Town of Winthrop : Record of Deaths 1928-1930, Part 45

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 45

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

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

No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .- Chap. 114, Sec. 46, G. L., as amended.

R-303

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

Medical Examiner's Certificate of Death (ISSUED UNDER THE PROVISIONS OF GENERAL LAWS, CHAPTER 38)

Winthrop (City or town)

199

State Massachusetts Registered No.

City or Town

Wintherh

No.

... 64 Buchanan St.,

............ .. Ward

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

(a)Residence.

No ....

64 Buchanan St

(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

4 COLOR OR RACE

Female White

5 SINGLE, MARRIED, WIDOWED, or

DIVORCED, (write the word)

Widow

5a If married, widowed, or diyørcod

HUSBAND of

(or) WIFE of

Charles

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

At home

8 BIRTHPLACE (City)

(State or country)

Mass

9 NAME OF

FATHER

Horace a lawyer

10 BIRTHPLACE OF

FATHER (City)

(State or country)

11 MAIDEN NAME

OF MOTHER

Unknown Hall

12 BIRTHPLACE OF

MOTHER (City)

Unhumor

(State or country)

Mr. M. Jerry Stone

Winthrop Mass

Filed

7/11/8

(Month)

(Day) (Year)

REGISTRAR

20 Burial permit issued by t Nr.D. Childress

Official position

Health office ?!

21 Date of issue 7/10/28

DATE OF BURIAL

July 10 '28

(Month) (Day) (Year)

19 UNDERTAKER

Q. Q. Rolling

ADDRESS

8. Boston.

Permit No. 1447

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: (If an injury was involved, state fully)

(See reverse side for description for unknown person)

17 In what City or town

was injury sustained?

(Signed)

M. D.

(Address)

Medical Examiner for. K

Date

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION,or REMOVAL

Woodlawn

Sirnett

(Cemetery)

(City or town)

County 3 SEX PARENTS Informant (Address) 14 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 information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF (b) Name of employer

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

0908

(Day)

(Year)

2FULL NAME

Los Frances

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

St.,

Ward.

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

1PLACE OF DEATH

Boston

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, 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 re- quired by law to be returned and recorded, which shall be accom- panied, 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 can- not 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 cer- tificate. 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 statement and certificate, shall forthwith countersign it and trans- mit 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 sball make examination upon the view of the dead bodies of only such persons as are supposed 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. . . . Gen- eral 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 .- General Laws, Chap. 38, Sec. 7.

The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.

... A medical examiner has no right to delay filing the certificate referred to (death certificate) until judicial inquiries have been concluded and certified, ..- Extract from Opinion of the Attorney General, July 29, 1926.

STATEMENT OF CAUSE OF DEATH

Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under man- ner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with as- sociated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether adminis- tered as a surgical anæsthetic." "Fracture of the skull with as- sociated internal injury sustained under circumstances unknown."

If investigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico- legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease,

presumably coronary sclerosis. (Sudden death.)"

DESCRIPTION (for unknown person)

NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap, 38, Sec. 14.

THIS CERTIFICATE CONSTITUTES SUCH PERMIT

July 7. 1928

Frances J. com

... .

M R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

(City or town)

130

City or Town

Winthing

21- hatt are

St., ___.

Ward

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

2FULL NAME

Winifred

Gertrude

(a) Residence. No.

(Usual place of abode)

21 - vierth arest.

(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 years months

days.

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

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

white

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Kingla

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

6 AGE

Years

Months

Days

IF LESS than

1 day.

.. hrs.

or ..... .. min.

IF STILLBORN, enter that fact here 1

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

Ingstão. L. Munro

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

mansfield

1 1 MAIDEN NAME OF MOTHER

Mildred Mooney

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

mass

Informant

Mysta L. Musco

(Address)

21 Hout are worthet

14 7/18/28

Filed

(Month) (Day) (Year)

REGISTRAR

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

Official position.

Date of issue of permit/ /// 28 Permit/ 4/42

CONTRIBUTORY

(Secondary)

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

What test confirmed diagnosis

(Signed)

M. D.

(Address)

Date Why 14,1929

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

(Cemetery)

(City or town)

DATE OF BURIAL 7/15/25

19 UNDERTAKER Chas. P. Permani

ADDRESS

that I last saw h_ alive on

19 26

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

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

1428

(Month)

(Day)

(Year)

16 I HEREBY CERTIFY

That I attended deceased from

July 13

19 2 Ft

Ich 13

1928

6.10 D

PARENTS

200,000. 9-26. NO. 6373

N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information should be carefully sup- 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-

1 PLACE OF DEATH

County

Tffalle

State

Registered No.

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

July

_yrs.

_mos ..

mg_ds.

(duration).

__ yrs ..

_mos.

ds.

V 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, Ciril 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) , (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 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 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (mercly symp- tomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uremia," "Weakness," cte., 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 oniy such persons as are supposed to have died by violence .- Gen. Laws, Chap. 38, Sec. 6.

R-301

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

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Suffolk

State

Muss

(City or town)

City or Town

YWinthrop-

That of Paige

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

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

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed or divorced

HUSBAND of

(or) WIFE of

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

Home

Grenville

8 BIRTHPLACE (City)

(State or country)

Main

9 NAME OF

FATHER

1 O BIRTHPLACE OF

FATHER (City)

(State or countryb/

Marnie

1 1 MAIDEN NAME

OF MOTHER

Don't Know-

12 BIRTHPLACE OF

MOTHER (City).

(State or country)

13 Sou in Law, Eiro 1. Breckenridge Informant

(Address)

# 1 Thore Drive Winetech.

7 028

Filed

(Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

July

(Month)

(Day)

(Year)

I HEREBY CERTIFY , That I attended deceased from

fence 15

1927, to July 13-

, 1928

that I last saw her

alive on

July 15

1928

2:30 a:

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

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

Diabetes

Mellitus.

(duration)

_. yrs.

.mos.

ds.

CONTRIBUTO mecabetic gangrene of righet foot ( Chuonic glomerular neplictis

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

What test confirmed diagnosis

clinical laboratory

(Signed)

Jacob aleang

(Address).

562 Shirley Street Wontheop

Date

July 15, 1928.

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

Honest Helle Coremotor

(Cemetery)

(City or town)

DATE OF BURIAL July 17/8

19 UNDERTAKER

ADDRESS

Walter es. While Achattrafi

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

Woman's Childress Official position

n/ Health Officer

Date of issue of permit 7/6/28

Permit No.

1446

----

No. 1. there

St .. Ward

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

2FULL NAME

1. Those Drive

(a) Residence. No.

(Usual place of abode)

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.

15 1928

large

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- apective 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 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 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," cte., 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.

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Town of Winthrop : Record of Deaths 1928-1930, Part 45

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

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