Town of Winthrop : Record of Deaths 1928-1930, Part 41

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 41

Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).

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.

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 licu 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 a to the manner or cause of the death, which the clerk or registra may require .- Chap. 114, Sec. 45, G. L., as amended.

Medical examiners shall make examination upon the view of th dead bodies of only such persons as are supposed to have died b violence .- Gen. Laws, Chap. 38, Sec. 6.

He shall in all cases certify to the town clerk or registrar in th place where the deceased died his name and residence, if knowr otherwise a description as full as may be, with the cause and manne of death .- Gen. Laws, Chap. 38, Sec. 7.

No undertaker or other person shall bury a human body or th ashes thereof which have been brought into the commonwealth un he has received a permit so to do from the board of health or its age appointed to issue such permits, or if there is no such board, from tl clerk of the town where the body is to be buried or the funeral is be held, or from a person appointed to have the care of the cemete or burial ground in which the interment is made .- Chap. 114, Sec. 4 G. L., as amended.

TRANSIT AND BURIAL PERMIT

No. 1.75.93

STATE OF NEW YORK~'

DEPARTMENT OF HEALTH OF THE CITY OF NEW YORK -

This Permit must be properly signed and presented, with Undertaker's Certificate, to the Railroad, Express or other Transportation Agent, before a body can be shipped.

JUN 2 5 1928

New York,

192

The Certificate of Death, having been furnished to me, as required by the Laws of this State, permission

is hereby granted

mlerbolle

holder of Undertaker's License No,

219

for the removal and shipment for

burial at

e of Lua

cremation matcher

Crumator Clangher toho di who died in

the Borough of la Borough of Manhattan daty of my , N. Y., on June 24,28, at 2.42, 192 G-, at.

06:45/M. Aged 50 -years months days. While _sex ._ color, the cause of death being Solera

which necessitates shipment under Rule No. _of the Rules of the New York State Department of Health for the Transportation of the Dead, as printed on the back of this Permit.

Signed Film Imati L. MA

(Signature of Undertaker)

Ass't Registrar

This Permit must be detached and delivered to the Person in charge of the Corpse.

Cemetery at

walden)

State of

__ the body of

NEW YORK STATE DEPARTMENT OF HEALTH ALBANY

SPECIAL ADMINISTRATIVE RULES RELATING TO THE TRANSPORTATION OF DEAD BODIES BY COMMON CARRIERS

Pts effect throughout the State of New York, except in the City of New York, on August 1, 1915.]

RULE 1. A transit permit and transit label issued by the local registrar of vital statistics must accompany each dead body transported by a common carrier.

The transit permit shallstate the date of issuance, the name, sex, race and age of the deceased, and the cause and date of death. The transit permit shall also state the date and route of shipment, the point of shipment and destination, the method of preparation of the body, and shall bear the signature of the undertaker and the signature and official title of the officer issuing the permit.

The transit label shall state the date of issuance, the name of the deceased, the place and date of death, the name of the escort or consignee, the point of shipment and destinatique and shall bear the signature and official title of the officer who issued the transit permit. The transit label shall be attached to the outer bocor case.

RULE 2. The transportation by common carriers of bodies dead of any discases other than those mentioned in Rule 3 shall be permitted only under the following conditions?5 - Not -

(a) The coffin or casket shall be encased in a strong outer box made of good sound lumber, not less than 2 of an inch thick. All joints shall be securely put together and the box tightly closed. Either the coffin or casket, or the outer box or case, shall be watertight.

(b) When the destination cannot be reached within 60 hours after death, all body orifices shall be closed with absorbent cotton, and the body placed at once in a coffin or casket which shall be immediately closed and the coffin or casket shall be encased in a strong outer box made of good sound lumber not less than ¿ of an inch thick. All joints must be securely put together and the box tightly closed and either the coffin or casket, or outer box or case, shall be watertight.

RULE 3. The transportation by common carrier of bodies dead of smallpox, plague, Asiatic cholera, typhus fever, diphtheria (membranous croup, diphtheritic sore throat), scarlet fever (scarlet rash, scarlatina), shall be permitted only under the following conditions:

All body orifices shall be closed with absorbent cotton, the body shall be enveloped in a sheet saturated with an effective disinfecting fluid and shall be placed at once in a coffin which shall be immediately and permanently closed. The coffin or casket shall be encased in a strong outer box made of good sound lumber, not less than § of an inch thick, all joints of which shall be securely put together and the box shall be tightly and permanently closed. Either the coffin or casket, or the outer box or case, shall be watertight.

RULE 4. No dead body shall be disinterred for transportation by common carrier without the previous consent of authorities having jurisdiction at the place of disinterment. The transit permit and transit label shall be required as provided in Rule 1, and Paragraph (a) of Rule 2 shall apply.

RULE 5. Every outside case holding any dead body offered for transportation by common carrier shall bear at least four handles and when over 5 feet 6 inches in length, shall bear six handles.

