Town of Winthrop : Record of Deaths 1928-1930, Part 138

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 138

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).

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 commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made .. . Chap. 114. Sec. 46, G. L., as amended.

State cause for which surgical operation was undertaken.

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.

OCCUPATIONI Is very important. See instructions and extracts from the laws on back of certificate. PARENTS

200M-11-'29. No. 7180-a

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed, with me BEFORE the boral or transit permit was issued:

(Signature of Agent of Board of Health or other)

1/27/36

(Official Designation)

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF DEATH Jan

(Month)

24 (Day)

1930 (fear)

19 I HEREBY CERTIFX , That I attended deceased from 19

gün 22

30. to

Jan 24 , 30

I last saw h& .....

.. alive on

19 death is said to have occurred on the date stated above, at m.

The principal cause of death and related causes of importance in order of onset were as follows:

Dateofonset

Chromo hugocanditi

Contributory causes of importance not related to principal cause:

abscon of week

Jeho 3,20

Name of operation

chicesia fabien

Date of

1-13-0

What test confirmed diagnosis?

Was there an autopsy?

20 Was disease or injury in any way related to occupation of deceased? If so, specify.

(Signed)

Synde gatos mm

M. D.

(Address).

Date. 1- 2%

19.30

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Holy Cross malden

(City or town)

DATE OF BURIAL Jan! 2/ 1930

22 NAME OF

UNDERTAKER

ADDRESS

Received and filed

FED- 0 1930

A TRUE COPY, ATTEST: (Registrar)

PLACE OF DEATH

Counts Withsah

(City or Town) No 4/8 Sargent St.,

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

(City or town making return)

Registered No.

Ward

(If death occurred in a hospital or institution,

give its NAME instead of street and number)

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

(If nonresident, give city or town and state)

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Female White

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

5a If married, widowed, or divorced HUSBAND of

(or) WIFE of

(Husband's nghe in full)

6 IF STILLBORN, enter that fact here.

7 74 Years Months

Days

If less than 1 day Hours Minutes

8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.

At Home

9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ....

10 Date deceased last worked at

this occupation (month and

year)

11 Total time (years) spent in this occupation

12 BIRTHPLACE (City).

(State or country)

Boston

13 NAME OF

FATHER

Jumothy Callahan

14 BIRTHPLACE OF

FATHER (City)

Ireland

(State or country)

15 MAIDEN NAME

OF MOTHER

Not Known

16 BIRTHPLACE OF MOTHER (City) . (State or country) Ireland

17 Informant (Address)

Walsh 68 sargent of.

Julia In. Welch

2 FULL NAME

(a) Residende,

(If deceased is a married, widowed or divorced woman, give also maiden name.)

No 48 Tangent

.St., ..

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

(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.

4 COLOR OR RACE

AGE

301

am. 2.4. 1930

Revised United States Standard Certificate of Death

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.

To be complete, an occupation return must state:

8 .- The trade, profession, or particular kind of work done.

9 .- The industry or business in which the work was done.

10 .- The month and year the deceased last worked at the occupation.

11 .- The number of years the deceased followed the occupation.

In stating the occupation, avoid the use of such indefinite terms as "employee, " "worker,' "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.

In stating the industry or business, avoid the use of such general terms as "store, "'factory, "mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.

Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.

Statement of cause of death .- Cause of death means the disease, injury, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease or injury causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contri- butory causes of importance not related to principal cause, name other important diseases or injuries.

Example

The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis

Date of onset

1015

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause: Fracture of arm

Automobile accident

May 3, 1927

In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.

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 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 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 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 exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, 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 satis- factory 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 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 purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such 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 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 " only such persons as are supposed to have died by violence .... Geny Laws, Chap. 38, Sec. 6.

.... He shall in allcases 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.

State cause for which surgical operation was undertaken.

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, Orysipelas, meningitis, mis- carriage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

301

PLACE OF DEATH

Suffolk County)

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

(City or town making return)

Registered No.

15.

(If death occurred in a hospital or institution,

give its NAME instead of street and number)

(If U. S.

War Veteran,

specify WAR)

(a)

Residence.

No ...

(Usual place of abode)

Length of residence in city or town where death occurred

14 Yrs.

mos.

days.

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

yTs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Female

4 COLOR QR RACE

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

Klamed

5a If married, widowed, or divorced

HUSBAND of

Charlie

(Give maiden name of wife in full)

(or) WIFE of

Perry

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

Years

Months

Days

If less than 1 day Hours ........ Minutes

8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.

