Town of Winthrop : Record of Deaths 1931, Part 45

Author: Winthrop (Mass.)
Publication date: 1931
Publisher:
Number of Pages: 540

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1931 > 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 ceme- tery or burial ground in which the interment is made .. . Chap. 114. Sec. 46, G. L., as amended.

State cause for which surgical operation was undertaken.

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.

MI R-302

Suffolk

(County)

Chelsea

(City or Town) No. Chelsea Memorial Host.

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

Chelsea

(City or town making return)

Registered No

340

.....

7/7

2 FULL NAME

David Joserh Gaddis

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a)

Residence. No.

23 Charles

St.,

Ward,

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred

Jrs.

mos.

days.

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

yTs.

mos. days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

white

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

married

5a If married, widowed, or divorced

Margaret Mansfield (Baddis)

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE 39 21 Months Days

If less than 1 day

Hours

Minutes

8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.

Asst. Treasurer

9 Industry or business in which work was done, as silk millSterling Paint Co. saw mill, bank, etc .....

10 Date deceased last worked at

11 Total time (years)

spent in thisg

occupation .. ..

12 BIRTHPLACE (City)

Cambridge,

Mass.

13 NAME OF

FATHER

David Gaddis

Ireland

15 MAIDEN NAME

OF MOTHER

Sarah Dixon

Ireland

Margaret Gaddis

(Address)

23 Cartes St.

(Registrar of city or town where death occurred)

DATE FILED June 8, 31

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

June 8, 1931

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

June 4,

June 8,

I last saw h

alive on

June 8,

death is said

2.40

A.M.

to have occurred on the date stated above,

The principal cause of death and related causes of importance in order of onset were as follows: Intestinal obstruction Dateofonset ... intussusception

DAT af inogange pot related to principal cause:

Hemor tilen

inteSoustraction

Name of operation

What test confirmed diagnosis Inical

Was there an autopsy20

20 Was disease or injury in any way related to occupation of deceased? n.Q. If so, specify ...

(Signed)

layton

(Address)

270 Conpascalth

Date

6/8

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Calvary

boston

DATE OF BURIAL

22 NAME OF

John W.O'Waley

UNDERTAKER

ADDRESS

Winthrop

Received and filed

JUIN 27 1931

(Registrar of City or Town where deceased resided)

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

St.,.

..... Ward

(LE U. S. War Veteran, specify WAR) winthrop

(Usual place of abode)

1 3 SEX Male HUSBAND of 7 this occu year) OCCUPATIONI (State or country) 14 BIRTHPLACE OF FATHER (City) 16 BIRTHPLACE OF PARENTS MOTHER (City) (State or country) Informant A TRUE COPY. tion should be carefully supplied. 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 ATTEST: important. 50m-2-'30. No. 7997- N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every nem vi Iivilla- (State or country)

PLACE OF DEATH

6/7/31

Av. Boston

(City or town) 31

dune 8,190

R-301 A

PLACE OF DEATH

(County) Winthrop, max. (City of Town) 15 Tewksbury No.

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

To be filed for burial permit with Board of Health or its Agent.

Registered No.

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

man

Bertha Surman

(If deceased is a marzied, widowed or divorced woman, give also maiden name.)

15 Tentestury

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

(If nonresident, give city or town and state)

days.

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

June

(Month)

(Day)

19.31 (Year)

19 I HEREBY CERTIFY, That | attended deceased from

May 31

1931, to

June y

1931

I last saw hun alive on

June 90

193. [ ..... , death is said

to have occurred on the date stated above, at ... 6 .. m.

The principal cause of death and related causes of importance in order of onset were as follows: Fi paral Setticemia anaphylaxis due to brand transfusion

Dateofonset June 4

Contributory causes of importance not related to principal cause:

Name of operation

Date of

What test confirmed diagnosis?

Was there an autopsy? MOT

20 Was disease or injury in any way related to occupation of deceased? .

If so, specify.

(Signed)

A.s.S. Rotman

M. D.

47 Washington ave Date June 10 1931

Beth Lareal

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

(Cemetery)

DATE OF BURIAL

June

22 NAME OF

UNDERTAKER

aubert Black

ADDRESS

JUM 16 1931

Received and filed .19

(Registrar)

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

(a)

Residence. No.

(Usual place of abode)

Length of residence in city or town where death occurred

утв.

4 COLOR OR, RACE

White

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

married

5a If married, widowed, or divorced

HUSBAND of

Joseph

(Give maiden name of wife in full)

Furman

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 32 Years Months Days

If less than 1 day

Hours

Minutes

8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ....

Housewife .

9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.

at home

10 Date deceased last worked at

11 Total time (years)

spent in this

this occupation (month and

year) ..

april 193

12 BIRTHPLACE (City)

Palestine

(State or country)

Jerusalem

13 NAME OF

FATHER

Solomon Gottliet

Palestina

15 MAIDEN NAME

OF MOTHER

Daich youdilovitz

Palestine

17 Joseph Jurman.

Informant (Address) 15 Touslesbury At Winthrop

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: wm. D. Childress

Signature of Agent of Blard & Health or other)

6/10/31

Health Office "Official Designation) (Date of Issue of Permit)

St.

