Town of Winthrop : Record of Deaths 1928-1930, Part 37

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 37

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. 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.

RULES OF PRACTICE

The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.

(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unre- lated to any form of injury, have died without recent medical at- tendance or whose physician is absent from home when the certificate of death is needed.

(3) Medical examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

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

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

State mas

(City or town)

110

Registered No.

City or Town

Winching-

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

2FULL NAME

#103 Upland Rost

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

Ward

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

Length of residence in city or town where death occurred 4 years months days. How long in U. S., if of foreign birth? years months

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4. COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

E. maynard Snow

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

at Home

8 BIRTHPLACE (City)

(State or country)

mais

9 NAME OF

FATHER

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country)

Ruiquail

1 1 MAIDEN NAME

OF MOTHER

Incultrá, Jones

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

England

Informant

2. Maynard Low

(Address)

103 Upland Rd. Wmchung-

Filed (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

I HEREBY CERTIFY , That I attended deceased from

1928 to

que 6

1925

that I last saw h. alive on Que 6 ,19 25

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

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

630

17 Where was disease contracted

if not at place of death

Did an operation precede death

20 :

For what

Date of operation

200

Was there an autopsy

What test confirmed diagnosis

clinical

(Signed)

(Address).

123 Urlaub St

Date

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Winchup Unchat

(Cemetery)

(City or town)

DATE OF 'BURIAL

6/8/28

19 UNDERTAKER

Chas P Gennem

ADDRESS

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

Nm.S. Childress

Official position

Health Officer

Date of issue of permit 6/7/28

No.

mit 1423

Ward

Cida florence.

(a) Residence. No.

(Usual place of abode)

days.

441

1928 (Year)

(duration)yrs .. mos.

ds.

CONTRIBUTORY

(Secondary)

(duration)_

-_ yrs ._____ mos.

ds.

M. D.

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

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

State

Registered No.

City or Town Wencheit-

Ward

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

2FULL NAME

ada filerance.

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

(a) Residence. No.

(Usual place of abode)

Length of residence in city or town where death occurred 4 years months

days.

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

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Simal

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

E. maynard Snow

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)

9 NAME OF

FATHER

10 BIRTHPLACE OF

FATHER (City)

(State or country)

1 1 MAIDEN NAME

OF MOTHER

Mattia, fores

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

England

Informant

2. May nend Low

(Address)

163 Welland Rd. Wircheck-

Filed

(Month) (Day) (Year)

REGISTRAR

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

Official

Date of issue of permit 6/7/25

Permit No.

it 1420

1928

15 DATE OF DEATH

(Month)

(Day)

(Year)

I HEREBY CERTIFY , That I attended deceased from

16 May 26 1928, 10 June 6 1945

that I last saw h.

lalive on

Que 6

,1925

and that death occurred, on the date stated above, at 630

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

8 m.

(duration) __ yrs ...

-mos.

ds.

CONTRIBUTORY

(Secondary)

(duration) _____ yrs. mos.

ds.

17 Where was disease contracted

if not at place of death

Did an operation precede death

For what

Date of operation

Was there an autopsy 200

What test confirmed diagnosis

Clinical

(Signed)

(Address)

123 Verything St

Date

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Winwhich is achiote

(Cemetery)

(City or town)

DATE OF BURIAL 6/8/28

ADDRESS

19 UNDERTAKER

Chas R Gennem

(City or town)

-103 Uhland Rast.

Ward

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

MEDICAL CERTIFICATE OF DEATH

PARENTS

200

M. D.

REVISED UNITEDSTATESSTANDARD CERTIFICATE OF DEATH

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

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, itre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Fore- man," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer-Coal mine, etc. Women at home, who are engaged in the duties of the household onty (not paid Housekeepers who receive a definite salary), may be entered as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Scrrant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death .- Name, first, the Disease Causing Death (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, meninges, 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 "Asthenia," "Anemia" (merely symp- tomatic), "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 peritonitis," etc.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)

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, menin- gitis, miscarriage, 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 deceased, furnish for registra- tion a standard certificate of death, stating to the best of his knowl- edge 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, 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 containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certi- ficate 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 ob- tained 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 certi- ficate 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 statement and certificate, shall forthwith counter- sign 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 cemetery or burial ground in which the interment is made .- Chap. 114, Sec. 46, G. L., as amended.

IR-301

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

State Mass

(City or town)

111

-City or- Town

100 Quincy ave,

St. Ward

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

2FULL NAME

100 Duthey Live

St.,

Ward

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

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 Female

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed or divorced

HUSBAND Of

(or) WIFE of

Nawet, 4. Ceplari

6 AGE

Years 68

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

Huiswrite

(b) Name of employer

8 BIRTHPLACE (City)

(State or country)

9 NAME OF

FATHER

1 0 BIRTHPLACE OF

FATHER (City)

(State or country)

1 1 MAIDEN NAME

OF MOTHER

Ellen Mell

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Ce pte

Lon Harand IV. d. itTT

Informant

(Address)

Filed June 21/28

(Month) (Day) (Year) REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH June 8 6928

(Month)

(Day)

(Year)

I HEREBY CERTIFY , That I attended deceased from

June 8

19 28, to

June 8

1928

that I last saw her alive on

Ferme 8

1928

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

10.30 P.

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

arteriosclerosis

(duration)

_yrs.

ds.

CONTRIBUTORY

chronic parenchymatous

(Secondary) nephritro

(duration)

Vys

_yrs

~ mos.

ds.

1 7 Where was disease contracted

if not at place of death.

Did an operation precede death

For what

Date of operation

Was there an autopsy History, symptoms off.

What test confirmed diagnosis

(Signed)

schuld hecho

OP. Exam.

Vallie N. Jaunders, (Address) 32 Woodside Park Winthrop Date June 10, 1928

18 PLACÉ OF BURIAL, CREMATION, OR REMOVAL Dubudge

Ven eru

(Cemetery)

(City or town)

DATE OF BURIAL Fire 11/28

19 UNDERTAKER

ADDRESS

Mars

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

W.D. Children 9.3.4.

Official position

Healthe Office

Date of Issue ice of permite /11/28

Permit No. 1429

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

200.000. 9-26. NO. 6373

Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. plied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified-

Emilia Vinista Paxton

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

(a) Residence. No.

(Usual place of abode)

.. 1.2.

Ficial

PARENTS

Registered No.

REVISED UNITEDSTATESSTANDARD CERTIFICATE OF DEATH

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

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, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sala (b) ; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Fore- man," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer-Coal mine, etc. Women at home, who are engaged in the duties of the household onty (not paid Housekeepers who receive a definite salary), may be entered as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the' occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death .- Name, first, the Discase Causing Death (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite) ; Tuberculosis of lungs, meninges, 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 "Asthenia," "Anemia" (merely symp- tomatic), "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. peritonitis," etc.

Stato cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)

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

EXTRACTS

FROM THE LAWS OF THE

COMMONWEALTH OF MASSACHUSETTS

GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

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

(City or town)

Registered No.

No. 48

L'argent

St., _Ward

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

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

(a) Residence. No.

(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

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from

-1. -2

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:

Cerebral Hammlangs,

(duration) yrs. .mos. 4 ds.

CONTRIBUTORY

(SECONDARY)

(duration) yrs .___ mos .. ds

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Town of Winthrop : Record of Deaths 1928-1930, Part 37

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

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