Town of Winthrop : Record of Deaths 1928-1930, Part 183

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 183

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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.

R-302

Suffolk

(County)

Boston

(City or Town) Boston City Hospital

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

Boston

(City or town making return)

Registered No.

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

2 FULL NAME

Kathleen I Kelly

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

(a) Residence. No (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

Female

4 COLOR OR RACE

White

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

Single

5a If married, widowed, or divorced HUSBAND of

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 56

AGE

Years. Months Days

If less than 1 day Hours

Minutes

OCCUPATION|

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

Dress Maker

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

At Home

10 Date deceased last worked at this occupation (month and year)

11 Total time (years)

Nov ..... 1929

spent in this occupation .. 65 yrs

12 BIRTHPLACE (City) (State or country)

New Brunswick

13 NAME OF

FATHER

Edward Kelly

14 BIRTHPLACE OF FATHER (City)

(State or country)

New Brunswick

15 MAIDEN NAME

OF MOTHER

Mary Burke

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

New Brunswick

17 Informant (Address)

C B Kelly

Winthrop, Mass.

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

BHD

August

1930

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

August 5,

1930

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

July

I last saw h Ør .... alive on August .5 ..... , 19 ... 30, death is said to have occurred on the date stated above, at6 : 35P .m.

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

Dateofonset

Carcinoma (site unknom)

unk

Secondary anemia 1

Contributory causes of importance not related to principal cause:

Cardiac Failure 2 dys

Name of operation

Date of

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)

A M Roscoe

M. D.

(Address)

Boston City Hosp.

Date

8/6/ 19 3Q

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Holy Cross

Malden

(Cemetery)

(City or town)

DATE OF BURIAL

August

22 NAME OF

UNDERTAKER

F A Magrath

E Boston, Mass,

ADDRESS

Received and filed

August

.19.30

(Official Designation)

A TRUE COPY, ATTEST:

(Registrar)

important.

50M-11-'29. No. 7180-b

tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very

PLACE OF DEATH

No.

St.,

Ward

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

16 Pearl Ave

.St., ..

Ward,

Winthrop

(If nonresident, give city or town and state)

19.3Q, to

August ...... 5.19 .30

(Give maiden name of wife in full)

(write the word)

PARENTS

(Signature of Agent of Board of Health or other)

aug. 5. 1930.

R-301

PLACE OF DEATH

Suffolk (County) : Revel Klasse Winthe

notifie;

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

(City dr town making return)

Registered No.

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

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

Kever

(If nonresident, give city or town and state)

mos. days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

3 SEX Male White

| 5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word) Single

5a If married, widowed, or divorced HUSBAND of

(Give maiden name of wife in full)

(Husband's name in fully

Stillborn

7 AGE Years Months .Days

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

Winthrop mass.

14 BIRTHPLACE OF FATHER (City) .

(State or country)

angelina Ruffo

(State or country) Italy

17 Patsy Langelatta 25Mer Chant St Venue

Enf KEBY CERTIFY inat a satisfactory standard certificate of death was Let will me bituRE

e bymal or vansit permet was issued: .

frial Designation mars.

7.12 938

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

(Month)

10 (Day) 1

(Year)

I HEREBY CERTIFY, That I attended deceased from

.. , to

I last saw h ............ alive on. 19 death is said

to have occurred on the date stated above, at.

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

Contributory causes of importance not related to principal cause:

Name of operation Date of

What test confirmed diagnosis?

Was there an autopsy?

20 Was disease or injury in any way related to occupation of deceased?

If so, specify .... Tazas 17 . (Signed) , M. D. (Address 12 'shotel ./. Date/ » 19.30.

21 PLACE OF BURIAL. CREMATION OR REMOVAL Woodlawn Everett (Cemetery)

DATE OF BURIAL

(City or town) 19

22 NAME OF UNDERTAKER L. Buonfiglio

ADDRESS

A TRUE COPY, ATT.ST: (Registrar)

Y No. 2 201930 2 FULL NAME (or) WIFE of OCCUPATION 13 NAME OF FATHER 15 MAIDEN NAME OF MOTHER PARENTS 16 BIRTHPLACE OF MOTHER (City) Informant (Address) No. 7180-a is very important. See instructions and extracts from the laws on back of certibrate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exactstatement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY PHYSICIANS should state 12 BIRTHPLACE (City) (State or country)

(a Residence.

Usual place of abode)

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

mos.

Ward

(City of Town) Winthrop Hospita Baby Lantillatta

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

No. 025 Mc Cluce

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

. Ward,

days.

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

yrs.

. . 7%.

6 IF STILLBORN, enter that fact here.

If less than 1 day

Patsy Lancillotto

Italy

Qua 10.1930 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 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.

State cause for which surgical operation was undertaken.

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

R-302

Suffolk

(County)

Boston

(City or Town) Strong Hospital No.

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

Boston

(City or town making return)

Registered No.

