Town of Winthrop : Record of Deaths 1928-1930, Part 113

Author: Winthrop (Mass.)
Publication date: 1928
Publisher:
Number of Pages: 1296

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1928-1930 > Part 113

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Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, es- pecially 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 ex- amples : (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 re- turn "Laborer," "Foreman," "Manager," "Dealer," etc., with- out 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 Housewife, House- work, 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 occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death .- Name, first, the Disease 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 meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never report "Typhoid pneumonia") ; Lobar pneumonia; Bronchopneumonia ("Pneu- monia," unqualified, is indefinite) ; Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of.

(name origin ; "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or 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 "Asthe- nia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions." "Debility" ("Congenital," "Senile," etc. ), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "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 peri- tonitis," etc.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Associa- tion.)

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, mis- carriage, 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 de- ceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the dura- tion 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 or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, 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 ex- hume 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 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 suffi- cient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a mem- ber of the board of health, or employed by it or by the select- men for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by vio- lence, the medical examiner shall make such certificate. If the death certificate 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 state- ment and certificate, shall forthwith countersign it and trans- mit 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 manner of death .- Gen. Laws, Chap. 38. Sec. 7.

No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the common- wealth 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 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

DIVISION OF VITAL STATISTICS

The Commoniscalth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON (City or town)

1 PLACE OF DEATH

County

Suffolk

Winthrop

State.

Massachusetts

Registered No. 70% 130

No.

210 Pauline Streetst,

Ward

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

2 FULL NAME Dr. Josepi P. Monahan

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

(a) Residence.

210 Pauline street

St., .............

.Ward,

Length of residence in city or town where death occurred irbyrs.

mos.

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

(If non-resident, give city or town and state) 15 Grs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE, MARRIED, WIDOWED,

or DIVORCED (write the word)

Married

5a If married, widowed, or divorced

HUSBAND of

(or) WIFECatherine A. Lynch

Days

IF LESS than 1 day , ....... hrs. or

.. min.

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

( Year )

16 I HEREBY CERTIFY, That I attended deceased from ..

6-31

aug

19.2.5 ... , 10

9/2

1929

that I last saw h

alive on

9 /2

13.2.9.

830 A.m.

angina Pectoris

(duration) liculi Jastatus

mos ..

.. ds.

CONTRIBUTORY

(Secondary)

(duration)

yrs.

mos. ds.

17 Where was disease contracted

if not at place of death

Did an operation precede death

For what.

Date of operation

Was there an autopsy If under one year, was infant Breast Fed? What test confirmed diagnosis.

(Signed)

HarEn

atelli

, M. D.

(Address)

2'00

Date 9/3/24

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Old Calvary, Boston

(Cemetery)

DATE OF BURIAL

sep. 5,1929.

(City or town)

19 UNDERTAKER

ADDRESS

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

Wm & Child ! a.H.

Official position

H.O.

Date of issue of permit Left 4/19

Permit No.

1628

200M 7-'28 No. 2787-c

13 Mrs. Catherine A. Monahan

Informant (Address) 210 Pauline Street

Filed: 21 4 211

(Month) (Day) (Year)

REGISTRAR

and that death occurred, on the date stated above, at. The CAUSE OF DEATH was as follows: (State fully)

( Month)

( Day)

City or Town. (Usual place of abode) 3 SEX 4 COLOR OR RACE Tale White 6 AGE Years Months 59 4 IF STILLBORN, enter that fact here 7 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work .. Dentist (b) Name of employer Self 10 BIRTHPLACE OF FATHER (City) (State or country) Ireland 11 MAIDEN NAME OF MOTHER Unknown 12 BIRTHPLACE OF PARENTS MOTHER (City) (State or country) Ireland CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. information sivulu ve carefully Supplied. Aus should be stated DAAVIDI. TILLVIVIAN DIVRI DLOVE 8 BIRTHPLACE (City) (State or country) Ireland

9 NAME OF

FATHER

Patrick Monahan

FROM THE LAWS OF THE

COMMONWEALTH OF MASSACHUSETTS

GOVERNING THE

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, es- pecially 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 ex- amples : (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 re- turn "Laborer," "Foreman," "Manager," "Dealer," etc.,' with- out 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 Housewife, House- work, 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 occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death .- Name, first, the Disease 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 meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never report "Typhoid pneumonia") ; Lobar pneumonia; Bronchopneumonia ("Pneu- monia," unqualified, is indefinite) ; Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of.

(name origin ; "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or intercurrent) affection need not be stated unless important. Example : Measles (disease causing death), 29 da .; Bronchopneumonia (secondary), 10 da. Never report mere symptoms or terminal conditions, such as "Asthe- nia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," ." "Exhaustion," "Heart failure." "Hemorrhage," etc. ), "Dropsy,rasmus," "Inanition." "Old age," "Shock," "Uremia." "Weakness." etc., when a definite disease can be ascertained ag the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUERPERAL septicemia," "PUERPERAL peri- tonitis," etc.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Associa- tion.)

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

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 de- ceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the dura- tion 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.

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.

City or Town of .... Springfield

during the month of .. .. September. 19 .. 29. .

