Town of Winthrop : Record of Deaths 1928-1930, Part 123

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 123

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"Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma,37 "Convulsions," "Debility" ("Congenital," "Senile," etc. ), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," """Old age,"" "Shock," "Uremia," "Inanition, , + when a definite disease can be ascertained as "Weakness,"

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 mole 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.

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Boston

1 PLACE OF DEATH

County

Suffolk

State

Registered No.

(Place of residence)

City or town

Boston

No.

ST ELIZABETHS HOSPITAL

St ..

-Ward

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

2 FULL NAME

MASS.

City or Town

No.

90 CHESTER AVE.

(a) Residence.

State

(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

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed, or divorced

f &HUSBAND

Name of ? (or) WIFE

LIZZIE Ball. / o Quasi

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

AUTO SALESMAN

(b) Name of employer

8 BIRTHPLACE (city or town)

GORHAM

(State or country)

MAINE

9 NAME OF

FATHER

RANDALL JOHNSON

10 BIRTHPLACE OF

FATHER (city or town)

GORHAM

(State or country)

MAINE

11 MAIDEN NAME

OF MOTHER

FRANCES E. ROBERTS

12 BIRTHPLACE OF

MOTHER (city or town)

WESTBROOK

(State or country)

MAINE

Informant

KATHERINE ELDER

(Address)

NAVAL HOSPITAL, CHELSEA

Filed

NOV 7, 19

Filed

Vov.8. 1929

Registrar of city or town where death occurred

Registrar of city or town where deceased resided

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH.

NOV 4, 1929

(Month)

(Day)

(Year)

I HEREBY CERTIFY,

That I attended deceased from

NOV 4

29. NOV 4

to.

that I las! saw h

alive on

NOV 4

29.

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

BACTERIAL ENDOCARDITIS ACUTE CARDIAC DILATATION

(duration)

yrs.

mos ..

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

mos.

da.

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

What test confirmed diagnosis.

(Signed)

T. J. QUIGLEY

M. D.

(Address)

Date NOV 4. 1929

18 PLACE OF BURIAL, CREMATION, QR REMOVAL GORHAM. MAINE

(Cemetery)

(City or town)

19 UNDERTAKER

C. R. BENNISON

DATE OF BURIAL

11-8

. 19

ADDRESS

(City or town) 9851

Registered No.

(Place of death)

GEORGE J. ELDER

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

PARENTS

nov. 4.1929.

I R-301

DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop

(City or town).

1 PLACE OF DEATH

County

Suffolk

State Massa

Massachusetts Registered No.

City or Town

Winthrop

No.

24 Lincoln

St.,

Ward

2 FULL NAME

William Edmund

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

(a) Residence.

No ...

24 Lincoln

St., ...

............. Ward,

(Usual place of abode)

Length of residence in city or town where death occurred2 5 yrs.

mos.

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

yrs.

mos.

dayı.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Male

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED,

or DIVORCED (write the word)

Widowed.

5a If married, widowed, or divorced

HUSBAND of

Elizabeth J. Munroe.

6 AGE

Years

Months

Days

IF STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Retired.

(b) Name of employer

8 BIRTHPLACE (City)

Newcastle

(State or country)

Maine.

9 NAME OF

FATHER

Charles Clarke.

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Unable to obtain.

11 MAIDEN NAME OF MOTHER Sarah Jane Brown.

12 BIRTHPLACE OF

MOTHER (City)

Unable to obtain.

(State or country)

13 Mrs. Joseph Davison-

Informant

(Address) 24 Lincoln St.

(daughter

14 Filed 00-12,29 (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

how.

(Month)

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from

Sept

192$

19 19 29

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: (State fully)

(duration) 2 yrs.

da.

CONTRIBUTORY

chroni interstitial replanta

(Secondary)

(duration)

.yrs.

mos ..

......

.ds.

17 Where was disease contracted

if not at place of death

Did an operation precede death

no For what.

Date of operation

Was there an autopsy

What test confirmed diagnosis.

(Signed)

1 Pwhay ton

M. D.

(Address)

186 withup Sh. Wasthumb man

Date

nav 8-1929

PLACE OF BURIAL, CREMATION, OR REMOVAL

Winthrop Winthrop.

(Cemetery)

(City or tow)

DATE OF BURIAL Nov. 9.1929.

19 UNDERTAKER

Charles R. Bennison.

ADDRESS Winthrop.

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

Date of issue Permit of permit .. 11/9/21 NO. 1650

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.

200M 7-'28 No. 2787-c

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

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

1929

IF LESS than

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

or .......... min.

myvenditis - chumi

PARENTS

Revised United States Standard Certificate of Death (Approved by U. S. Census and American Public Health Ass'n.)