.3.8.90

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

2 FULL NAME

Ruth E, Maclauchlan

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

96 Marshall

St.,.

..........

Ward,

Winthrop

(If nonresident, 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

Female

4 COLOR OR RACE

White

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

Single

5a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE 13 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 school

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

Mass.

13 NAME OF

FATHER

Charles R. Maclauchlan

14 BIRTHPLACE OF

FATHER (City)

Boston

(State or country) Mass.

15 MAIDEN NAME

OF MOTHER

Margaret S. Bennett

16 BIRTHPLACE OF MOTHER (City)

Dover

(State or country)

N H

17 Informant (Address)

Charles Maclauchlan

Winthrop, Mass.

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

Henry F .... Riley

(Signature of Agent of Board of Health or other)

BHD

August

10,

1930

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

August 10,

1930

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

August

August 10 ,1,30

I last saw h

alive on

August 10

19 30

death is said

to have occurred on the date stated above, at. 3 A m.

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

Dateofonset

Acute rheumatic fever

Sept@caemia

Contributory causes of importance not related to principal cause:

Rheumatic carditis

days?

Name of operation

What test confirmed diagnosis?

Was there an autopsy?

Date of

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

(Signed)

Richard Metcalf

(Address)Boston, Mass.

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Holy Cross

Malden

(Cemetery)

(City or town)

DATE OF BURIAL

August

12, 1930

22 NAME OF

UNDERTAKER

Fred. H. Tape

ADDRESS

Winthrop, Mass.

Received and filed James 1. Mulig

12 19 .30

A TRUE COPY, ATTEST:

(Registrar)

important.

50M-11-'29. No. 7180-b

OCCUPATION tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very PARENTS

PLACE OF DEATH

St.,

Ward

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

(a)

Residence. No.

(Usual place of abode)

(write the word)

(Official Designation)

., M. D. 30

Date 8/10% ·19

7/5/30

aug. 10. 1930

R-301 A

PLACE OF DEATH

Suffolk (County) Hintrop (City or fown)

30 atlantic No ..

St.,

Ward

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

Florence

Keighley

(If deceased is a married, widowel or divorend woman, give also maiden name.)

specify WAR)

30 atlantic C

St.,

Ward,

(If nonresident, give city or town and state)

days.

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

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

Widowed

5a If married, widowed, or divorced

HUSBAND of

Sahne Jeighley

(Husband's paghe in full)

(Give maiden name of whe in full)

If less than 1 day Hours Minutes

Laiswoman

Hat + Town Shops

11 Total time (years)

spent in this

occupation ..

12 BIRTHPLACE (City).

>radford- Yorkshire

(State or country)

England

13 NAME OF

FATHER

Thomas Carrou

14 BIRTHPLACE OF

Bradford, Yorkshire

(State or country) England

Elizabeth Colimaçon

16 BIRTHPLACE OF

MOTHER (City) ;

Bradford-Yorkshire

(State or country)

England.

Emma

Whittaker

Informant (Address) 30 ittantic St. Wentivoy

I HEREBY CERTIFY that a satisfactory standard certificate of death was

filed with me BEFORE the burial or transit permit was issued:

William W. Childress

(Signature of Agent of Board of Health or other)

Health Officer

Cmq 16/30

(Official Designation) I (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

aug

1930

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

inBad

I last saw h ...

alive on

19 .. death is said

to have occurred on the date stated above, a

chauf m. 645am

The principal cause of death and related causes of importance in order of

onset were as follows:

Dateofonset

Cerequia Pastores

Contributory causes of importance not related to principal cause:

Name of operation

Date 'of

What test confirmed diagnosis?

Was there an autopsy?

20 Was disease or injury in any way related to occupation of deceased?

If so, specify ...

(Signe Treille Efetuar

.. , M. D.

(Address) 23 /billys

DateCH) 5 1950

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Ouanthrop Menthvor

(Cemetery)

(City or town)

DATE OF BURIAL

ing. M. 1930

22 NAME OF

UNDERTAKER

a. Collins

ADDRESS

E. Boston, mars

Received and filed

aug 23,

19.50

(Registrar)

75m-2-'30. No. 7997-a

1 2 FULL NAME 3 SEXO 4 COLOR OR RACE White (or) WIFE of 6 IF STILLBORN, enter that fact here. 7 59 AGE Years Months Days 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. 15 MAIDEN NAME OF MOTHER PARENTS OCCUPATION| information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 10 Date deceased last worked at this occupation (month and year) 14/30 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.

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

To be filed for burial permit with Board of Health or its Agent.

Registered No.

(If U. S.

War Veteran,

(a)

Residence. No ...

(Usual place of abode)

Length of residence in city or town where death occurred 20

yTs.

mos.

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.

Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease 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 contributory causes of importance not related to principal cause, name other important diseases.

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

1021

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause:

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Town of Winthrop : Record of Deaths 1928-1930, Part 183

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

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