CERTIFICATE OF DEATH STATE OF VERMONT

131

ce of death :

nty Windsor

: (or) Town. Springfield

Ward

et and No.

Name

Thomas Hunt

PERSONAL AND STATISTICAL PARTICULARS

male

Color or race

white

Single, Mxxxist

Date of birth

Month

June

Single

Age 50 years 2 mos.

cupation

(If none so state)

Soldier

thplace

(State or Country)

Ireland

me of husband or wife, if married none

me of Father William Hunt

thplace of Father

(State or Country)

Ireland

iden name of Mother Bridget Hogan

thplace of Mother

(State or Country)

Ireland

Te above particulars are true to the best of my knowledge and belief.

ormant

R. E. Houke, Major M C USA

Address .

Fort. Banks, Winthrop, Mass.

ce of burial.

Military Reservation

Fort Ethan Allen, Vt.

Lte of burial

.Sept: 5, 1929

Edertaker.

C ... E ... Angel1

Address .Springfield . -. V.t ..

be filled out by person issuing bur ermit.

MEDICAL CERTIFICATE AT DEATH

Date of death

Month

September

Day

Year 192.9.

I hereby certify that I attended the deceased from

Day

Year

1879

.. Sept ... 2 ....

. 192.9. . to .... Sept .. . 3

192 9

days

that I last saw him alive on. ..

Sept .. . 2.

1929

and that death occured on the date stated above at. 2. A.M. To the best of my knowledge and belief the cause of death was as follows: CAUSE OF DEATH (See instructions on back)

Chief.

Cerebral Hemorrhage

Contributing

Arterial Hypertension

Duration .

a. hour

Where contracted

Signed

R ...... Houke

Major MC US Am.

M. D.

Date

Sept.3. .. 1929

Address. .

Fort. Banks .. . Winthrop .. Mass.

Filed ... Sept.

192.9

Zada Kendall, Ass't. Town Clerk

Special Information for Hospitals, Institutions, Transients, or

Non-Residents.

Fort Banks,

Former, or Usual Residence ..

.Winthrop,. Masa

How long at place of death

1 .. day.

If in Hospital or Institution give its name

none

I hereby certify that the foregoing is a true copy.

fada m. Kendall Ass't. Town Clerk .. Sept. 4 192 9

7 information

Section 3777. Non-Residents; Certified Copies.

Certified copies when parties are non-residents. Said clerk shall, on the first day of each month, make a certified copy of all births, marriages and deaths filed in his office during the preceding month, wheneve the parents of a child born, or a bride or a groom or a deceased person was a resident in any other towy at the time of such birth, marriage or death, and shall transmit such certified copies to the clerk of the tow in which such parents of a child born, the bride or the groom or the deceased was a resident at the time of such birth, marriage or death; and the clerk receiving such copies shall file the same.

These blanks may be obtained of the Secretary of the State Board of Health,

€

WRITT PLAINLY, WITH UNFADING BLACK TRA- THIS IS X PERMANENT RECORD. Every Tiem of

MR-301

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

BOSTON

(City or town)

132

City or Town

Boston

luop

Weichung Community Hospital St.

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

2FULL NAME

Michael H Martin 30 Hodside av

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

St., Ward,

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

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

months

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

Stati

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Manier

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

many- Blake

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

Machinist

Fall River

8 BIRTHPLACE (City) (State or country)

John martin

man

10 BIRTHPLACE OF

I FATHER (City)

Fall River

(State or country)

Mass

1 1 MAIDEN NAME

OF MOTHER

Eliza

Blake

12 BIRTHPLACE OF

MOTHER (City).

(State or country)

leland

Many

Informant

(Address)

14 Filed-

(Month) (Day) (Year) REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

SuX 7 1926

(Monthy

(Day)

(Year)

16 I HEREBY CERTIFY , That I attended deceased from

195, to

1773

19 29

that I last saw h

ative on

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

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

17 Where was disease contracted

if not at place of death.

Did an operation precede death 44 47 For what

Date of operation

Soft, 1, 1429

Was there an autopsy It under one year, was infant Breast Fed ? What test confirmed diagnosis

(Signed) , M. D.

(Address)

Date Soft8,1424

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

DATE OF BURIAL

Mor Holy Cross (Cemetery)

Lefor 10mg

19 UNDERTAKER

ADDRESS 75 humbert Barton

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

WEChildren

Official

position

Date of issue Permit No. of permit Sept4/24 1631

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.

7-20M

200.000. 9-26. NO. 6373

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

State

Massachusetts

Registered No.

(duration).

.mos.

ds."

CONTRIBUTORY

yrs .. mos. ds.

9 NAME OF

FATHER

PARENTS

Martin

Ka) Residence. No. (Usual place of abode) Length of residence in city or town where death occurred years months

REVISED UNITED STATESSTANDARD CERTIFICATE OF DEATH

(Approved by U. S. Census and American Public Health Association)

Statement of occupation .- Precise statement of occupation is very important, Ro 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 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 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.

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Town of Winthrop : Record of Deaths 1928-1930, Part 113

Author: Winthrop (Mass.) Publication date: 1928 Publisher: Number of Pages: 1296

Author: Winthrop (Mass.)
Publication date: 1928
Publisher:
Number of Pages: 1296