Town of Winthrop : Record of Deaths 1928-1930, Part 66

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 66

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

(Usual place of abode)

15 DATE OF DEATH

(Month)

MEDICAL CERTIFICATE OF DEATH OSx 4

(Day)

1928 (Year)

man

(Address)

werteno when

14 026

Fil 1

City or Town

Wertlow

ida. 01.

Dec. 4. 1928

I 1

R-301 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS I PLACE OF DEATH County

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Wasthrox BOSTON

(City or town)

192

City or Town

Boston

No. 6G, Plemmur St

St. _Ward

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

2 FULL NAME

alice W. Hodno

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

66 Plumones St.

St.

Ward.

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

months days

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

1928.

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

hv 24

128

to.

1928

that I last saw h&

alive on

1928.

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

6:30P.

The CAUSE OF DEATH was as follows:

Chemie Myocarditis

(duration)

_yrs.

mos. .ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs.

.mos.

17 Where was disease contracted

if not at place of death?

Did an operation precede death ?.

Date of

Was there an autopsy ?.

If under one year, was infant

What test confirmed diagnosis? Lesm

Raymond B. Parker, M. D.

(Signed)

(Address) / Wintnich

Data

1928.

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION OR REMOVAL

DATE OF BURIAL Dre. 9. 1928

(Cemetery)

(City or town)

19 UNDERTAKER

ADDRESS

Boston

20 1 HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued Amit Childress

Official position

Health officer Date of issue

12/7/28 Permit NO. 15 g

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

PARENTS

10 BIRTHPLACE OF

FATHER (City)

Barnstable

(State or country)

usa

11 MAIDEN NAME

OF MOTHER

Charlotte 8. Build

12 BIRTHPLACE OF

MOTHER (City)

Streng

(State or country)

13 Harocd H. Hodges

Informant

(Address)

Radcliffe St Direbesten non

De, 18/24

Filed

(Month) (Day)/ (Year)

REGISTRAR

2011

3 SEX

4 COLOR OR RACE

winte

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

widow

Sa If married, widowed or divorced

HUSBAND of

(or) WIFE of

Javeces G. Hodno

6 AGE

Years

Months

Days

If LESS than 1 day, _._ hrs. OF_min.

If STILLBORN, enter that fact hore

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

Chr.+. Itallest.

Suffolk

State

Massachusetts

Registered

(a) Residence. No.

(Usual place of abode)

Langth of residence in city or town where death occurred

years

months

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

Alec 7. 1928 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- 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, eto. 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 CAUBING DEATH (the primary affection with respect to time and causatien), 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), 89 ds .; 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," eto

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, 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 ig gouged by viclones, 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 laws calls for the observance of the following rules of practice:

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

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

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

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

Boston

1 PLACE OF DEATH

County

Suffolk

State

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

EMMA O. HOWARTH

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

WINTHROP

No.

320 BOWDOIN

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

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed, or divorced

S HUSBAND

Name of ? (or) WIFE

REUBEN

6 AGE

Years

Months

Days

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

If STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

AT HOME

8 BIRTHPLACE (city or town)

N. WILBRAHAM

(State or country)

MASS.

9 NAME OF

FATHER

PEASE

10 BIRTHPLACE OF

FATHER (city or town).

N. WILBRAHAM

(State or country)

MASS.

11 MAIDEN NAME

OF MOTHER

CANNOT BE LEARNED

12 BIRTHPLACE OF

MOTHER (city or town)

(State or country)

ENGLAND

13 Informant

A. C. FLOYD

(Address)

320 BOWDOIN ST. WINTHROP

Filed

DEC. 15. 19 28.

Filed.

2.3:18

Registrar of city or town where death occurred

Registrar of city or town where deceased resided

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

DEC. II

(Month)

(Day)

(Year)

I HEREBY CERTIFY,

NOV. 30

DEC. 11

19.28

that I last saw h

alive on

DEC. 11

19 28

and that death occurred, on the date stated above, a:

The CAUSE OF DEATH was as follows:

(State fully)

CEREBRAL HEMORRHAGE

(duration)

yrs.

mos.

ds.

CONTRIBUTORY

ARTERIO SCLEROSIS

(SECONDARY)

(duration)

YT8.

mos

de.

