USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1928-1930 > Part 198
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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
I915
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.
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.
6654)
2-302
Suffolk
(County) Boston
(City or Town)
No. Mass. General Hospital
St.,
.Ward
give its NAME instead of street and number)
2 FULL NAME
Jeremiah P Tells
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence.
No.
194 ... Washington.
.St.,.
Ward, Winthrop
(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
Male
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.
7
AGE
24
Years Months Days
If less than 1 day Hours. .Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Gardener
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
Various Jobs
10 Date deceased last worked at
this occupation (month and
year)
Sept, 1930
spent in this occupation .. 6 .yrs.
12 BIRTHPLACE (City)
Somerville.
(State or country)
Mass
13 NAME OF
FATHER
Jeremiah B. Wells
14 BIRTHPLACE OF
FATHER (City)
Cambridge
(State or country) Mass.
15 MAIDEN NAME
OF MOTHER
Rosalie E. Dickinson
16 BIRTHPLACE OF MOTHER (City)
Wiscasset
(State or country) L'e.
17 Informant J B Wells
(Address)
Winthrop, Kass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
C Sullivan (Signature of Agent of Board of Health or other)
October 14 1930
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
October
13,
1930
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
October
19 30 to October
19.
3.0, death is said
13.
..... , 19.3.0
I last saw h ... ].m.alive on
October
13
to have occurred on the date stated above, at 5:05P m.
The principal cause of death and related causes of importance in order of onset were as follows:
Dateefonset
Appendicitis Acute
15
days ..
Peritonitis
8
days ..
Contributory causes of importance not related to principal cause:
Bronchitis, Acute
2 days
Name of operationDr.of appendix abscesale of 10/5/30 What test confirmed diagnosis? Was there an autopsy? Yes
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
M ... J .... Rhees
M. D.
1
(Address)
Boston, Mass.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
St. Pauls
Arlington
(City or town)
1
DATE OF BURIAL
(Cemetery)
October
16.
19
30.
22 NAME OF
UNDERTAKER
W J Doherty
ADDRESS
Dorchester, Mass.
Received and filed.
October ....... 16.
.19.30 ...
não
A TRUE COPY, ATTEST:
(Registrar
1
1
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Bo: ton
(City or town making return)
Registered No.
8590811
(If death occurred in a hospital or institution,
(If U. S.
1
PLACE OF DEATH
OCCUPATION! OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very PARENTS important.
50M-11-'29. No. 7180-b
(Official Designation)
Wir 29 1930
Date
10/13/19 30
11 Total time (years)
(If nonresident, give city or town and state)
(write the word)
2
Oct. 13. 1930
2-302
Suffolk
(County)
Boston
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Boston
(City or town making return) 226
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Baby Epstein
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No ..
39 Pearl Ave.
(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 Male
4 COLOR OR RACE
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)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
Stillborn
7 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
12 BIRTHPLACE (City) (State or country)
Mass.
13 NAME OF
FATHER
Charles Epstein
14 BIRTHPLACE OF
FATHER (City)
Woonsocket
(State or country) RI
15 MAIDEN NAME
OF MOTHER
Sarah Buinze
16 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country) Mass.
17
Informant
(Address)
Father
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
A .. E. C.
f'Äger
18-30
(Official Designation)
(Date of Issue of Permit)
man. 18. 19 193
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
October
16.
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
19
to
19
I last saw h
alive on
19
death is said
to have occurred on the date stated above, al ..: 32P .m. The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
Stillborn Macerated faetus
Contributory causes of importance not related to principal cause:
Asphyxia from knot in umbilical cord.
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)
CA. Powell
M. D.
(Address) Mass. Memorial Hosp. .. Date 9/17 / 19
22 PLACE OF BURIAL,
CREMATION OR REMOVAL
Mt. Leban B E
(Cemetery)
(City or town)
3d
DATE OF BURIAL
October.
17.
19 :31
22 NAME OF UNDERTAKER J. H .Levine
ADDRESS
Dorchester Mass.
Received and filed ..
October
20,
31
19
A TRUE COPY, ATTEST:
(Registrar)
50M-11-'29. No. 7180-b
OCCUPATION OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very PARENTS important.
1
PLACE OF DEATH
No.
(City or Town)
Mass. Memorial Hospital
St.,
Ward
(If U. S. War Veteran, specify WAR) Winthrop, Mass.
St.,.
Ward,
(If nonresident, give city or town and state)
1935
1931.
W Roxbury
Boston
-301
CAUSE OF DEATH In plain terms, so that it may be properly classined. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
200 M-11-'29. No. 7180-a
-
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
No .. 52 Revere St.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop
(City or town making return)
Registered No.
(If death occurred in a hospital or institution,
Ward
give its NAME instead of street and number)
2 FULL NAME
Lavinia Mead
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
52 ... Revere .... S.t.
St.,
..........
. Ward,
(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
(write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
James ...... leade
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
75
AGE
Years Months Days
If less than 1 day
Hours
Minutes
OCCUPATIONI
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ...
None
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)
spent in this
occupation.
12 BIRTHPLACE (City)
(State or country)
Prince Edward Island
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
unable to learn
16 BIRTHPLACE OF
MOTHER (City)
(State or country) Prince Edward Island
17 Norma Crosby
Informant
(Address)
52 Revere St. Winthrop, Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: W/m.D. Chil dress
(Signature of Agent of Board of Hardth or other)
1 Health officer
/ 1130
Z (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
17
1730
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
I last saw h .... . alive on
to have occurred on the date stated above, at. IN .m.
The principal cause of death and related causes of importance in order of onset were as follows:
Dateefonset
8/20/29
.
Contributory causes of importance not related to principal cause:
19.29
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)
(Address)
M. D.
Date
01.1.7.19
2
C
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Mt.Hope
Bœ ton
DATE OF BURIAL
October
19
(Cemetery)
(City or town)
19 ..
30.
22 NAME OF
UNDERTAKER
Wt Graham
ADDRESS
Boston, mare
Received and filed
100% 27
19
A TRUE COPY, ATTEST: (Registrar)
1
St.,
(If U. S.
War Veteran,
specify WAR)
(Usual place of abode)
195 to
est 17
, 19 37
15
........ , 19.52., death is said
13 NAME OF
FATHER
Charles Crozier
CZCA. 17. 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
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 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.
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 .. . Chop. 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.
=-
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION PARENTS is very important. See instructions and extracts from the laws on back of certificate.
1
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed of divorced woman, give also maiden name.)
430 Meridian St, E.63
.. St.,
(a) Residence. No ... (Usual place of abode)
Length of residence in city or town where death occurred
Jis. mos.
days. How long in U. S., if of foreign birth? 26 yrs. mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Viale Write
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
5a If married, widowed, at divorced~
Ube Mina
Hakonson
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
7
51
. Years
1
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