Town of Winthrop : Record of Deaths 1928-1930, Part 38

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 38

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17 Where was disease contracted

if not at place of death?

FOR WHAT?

Did an operation precede death?

-Date of

Was there an autopsy?

Under One Year. Was Baby Breast Fed

What test confirmed diagnosis ?.

(Signed)

M. D.

(Address)

Date

(Month)

8.1928 (Day) (Year)

13 Men Edward Full an Informant

(Address)

48 Sargent It Ein.

(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 W. S. Children

18 PLACE OF BURIAL, CREMATION OR REMOVAL Holyleron Malden

DATE OF BURIAL June 11/28

Cemetery

(City or town)

ADDRESS Dorchester

Offleial position

Health officer

Date of issue of permit

6/11/25

Permit NO.

1428

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Married

5a if married, widowed or divorced

HUSBAND of

(or) WIFE of

Julia M. Callahan

Months

Days

If LESS than 1 day .___ hrs. or ___ min.

# STILLBORN, enter that fact herd

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

Boston

mass

9 NAME OF

FATHER

James Welsh

10 BIRTHPLACE OF

FATHER (CityY

Ireland

11 MAIDEN NAME

OF MOTHER

Johanna Cotter

12 BIRTHPLACE OP

MOTHER (City)

(State or country)

Irstand

State Massachusetts

Michael J. Welsh

48 Parent

St., Ward.

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

8 1925

Retired

R-501 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS 1 PLACE OF DEATH County Suffolk monthrop City or Town 2 FULL NAME. 3 SEX 6 AGE Years 8 BIRTHPLACE (City) (State or country) PARENTS instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH 14 Filed N. D.WRITE PLAINET , WIETT ONTADINO DLAGR INA THIS TO ATLAMMANLITT ALVORD. LYCry ItENT Of INTOTTTTaLION (State or country)

23-20M 00.000

19 UNDERTAKER

W. O. Doherty

REVISED UNITED STATES STANDARD 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- e 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 only (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 CAUBING 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 de .; Bronchopneumonia (secondary), 10 da. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "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, meningitis, 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, bis 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 a human body. . . until he has received a permit from the board of health or its agent. .. or. .. from the clerk of the town where the person died ;. . . No such permit shall be issued until there shall have been delivered to such board, agent or clerk. . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the pur- pose, 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. .. 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 re- quire .- Gen. Laws, Chap. 114, Sec. 45.

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.

RULES OF PRACTICE

The fulfilment of the purpose of these lawa 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 deatha 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.

R-301

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

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

State Massachusetts

Registered No 1162

128 Pauline Street

St.,

Ward

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

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

St.,

Ward.

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

days.

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

years

months

days

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH.

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from 28, to_ Amee 3 19 AMIL 19

that I last saw h

walive on

11.30 T

The CAUSE OF DEATH was as follows:

imethatits

(duration)

.yrs.

2 ños.

_ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs.

.mos.

_. ds

17 Where was disease contracted

if not at place of death?

FOR WHAT ?

Did an operation precede death?

14 Date of

Was there an autopsy ?. If under one Year, was infant Breast Fed ? . What test confirmed diagnosis?

(Signed)

., M. D.

(Address)

1918

Date

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION OR REMOVAL

Holy Cross Malden (Cemetery)

(City or town)

19 UNDERTAKER

Dechardle Culeast Boston

ADDRESS

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

Wm. D. Children

Official position

Health Officer

Date of issue

6/16 /28 00 Permit 1432

30,000

County

Suffolk

City or Town

Winthropn

2 FULL NAME

Daniel J. Donoghue

(a) Residence. No ..

128 Pauline Street

(Usual place of abode)

Length of residence in city or town where death occurred

months

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Male

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Married

5a If married, widowed or divorced

HUSBAND of

Mary C.B. Gorman

(or) WIFE of

6 AGE

Years

Months

I LESS than

1 day .__ hrs.

OF ____ min.