Ward

MOS.

If days. How long in U. S., if of foreign birth? 23 O yrs.

1 2 FULL NAME 3 SEX Female (or) WIFE of AGE 14 BIRTHPLACE OF FATHER (City) PARENTS OCCUPATION| 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 information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 75m-2-'30. No. 7997-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT KECURD. Every item or (State or country)

- - -

(City or town) 19.3.1

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Fernsehum

Revised United States Standard Certif

certificate of Death

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.

To be complete, an occupation return must state:

8 .- The trade, profession, or particular kind of work done.

9 .- The industry or business in which the work was done.

10 .- The month and year the deceased last worked at the occupation. 11 .- The number of years the deceased followed the occupation.

In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.

In stating the industry or business, avoid the use of such general terms as "store, ' "'factory,' "mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.

Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.

Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.

Example

The principal cause of death and related causes of importance in order of onset were as follows:

Date of onset

Arteriosclerosis

1915

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause:

In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. "The principal cause in the above example happens to be the second cause given.

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, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, 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 satis- factory 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 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 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 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 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 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 fulfillment 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 un- related to any form of injury, have died without recent medical attend- ance 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.

Ri R-301 A

information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A I LANVIANALIN 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

PLACE OF DEATH

Suffolk (County)h

Gosto notifies

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

To be filed for burial permit with Board of Health or its Agent. 119 120

Registered No.

(If death occurred in a hospital or institution,

give its NAME instead of street and number)

2 FULL NAME Jessie Botrell Allen

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence.

No.56 Hancock St. Boston, Mass.

Ward,

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred

yrs.

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

yrs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Time

10 1931

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That i attended deceased from

Jima.

198 ......

Jime 7

19 3.4., to

I last saw h . alive on

9. . ..... , 19 3 .. /., death is said

to have occurred on the date stated above, at. ......... A.m. The principal cause of death and related causes of importance in order of onset were as follows: Lobar Paumonia Datoofonset

Kolt Bana

Contributory causes of importance not related to principal cause:

myo condition

5.2cm

Name of operation

What test confirmed diagnosis?

Date of

Was there an autopsy?

20 Was disease or injury in any way related to occupation of deceased?

If so, specify.

(Signed)

Nare W. Santael

M. D.

(Address)

V. Bou State Ro Date 5 May 10 1931

21 PLACE OF BURIAL, Mt.Auburn Cem

CREMATION OR REMOVAL

(CemeteCambridgeyMas's

DATE OF BURIAL

une 121921

22 NAME OF

UNDERTAKER

IS Waterman, Vous

ADDRESS 495 Commonwealth Ave. Boston

Received and filed

JUN 16 1931

.. 19.

(Registrar)

75m-2-'30. No. 7997-a

Informant Gladys Johnson (daughter) (Address 03 Winthrop St., Winthrop, Magg

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:

Com. Whilders

(Signature of Agent of Board of Health or other)

N.O.

12/3/

(Official Designation)

(Date of Issue of Permit)

5 SINGLE

(write the word)

MARRIED

OF DIVORCED

5a If married, widowed, or divorced HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of Fredenic 4.Alcan

6 IF STILLBORN, enter that fact here.

AGE 78 Years .6Months I.8. ... Days

If less than 1 day

Hours

.Minutes

8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc .. Housework

9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.

OwnHome

11 Total time (years)

10 Date deceased last worked at this occupation (month and year) ..

May 193I

spent in this

12 BIRTHPLACE (CitSt.Johns Newfoundland (State or country)

13 NAME OF FATHER Richard Atwell

PARENTS

14 BIRTHPLACE OF FATHER (City Devonshire, England

(State or country)

15 MAIDEN NAME

OF MOTHER

Eliza Luscomb

16 BIRTHPLACE OF MOTHER (City) Devenshire, England

(State or country)

occupation.

OCCUPATIONI

Winthrop

(City or Town) I23 Winthrop St. , Winthrop Mass. .Ward

(If U. S. War Veteran,

specify WAR;

(Usual place of abode)

3 SEX

female

4 COLOR OR RACE

white

Sinon 6.30

Revised United States Standard Certificate of Death

To be complete, an occupation return must state:

8 .- The trade, profession, or particular kind of work done.

9 .- The industry or business in which the work was done.

10 .- The month and year the deceased last worked at the occupation.

"11 .- The number of years the deceased followed the occupation.

In stating the occupation, avoid the use of such indefinite terms as "employee, " "worker. "" "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.

In stating the industry or business, avoid the use of such general terms as "store. " "factory, "

"mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.

Example

The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis

Date of onset

1915

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause:

In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.

EXTRACTS TR

FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

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Town of Winthrop : Record of Deaths 1931, Part 45

Author: Winthrop (Mass.) Publication date: 1931 Publisher: Number of Pages: 540

Author: Winthrop (Mass.)
Publication date: 1931
Publisher:
Number of Pages: 540