Town of Winthrop : Record of Deaths 1928-1930, Part 62

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 62

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Statement of cause of death .- Name, first, the Disease Caus- ing Death (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never report "Typhoid pneumonia") ; Lobar pneumonia; Bronchopneumonia ("Pneu- monia," unqualified, is indefinite) ; Tuberculosis of lungs, men- inges, 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 "Asthe- nia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma." "Convulsions," "Debility" ("Congenital," "Senile," etc. ), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "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 peri- tonitis," etc.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Associa- tion.)

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 canse of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage. gangrene, pastritis, ervsipelas, meningitis, mis- carriage, 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 de- ceased, 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 dura- tion 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 ex- hume 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 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 suffi- cient reasons, his certificate cannot be obtained carly enough for the purpose, or is insufficient, a physician who is a mem- ber of the board of health, or employed by it or by the select- men for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by vio- lence, the medical examiner shall make such certificate. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health or its agent, upon receipt of such state- ment and certificate, shall forthwith countersign it and 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 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 common- wealth 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.

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Cambridge

(City or town)

Registered No.

1560

(Place of death)

Registered No.

(Place of residence)

St.,

Ward

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

2 FULL NAME

Cornelius Bresnahan

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

(a) Residence.

State Lass

(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

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) Married

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

Margaret P. Sullivan

6 AGE

, Years

Monthe

Days

If LESS than 1 day,. . . brs. or .... min. -

If STILLBORN. enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

Retired

8 BIRTHPLACE (city or town)

Boston

(State or country)

Mass.

9 NAME OF

FATHER

John

10 BIRTHPLACE OF

FATHER (city or town)

Boston

(State or country)

Lass.

11 MAIDEN NAME

OF MOTHER

Ellen

12 BIRTHPLACE OF MOTHER (city or town) (State or country) Ireland

Informant

Margaret

. Bresnahan

(Address)

338 Revere st. winthrop

Filed Nov 2 1958

Filed

Dec. 12, 19 28

Registrar of city or town where death occurred

Registrar of city or town where deceased resided

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

October 31 1928

(Month)

(Day)

(Year)

I HEREBY CERTIFY,

That I attended deceased from

Oct 18

alive on

October 30

19 28

and that death occurred, on the date stated above, at. 4.15 m.

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

Chronic lyocardi tis

(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

What test confirmed diagnosis.

(Signed)

Willard Futnam

M. D.

(Address)

16 Garfiel St. Cambridge

Date Oct 31 1928

18 PLACE OF BURIAL, CREMATION, OR REMOVAL Old Calvary Cem. Boston

DATE OF BURIAL Lov 3 2.8

, 19

(Cemetery) (City or town)

19 UNDERTAKER

James J Shea

ADDRESS Cambridge

may be properly classified. Exact statement of OCCUPATION is very important.

PARENTS

. 4312

1 PLACE OF DEATH

County

Middlesex

State

Mass.

City or town

Camoridge

No.

Holy Ghost Hospital

City or Town

Winthrop

No.

356 Revere

St.

Oct 30

that I last saw h

ect. 31, 1928

.......

RM R-301

DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop (City or town)

1 PLACE OF DEATH

County

Suffolk

State Massachusetts

Registered No.

1.80

City or Town

Winthrop

VAwithrop Community Hospital Ward

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

agnes Therese me Intyre.

(a) Residence.

No.

95 Quincy ave

(Usual place of abode)

Length of residence in city or town where death occurred; Lyrs. mos. days. How long in U. S., if of foreign birth ? yrs.

mos. days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE | 5 SINGLE, MARRIED, WIDOWED, White or DIVORCED (write the word) married.

5a If married, widowed, or divorced HUSKAMIT (or) WIFE of Heury Q. Mc Lntyre.

Months 11

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.

England.

William S. Gibbet.

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

Elizabeth S. Edmundo

12 BIRTHPLACE OF MOTHER (City) (State or country) England.

13 Informant Offury 4. Martyre

( Address) 95 Louncy ave

Filed (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH Nov. 7 1928

(Month)

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from @ct- 30 1928 , to Nov. 7

1928.

that I Jast saw h

alive on

Nov. 7

1929.