PROMULGATED BY STATE COMMISSIONER OF HEALTH AT ALBANY, JUNE 25, 1915.

June 24. 1

R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

1 PLACE OF DEATH County

Suffolk

State mass

(City or town)

Registered No.

City or Town

Winthrop

63 Cest avec

St ..

Ward

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

2FULL NAME Nella a. moore.

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

Ka) Residence. No.

63 Queet ave

St.,

Ward

(Usual place of abode)

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

Length of residence in city or town where death occurred

25 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

white

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Tedaword

5a If married, widowed or divorced

HUSBAND cf

(or) WIFE of

Bart S. Moore

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

Dorchester, mass

8 BIRTHPLACE (City) (State or country)

9 NAME OF

FATHER

1O BIRTHPLACE OF FATHER (City) (State or country)

John Higgins

Ouiland

1 1 MAIDEN NAME OF MOTHER Ellen OBrien

12 BIRTHPLACE.OF

MOTHER (City)

(State or country)

chilaud

Informant

(Address)

63 Custar Withrop.

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

W. D. Childress

Official 2position

Health officer

Date of issue of permit

6/27/28 1436

No.

9.3.9.

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

Arme 26-1929.

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

fume

1928, to June 26

1928

that I last saw halive on

June = 6

1928

and that death occurred, on the date stated above, at 10

The CAUSE OF DEATH was as follows:

(State fully)

chroni interstitial

about.

(duration)

_yrs

ds.

mos

CONTRIBUTORY.

(Secondary)

(duration).

_yrs.

mos ¿s.

17 Where was disease contracted

if not at place of death.

Did an operation precede death

200

Tor what.

Date of operation

Was there an autopsy 200

What test confirmed diagnosis

(Signed)

Ti Way to

, M. D.

(Address)

186 withup Sh-levelup

Date

6/ 22 28

18 PLACE OF BURIAL, CREMATION, OR REMOVAL IMMACULATE CONCEPTION (Cemetery) ( Cify cr town)

LAWRENCE,

DATE OF BURIAL 6/09/28

19 UNDERTAKER

m.) .Mahoney

ADDRESS Laurence.

------

200.000. 9-26. NO. 6373

plied. 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 important. See instructions and extracts from the laws on back of certificate.

PARENTS

Lab. + chuml

$11,18 26. 1720 REVISED UNITED STATESSTANDARD 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) 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 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 da .; 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. .

EXTRACTS

FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS

GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

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 onty 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.

R-301

OFFICE OF THE SECRETARY

DIVISION OF VITAL STATISTICS

I PLACE OF DEATH

County

Suffolk

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

State Mass.

Registered

No.

City or Town

Winthrop

No. 15 Read Street

St .. Ward

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

2 FULL NAME

Henry Lincoln Thompson

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

(a) Residence. No. 15 Read Street

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

St.

Ward.

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

days.

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

years

months

days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Male

White

Single

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Months

Days

If LESS than 1 day .___ hrs. Of ...._ min.

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work.

Clerk

(b) Name of employer

Federal Reserve Bank

Boston

8 BIRTHPLACE (CityNorth Hampton

(State or country)

Mass.

CONTRIBUTORY.

(SECONDARY)

(duration)

.yrs.

mos ..

9 NAME OF

FATHER

Henry A. Thompson

PARENTS

10 BIRTHPLACE OF

FATHER (City) Brooklyn

(State or country)

New York

11 MAIDEN NAME

OF MOTHER

Gertrude Kean

12 BIRTHPLACE OF

MOTHER (

Shelburne

(State or country)

Nova Scotia

17 Where was disease contracted

if not at place of death ?.

Did an operation precede death? yes

Date of.

May 21/28

Was there an autopsy?

What test confirmed diagnosis?

(Signed)

(Address)

308 Juvinnes Queel 0

Data

June

1928 au /020

(Month)

(Day)

(Year)

13 Informanurs . L.Gertrude Thompson

18 PLACE OF BURIAL, CREMATION OR REMOVAL

Winthrop

winthrop

DATE OF BURIAL 6/30/28

(Cemetery)

(City or town)

19 UNDERTAKER

Long & Margeson Service

ADDRESS Winthrop

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

01.1

wildress 9.2

Official death Officer

Date of issue of permit

6/29 128 Por 1437

200,000 9-25 NO. 2662 - 3.

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

Filed (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day}

1928 (Year)

16 I HEREBY CERTIFY, That I attended deceased from June 13 4

that I last saw h

alive on

1922

and that death occurred, on the date stated above, at. 1030 m. The CAUSE OF DEATH was as follows:

Carcinoma

(duration)

-yrs. 5 mos.

.ds.

M. D.

(Address)

15 Read St. Winthrop Mass.

(City or town)

19 28, to

June 27%

REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH

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

Statement of cause of death .- Name, first, the DIBBABE CAUBING 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 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.

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

Town of Winthrop : Record of Deaths 1928-1930, Part 41

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

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