Days

I STILLBORN, enter that fact bore

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Shipper

& BIRTHPLACE (City)

(State or country)

England

9 NAME OF

FATHER

Cornelius J. Donoghue

10 BIRTHPLACE OF

FATHER (City)

Ireland

(State or country)

11 MAIDEN NAME

OF MOTHER

Johannah Myron

12 BIRTHPLACE OF

PARENTS

MOTHER (City)

(State or country)

Ireland

Informant Mrs. Mary Donoghue

should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH

instructions and extracts from the laws on back of certificate.

in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See

(b) Name of employer

NE. Confectionery Co

(Address)

128 Pauline Street Winthrop

DATE OF BURIAL June 16,1928

BOSTON

(City or town)

12 1928

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

June 12, 1420 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

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

Statement of occupation .- Precise statement of occupation ia 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) 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," eto., 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 only (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, 88 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 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, eto., 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 da .; Bronchopneumonia (secondary), 10 da. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "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.

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 a human body. . . until he has received a permit from the board of health or its agent. .. or ... from the clerk of the town where the person died ;. . . No such permit shall be issued until there shall have been delivered to such board, agent or clerk. .. a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the pur- pose, 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. . . 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 re- quire .- Gen. Laws, Chap. 114, Sec. 45.

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.

Dr. Mahoney

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.

(3) Medical examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatiam (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.

R-303

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

Medical Examiner's Certificate of Death

¡City or town)

1 PLACE OF DEATH

(ISSUED UNDER THE PROVISIONS OF GENERAL LAWS, CHAPTER 38)

County

City or Town .... Besthit

Both Hailer at Winthrop was Pleasant Park yuscht Clubsand State Registered No.

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

2 FULL NAME

(a) Residence. No .. (Usual place of abode)

No Wintimp , vo main

.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 toreign birth? years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX male

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

White Single

5a If married, widowed, or divorced HUSBAND of (or) WIFE of

6 AGE

Years 57

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

Peterel

(b) Name of employer

8 BIRTHPLACE (City) (State or country)

9 NAME OF

FATHER

10 BIRTHPLACE OF FATHER (City) (State or country)

11 MAIDEN NAME

OF MOTHER

12 BIRTHPLACE OF Le Pr Daquel MOTHER (City) (State or country)

13 Informant

(Address)

So Maca OK

Filed

June 191925

(Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

13 (Day)

1928 (Year)

16 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows :

Natural Cames: Presente Cardiovascular disease-

Good deal in tiden water which he had cutered for a surm.)

(See reverse side for description for unknown person)

17 Where was injury sustained if not at place of death ?

(Signed)

(Address)

Medical Examiner for.

Date

(Month)

June 13

1928 (Year)

18 PLACE OF BURIAL, CREMATION, or REMOVAL

DATE OF BURIAL June 16/25 (Month) (Day)"Year

(Cemetery)

(Cfy or town)

19 UNDERTAKER

Del. Mccaffrey

ADDRESS

20 Burial permit,

issued by

....

Official Heath fficer D issue

6/14/ 28 Permit No. 1430

information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF ... ..

Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes of

PARENTS

M.D.

Ireland

16,535

Patrick E. Hamahan

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

EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has at- tended during his last illness, at the request of an under- taker 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 so that it can be clas- sified under the international classification of causes of death), 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. . . .- General Laws, Chapter 46, Section 9.

No undertaker or other person shall bury or other- wise dispose of a human body in a town, or remove there- from a human body which has not been buried, until he has received a permit from the board of health . . . , 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 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, . . . or clerk .. .. a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied . . . by a satisfac- tory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as herein- after 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 physi- cian 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. The board of health or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The per- son 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 man- ner or cause of the death, which the clerk or regis- trar may require .- General Laws, Chap 114, Sec. 45 a8 amended.

Medical examiners shall make examination upon the view of the dead bodies of only such persons as are sup- posed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same. . . . General Laws, Chap, 38, Sec. 6.

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Town of Winthrop : Record of Deaths 1928-1930, Part 38

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

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