

(duration

mos

1 7 Where was disease contracted

if not at place of death

Did an operation precede death.

For what

Date of operation

Was there an autopsy

What test confirmed diagnosis H Schwart . M. D.

(Signed)

(Address)

43 Princelos 52

Date Que. 28.1927

18 PLACE OF BURIAL, CREMATION, OR REMOVAL /

Winthrop

Minturno

(Cemetery)

(City or town)

DATE OF BURIAL Dee 29-1927

19 UNDERTAKER

ADDRESS

Frank 8. Brown Sast Boston

Ofthe office of permit.

Date of issue 12/28/2 Pont 1241

Winthrop

County.

Suffolk

City or Town

Withrop

2FULL NAME

Jennie S. Swensen

(a) Residence. No.s

(Usual place of abode)

36 Geal

St.

Ward,

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

200.000. 9-26. NO. 6373

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

PARENTS

1 1 MAIDEN NAME OF MOTHER

South Boston

_yrs.

ds.

State. No. 36 Beal St

Klec, 27. 1921

REVISED UNITEDSTATESSTANDARDCERTIFICATE 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 forni 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 ony (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 he taken to report specifically the occupations of persons engaged in domestie 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.

Statement of cause of death .- Name, first, the Disease Causing Death (the primary affection with respect to time and eausation), using always the same accepted term for the same disease. Exam- ples: Cerebrospinol fever (the only definite synonym is "Epidemic ' cerebrospinal meningitis"); Diphtheria (avoid usc of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, meninges, peritoneum, etc., Careinoma, Sarcoma, etc., of. (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasmis); Meosles; Whooping cough; Chronic volvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or intereurrent) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronehopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symp- tomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite discare can be ascertained as the eause. 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 by Con- mittee on Nomenclature of the American Medical Association.)

Bronchopneumonia: If primary cause, write the word "primary"; if secondary, givo 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, miscarriago, 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 hury or otherwise dispose of a human hody in a town, or remove thercfrom a human body which has not heen buricd, until he 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 he 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 shall 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 lieu 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 hoard of health, or employed by it or by the selectmen for the purpose, shall unon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make sueli certificate. 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 the 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 clerk of the town for registration. 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 require .- Chap. 114, Sec. 45, G. L., as amended.

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 mauner of death .- Gen. Laws, Chap. 38, See. 7.

No undertaker or other person shall bury a human hody or the ashes thereof which have been hrought 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 huried or the funcral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .- Chap. 114, Sec. 46, G. L., as amended.

RM R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

1 PLACE OF DEATH

County

Suffolk

State Mass

(City or town)

Registered

347

City or Town

Winthrop

No.

29 River Rd

St.,

Ward

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

2 FULL NAME

Sarah Mc Cleary

(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

manths

days.

How lang 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

1921, to

Ole 28, 1927.

that I last saw h

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

4Am.

The CAUSE OF DEATH was as follows:

luciana of intestinos

(duration)

.yrs.

mos. ds.

CONTRIBUTORY

Chris Suplentes

(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 ?.

(Signad)

. M. D.

(Address)

Date

(Month)

(Dấy)

(Year)

18 PLACE OF BURIAL, CREMATION DR REMOVAL

Winthrop)

Winther

DATE OF BURIAL

Fee 40/27

(Cemetery)

(City or town)

ADDRESS

Sav, 3/27

Filed.

(Month) (Day) (Year)

REGISTRAR

19 UNDERTAKER

Walter

20 | HEREBY CERTIFY thaf a satisfactory stan- dard certificata af death was filed with me BEFORE the burial or transit permit was issued Nm. A. Children

Officlal Health Officer

Date af ISSUO of permit 12/30/21

Pormit NO. 1344

200,000 9-25 NO. 2662 - 3. 3 SEX Female PARENTS 13 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 af employer

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

9 NAME OF

FATHER

John Wie Cleary

10 BIRTHPLACE OF

FATHER (City)

(Stafe or country)

England

11 MAIDEN NAME

OF MOTHER

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Informant

Piece its Etter 4 Dixon

(Address)

29 River Rd Winthrop

Days

If LESS than

1 day .__ hrs.

_min.

If STILLBORN, anter that fact here

7 OCCUPATION OF DECEASED

(a) Trada, profession, or

particular kind of work

16 auswork

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Single

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Months

ilfaut 72 Years date nothemon

4 COLOR OR RACE

White

29 River Road

-St.,

Ward.

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

alive on

Que 27, 1927.

8 BIRTHPLACE (City)

(State or country)

England

Dec 28. 1927 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

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.

IM R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS 1 PLACE OF DEATH County. Suffolk

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop

(City or town)

Registered No.

City or Town

Winthrop.

79 Atlantic

St., Ward

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

2FULL NAME

Bridget Kelly

(If U. S. War Veteran, specify WAR)

(a) Residence. No

79 Atlantic.

St.

Ward

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

Length of residence in city or town where death occurred 40 years

months

days.

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

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Widowed

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

Patrick

Months

Days

IF LESS than

1 day ......... hrs.

or ........ min.

IF STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

At Home

8 BIRTHPLACE (City)

Wexford

(State or country)

Ireland

NAME OF

FATHER

Cannot be learned

1 O BIRTHPLACE OF

FATHER (City)

(State or country)

Ireland

1 1 MAIDEN NAME

OF MOTHER

Cannot be learned

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

Informant

Arthur J. OMaloy.

(Address)

70 Atlantic

Can 3/28

(Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

(Year)

Am I

I HEREBY CERTIFY , That I attended deceased from

2 ) to com

that I last saw h_alive on

Den 24

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

The CAUSE OF DEATH was as follows: (State fully)

(duration).

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Town of Winthrop : Record of Deaths 1925-1927, Part 252

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

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