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)

G. H. SCOTT

M. D.

(Address)

Date

DEC. 12. 1928

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

ORTH WILBRAHAM, MASS.

DATE OF BURIAL

12-17

. 19 28

(Cemetery) (City or town)

19 UNDERTAKER

F. J. CROSBY

ADDRESS

1312

Registered No.

City er to

10901/

( Place of death)

193

City or town

Boston

No. 6 WABON ST.

(a) Residence.

State

MASS.

City or Town

1928

That I attended deceased from

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

S SNVIDI PHYSIC

AGE should be stated EXACTLY.

should be carefully supplied.

Imma W.Vaworth

Dec. 11, 1928

R-301 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS I PLACE OF DEATH County Suffolk Winthrop

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Winthrop BOSTON

(City or town)

State Massachusetts

Registered No.

City or Town

Boston

No. 99, Winthrop

St., __ Ward

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

2 FULL NAME

Frank B. Snowman

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

99 Winthrop

St.

Ward.

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

months days

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

3 SEX

Male

4 COLOR OR RACE

White

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

Married

Sa If married, widowed or divorced

HUSBAND of

(or) WIFE of

Mary M.

6 AGE

Years

Months

Days

IF STILLBORN, enter that fact bers

7 OCCUPATION OF DECEASED

(a) Trade, profession, w

particular kind of work

(b) Name of employer

Retired

(duration)

_. yrs.

mos.

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

_yrs.

mos.

17 Where was disease contracted

if not at place of death ?.

ALIWHAT?

Did an operation precede death?

Date of

Was there an autopsy ?.

If under one year, was infant Breast

What test confirmed diagnosis?

Gayund

(Signed)

M. D.

(Addresy).

Date

(Month)

(Day) (Year)

18 PLACE OF BURIAL, CREMATION OR REMOVAL

Evergreen Portland M&

(Cemetery)

(City or town)

DATE OF BURIAL

Dec. 13,128

14 Filed Add :rizk

(Month) (Day) (Year)

REGISTRAR

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

Man. D. Childrens

Official position.

Dete of Viatile Ria Derait 12/12/20 10. 1972 Permit

instructions and extracts from the laws on back of certificate.

PARENTS

9 NAME OF

FATHER

Dojon Snowman

10 BIRTHPLACE OF

FATHER (City)

Renobscot

(State or country)

Mains

11 MAIDEN NAME

OF MOTHER

Isabell M. Pain

It Stwin

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

Maine

Mary

Informant

M. Snowman

Winthrop Mass

(Address)

19 UNDERTAKER

ADDRESS

C. Sério

000

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

(a) Residence. No.

(Usual place of abode)

Length of residence in city er town where death occurred

years

months

days.

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

years

1928

(Day)

(Year)

16 I HEREBY CERTIFY, That I attended deceased from Sept 30

192F.,

M LESS than

1 day,

that I last saw h

alive on

De 11

192F

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

Of ___ Min.

10 7. .m. The CAUSE OF DEATH was as follows:

Strach and

Portland

8 BIRTHPLACE (City)

(State or country)

Maine

15 DATE OF DEATH

(Month)

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- 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 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.

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

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 & 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 laws calls for the observance of the following rules of practice:

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

R-301

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

The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH

State_Mass

(City or town) Registered No.

175

City or Town

Winthrop

No.

16 Ocean Ave

St ... Ward

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

2FULL NAME

Kary Fraser

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

(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

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

william

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)

Antigonish

(State or country)

N.S.

9 NAME OF

FATHER

William Cleary

10 BIRTHPLACE OF

FATHER (City)

Antigonish

(State or country)

N.S.

1 1 MAIDEN NAME

OF MOTHER

Ann Blackwell

12 BIRTHPLACE OF

MOTHER (City)

Antigonish

(State or country)

F.S.

Informant

Mrs. Charles Flannagan

(Address)

16 Ocean Ave.

Altos 16/208

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

I'm. D. ildres position lealthe officer

Date of issue of permit /2/14:28

Permit

13/42

15 DATE OF DEATH

On 12

(Month)

(Day)

(Year)

16 I HEREBY CERTIFY

That I attended deceased from

24 to

, 19

that ! last saw h.

M alive on

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

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

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Town of Winthrop : Record of Deaths 1928-1930, Part 66

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

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