5:30 P

Acure obstructure of Bowel

7 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.

What test confirmed diagnosis Edward . Frainger.

(Signed)

(Address)

476 Sturdy

Date

Nov-8-1928

PLACE OF BURIAL, CREMATION, FOR REMOVAL Authrop

DATE OF BURIAL nov. 10,1928

(Cemetery )

(City or town)

ADDRESS

19 UNDERTAKER

Charles R. Bennison Nuithrop.

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

Ofwir Culdoes Health Officers Official

Date of issue 1.18 28 Permit No ...

15 34

2 FULL NAME 3 SEX female 6 AGE Years 54 8 BIRTHPLACE (City) (State or country) 9 NAME OF FATHER 11 MAIDEN NAME OF MOTHER PARENTS 14 information should be carefully supplied. AGE should be stated RAACILI. PHISICIANS should State (b) Name of employer is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION

200M 7-'28 No. 2787-c

(duration) + .yrs

.Anos ..

Carcinoma of

intestines

M. D.

Winthrop

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

St., ....... .. Ward,

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

and that death occurred, on the date stated above, at ... The CAUSE OF DEATH was as follows: (State fully)

-ans

4 Pinoys voyeu110

7100.7 1928

Revised United States Standard Certificate of Death (Approved by U. S. Census and American Public Health Ass'n.)

out 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 Housewife, House- work, 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 occupation 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.

(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 : Mcasles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthe- nia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc. ), "Drops> {{Marasmus," "Old age," "Shock," ," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "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 peri- tonitis," etc.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Associa- tion.)

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

Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion. cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, mis- carriage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

. . 1

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 ex- hume 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 lown 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 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 suffi- cient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a mem- >er of the board of health, or employed by it or by the select- nen for the purpose, shall upon application make the certificate "equired of the attending physician. If death is caused by vio- !ence, the medical examiner shall make such certificate. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health or its agent, upon receipt of such state- inent 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 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.

R-301

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop

(City or town)

Registered No.

Gity er Town

Winthrop

No Meuthrop Community Hospital

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

Jacob Phillip Suint.

Ka) Residence. No.

(Usual place of abode)

Length of residence in city or town where death occurred 40 years months

days.

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

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

male

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Widowed.

5a If married, widowed or divorced

HUSBAND of

COD WWLEE of

Ella Jane Saint.

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

Retired:

8 BIRTHPLACE (City)

Syracuse.

. (State or country)

new york

PARENTS

:1 1 MAIDEN NAME

OF MOTHER

Marguerite matzeubacker

:12 BIRTHPLACE OF -

MOTHER (City)

(State or country)

germany.

Informant Charles R. Bennison.

(Address)

147 Winthrop St.

Hang 13/2.

Filed (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

(Day)

(Year)

I HEREBY CERTIFY , That I attended deceased from

Oct 2

1928 to Now 7

192.

that I last saw her alive on

Ner 7

1928

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

The CAUSE OF DEATH was as follows:

(State fully)

Valvular heart disease

Uremia Pasiv congestive (quesal!

(duration).

_yrs.

mos

ds.

CONTRIBUTORY

Nephritis

(Secondary)

(duration)

1 yrs.

ds.

mos.

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

Urinary analysis

(Signed)

Horace à Soule

, M. D.

@Address)

Winterof Mass

Date Nov 8, 1978

1,8 PLACE OF BURIAL, CREMATION, OR REMOVAL

Jethrop.

Winthrop.

(Cemetery)

(City of town)

DATE OF BURIAL nov. 9, 1928.

19 UNDERTAKER

ADDRESS

Charles R. Bennison. Winthrop.

20 | HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued (Km.D. Childress Official n /Vealthe officer

Date of issue of permit 11/8/20

Permit No. 1533

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. ... .

2FULL NAME

1 Burrill Terrace.St.

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

Ward,

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

1 PLACE OF DEATH County Suffolk

State Massachusetts

9 NAME OF

FATHER

John Mendell Swint

10 BIRTHPLACE OF

FATHER (City)

(State or country)

germany.

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 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 Scrvant, 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 discase; 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 da. 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.

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Town of Winthrop : Record of Deaths 1928-1930, Part 62

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

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