9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.

10 Date deceased last worked at

this occupation (month and

year)

11 Total time (years)

spent in this

occupation ..

Charlesterin

12 BIRTHPLACE (City)

(State or country)

Mass

13 NAME OF

FATHER

William H. Pray

14 BIRTHPLACE OF FATHER (City) . . (State or country)

15 MAIDEN NAME

OF MOTHER

Mrazices a Greenlawn

16 BIRTHPLACE OF

MOTHER (City)

Broufield

(State or country) Maine

17 his Sister S da B. Winans

Informant

(Address)

Trialden

Mass

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:

millia

10, Children

(Signature of Agent of Board of Health or other)

agent Jan: 31/30

(Official Designation)

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

(Month)

(Day

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

19 2.4., to

., 19 3.0

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

gameq.

19 .0., death is said

3Pm.

to have occurred on the date stated above, at The principal cause of death and related causes of importance in order of Dateofonset onset were as follows: Elena y Kungs.

Contributory causes of importance not related to principal cause:

chimie suplentes

Name of operation What test confirmed diagnosis?

Date of

Was there an autopsy?

20 Was disease or injury in any way related to occupation of deceased? If so, specify

(Signed)

., M. D.

(Address)

Datei

. 19.

21 PLACE OF BURIAL,

CREMATION OR REMOVAL *

wenn beimbridge

(Cemetery)

(City or town) (

DATE OF BURIAL Namary.

3/ 27

193.5

22 NAME OF

UNDERTAKER .

Trite-

ADDRESS

Minttrio,2

Received and filed

FES . 3.000

A TRUE COPY, ATTEST: (Registrar)

OCCUPATION: is very important. See instructions and extracts from the laws on back of certificate. PARENTS

200M-11-'29. No. 7180-a

(City or Town)/ 96 Johnson ane No Minnie Florence (Bray) Perry

St.,

Ward

2 FULL NAME

(If deceased is a married, widowed or divorced woman, give also maiden name.) 96 Johnson ave

St.,

Ward,

(If nonresident, give city or town and state)

Jan. 29. 19300 Revised United States Standard Certificate of Death

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed. on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.

To be complete, an occupation return must state:

8 .- The trade, profession, or particular kind of work done.

9 .- The industry or business in which the work was done.

10 .- The month and year the deceased last worked at the occupation. 11 .- The number of years the deceased followed the occupation.

In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.

In stating the industry or business, avoid the use of such general terms as store, "

"factory. " mill." etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.

Example

The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis

Date of onset

1915

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause : Fracture of arm

Automobile accident

May 3, 1927

In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in & group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.

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 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 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 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 exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, 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 satis- factory 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 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 purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such 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 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.

State cause for which surgical operation was undertaken.

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, pyemnia, septicemia, tetanus.

R-301

DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON

1 PLACE OF DEATH

County

Winthrop

Suffolk

State.

Massachusetts

Registered No.

City or Town

oston

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

John Alexander

(a) Residence.

No.

255 Seasonk

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

.. Ward,

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

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

Male

4 COLOR OR RACE

White

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

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

Hannali Frances (Stubbs)

6 AGE

Years

Months

Lays

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 employe teamEna ser

Retired

8 BIRTHPLACE (City)

(State or country)

Ofopsam

Maine

9 NAME OF

FATHER

William J. Treflander

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Maine

11 MAIDEN NAME

OF MOTHER

nancy Messiman

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Harpourel Maine

13 Alice T. alexander

Informant

( Address)

250 Pleasant ir

FED - 3 1930

Filed'

(Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

Dany

19 1930

( Month

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from.

that I lact saw h ..

zu alive gr

Hlavy 29, 1930

1000

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

Theart Dereais

Mo (ration )

yrs ............. mos.

-ds.

CONTRIBUTORY

astuce selon

(Secondary)

.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

200

Is under one year, was infant Breast

What test confirmed diagnosis

(Signed)

(Address)

123 Umerkelig

Date

Jay 30/2 lub ne

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Bath Maine

DATE OF BURIAL 40-2/30

(Cemetery)

(City or town)

19 UNDERTAKER

C. T. Rollins

ADDRESS Biston

Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.

Town of Winthrop : Record of Deaths 1928-1930, Part 138

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

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