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," "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 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 nole 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.

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.

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Boston

1 PLACE OF DEATH

County

Suffolk

State

Registered No.

(Place of residence '

St., Ward

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

2 FULL NAME

EDMUND F. CHRISTOPHER

MASS.

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

No.

179 WINTHROP

St.

(a) Residence.

State

(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

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

53 If married, widowed, or divorced

Name of & HUSBAND

? (or) WIFE

EDITH M. Verde

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

CUTTER

(b) Name of employer

8 BIRTHPLACE (city or town)

(State or country)

WALES

PARENTS

10 BIRTHPLACE OF

FATHER (city or town)

(State or country)

IRELAND

11 MAIDEN NAME

OF MOTHER

HELEN LANNIGAN

12 BIRTHPLACE OF

MOTHER (city or town).

(State or country)

ENGLAND

Informant

F. CHRISTOPHER

(Address)

WINTHROP MASS

Filed

NOV 14 , 19

zum Stenen

Registrar of city or town where death occurred

Filed

nov.19

1919

Registrar of city or town where deceased resided

312

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

NOV 12, 1929

(Month)

(Day)

(Year)

I HEREBY CERTIFY,

That I attended deceased from

OCT 14

,29

NOV 12

., 19

that I last saw h IM

_alive on

NOV 12

19 29

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

9 A

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

CARCINOMA OF RECTUM

(duration)

yrs.

da.

CONTRIBUTORY

(SECONDARY)

POST OPERATIVE SHOCK

(duration).

yrs ..

mos.

da.

17 Where was disease contracted

if not at place of death.

Did an operation precede death.

YES

For whats

Date of operation

NOV 8. 1929

Was there an autopsy

What test confirmed diagnosis.

(Signed)

N. C. BAKER

M. D.

(Address)

Date

NOV 12 1929

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

ST JOSEPH BOSTON

(Cemetery)

(City or town)

DATE OF BURIAL

11-15

, 19

ADDRESS

19 UNDERTAKER J. F. O'MALLEY

Registered No.

( Place of death)

Boston

No.

MASS. GEN HOSPITAL

City or town

City or Town

WINTHROP

9 NAME OF

FATHER

JOHN

nov. 12.1929

R-301

The Commonwealth of Massachuset's DIVISION OF VITAL STATISTICS atill STANDARD CERTIFICATE OF DEATH

Winthrop (City or town)

1 PLACE OF DEATH

County

* falk

City or Town

2 FULL NAME

annie U

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

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

(a) Residence.

71 Jun

St.,

(Usual place of abode)

Length of residence in city or town where death occurred yrs. mos. days. How long in U. S., if of foreign birth ? yrs. mos. days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Femalle

4 COLOR OR RACE White

5 SINGLE, MARRIED. WIDOWED, or DIVORCED (write the word) Widow

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Horace F

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

8 BIRTHPLACE (City)

(State or country)

Baltimore

Maryland

9 NAME OF

FATHER

William Mclaughlin

PARENTS

10 BIRTHPLACE OF

FATHER (City)

Ireland

(State or country)

11 MAIDEN NAME

OF MOTHER

Ann Winowy Butler

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

Ireland Feedand

Informant (Address)

Mrs .Brady

Quincy Masa

1 Bessie L. Dodge

Filed (Month) (Day) (Year)

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

ives

(Month)

(Day)

1224

(Year)

I HEREBY CERTIFY, That I attended deceased from

Peut 15, 1929, to

no0 11

19-2.9.

that I last saw h .......... alive on

915 Fm.

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

(duration)

3 yrs mos.

... ds.

Clavier Vala Heart

CONTRIBUTORY

(Secondary)

Recions (duration)

.. mos ....

..... ds.

17 Where was disease contracted if not at place of death

Did an operation precede death.

.MO. For what

Date of operation

Was there an autopsy 200

What test confirmed diagnosis.

(Signed)

-, M. D.

(Address)

Date

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

DATE OF BURIAL

Scarboro

Maine

(Cemetery)

(City or town)

11/20/29.

19 UNDERTAKER

REGISTRAR Wheel & Parcella 10 N. Bennett

ADDRESS St

Boston

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

Date of issue of permit

Permit 11/18/29 No. 16.51

200M 7-'28 No. 2787-c

CAUSE OF DEATH If plant tellis, DO tilat it they De property vabene is very important. See instructions and extracts from the laws on back of certificate.

Revol

State, 34 Chceau Cu St.

Registered No.

164

Ward

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

Housewife

Revised United States Standard Certificate of Death (Approved by U. S. Census and American Public Health Ass'n.)

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.

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Town of Winthrop : Record of Deaths 1928-1930, Part 123

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

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