Town of Winthrop : Record of Deaths 1931, Part 74

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1931 > Part 74


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(a)


Residence.


No.


65 Cours Ry


.St.,


(Usual place of abode) Length of residence in city or town where death occurred yrs.


mos.


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


yra.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


harried


5a If married, widowed HUSBAND of Mary C. M Grann (Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


AGE ..


7 64 Years Months Days


If less than 1 day


Hours


Minutes


8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. 9 Industry or business in which work was done, as tilk mill, saw mill, bank, etc.


Hotel Proprietor


10 Date deceased last worked at


11 Total time (years)


3 yrs


spent in this/5 MAo


occupation


year)


12 BIRTHPLACE (City)


(State or country)


Mais


13 NAME OF


FATHER


John Lane


14 BIRTHPLACE OF


FATHER (City)


Jeland


(State or country)


15 MAIDEN NAME


OF MOTHER


Ann Joomay


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


17 no. Ju. C. Leane


Informant


(Address)


65 Court Road


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


(Signature of Agent of Board of Health or other)


Health officer 10/13/31


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


(Month)


(Day)


19 I HEREBY


CERTIFY, That I attended deceased from


19


19


., to


I last saw h ..........


.alive on


19


death is said


to have occurred on the date stated above, at


m.


The principal cause of death and related causes of importance in order ot


onset were as follows:


Date of Onset


(fim luctry )


Contributory causes of importance not related to principal cause:


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)


(Address).


., M. D.


21 PLACE OF BURIAL,


DATE OF BURIAL


let 1 14


(City or town) 193


22 NAME OF


UNDERTAKER


Fredk & muaquatto


ADDRESS


cart Button


Received and filed


OCT 19.1931


19


(Registrar)


1


RM R-301A


1


No ..


2 FULL NAME


(If U. S.


War Veteran,


specify WAR)


Ward,


(If nonresident, give city or town and state)


(write the word)


1


1931


(Year)


3 yrs


hetatt


Oct. 11,1931


Revised United States Standard 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: 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 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 à 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.


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.


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 rertify to such deaths only as those of persons who, though disabled by recognized disease un- 1Mlated 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.


RM R-301 A


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 100m-9-'30. No. 9954 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS


PLACE OF DEATH


Suffolki (County)


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. 197


(If death occurred in a hospital or institution,


give its NAME instead of street and number)


Nina Dunn (Allen) Belcher.


2 FULL NAME


(If U. S.


War Veteran,


specify WAR)


(a)


Residence. No. 153 Winthrop


(Usual place of abode)


Length of residence in city or town where death occurred


50 .


mos.


St.,


Ward,


(If nonresident, give city or town and state)


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


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Female


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married.


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


e mailen name of wife in full)


David Belcher


(Husband's name in full)


6 IF STILLBORN, enter that fact here


AGE


7


66


Years


10


Months .


22 Days


If less than 1 day


Hours


Minutes


8 Trade, profession, or particular


kind of work done, as spinner,


sawyer, bookkeeper, etc ..


at home


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


10 Date deceased last worked at


this occupation (month and


year) .


11 Total time (years)


spent in this


occupation


12 BIRTHPLACE (City).


(State or country)


Nova Scotia.


13 NAME OF FATHER Henry H. Allen.


14 BIRTHPLACE OF


FATHER (City)


Allendale.


Nova Scotia.


15 MAIDEN NAME


OF MOTHER


Arabella Dunn.


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Nova Scotia.


17 at David Belcher. Informant (Address) 153 Winthrop St.


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


(Signature of Agent of Board of Health or other)


Health oficer 10/13/3/


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


11


1931


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


11


que


1930, to


Cut


31


19


I Just saw her alive on 10, 19/, death is said to have occurred on the date stated above, at 6 Pm The principal cause of death and related causes of importance in order of Date of Onset onset were as follows: Cammina lift Bucont.


July 1930


Cent 6,1931


Contributory causes of importance not related to principal cause:


Name of operation


What test confirmed diagnosis and Of


Date of


Was there an autopsy? Na


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


( Signed)


mond & Garten


M. D.


dress) Wintry Juan


Date Not 13 1931


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Winthrop Winthrop


( Cemetery)


(City of town)


1931,


DATE OF BURIAL


October 14.


22 NAME OF


UNDERTAKER


Charles P. Bennison.


ADDRESS


Winthrop Moss.


Received and filed OCT 2 0 1931 19


(Registrar)


1


Winthrop. (City or Town)


No 153 Winthrop St., Ward


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


Allendale


(State or country)


Allendale.


sicher


Oct. 11, 1991


Revised United States Standard 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: Arteriosclerosis


Date of onset


1915


Chronic interstitial nephritis


I021


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 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, atter 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.


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.


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.


OCCUPATIONI 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 100m-9-'30. No. 9954. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS


PLACE OF DEATH


Winthrop (City or Town) No. Sta Fosp., Fort Banks, Mass


Manchester notified The Commonwealth of Massachusetts OFFICE OF THE SECRETARY Suffolk DIVISION OF VITAL STATISTICS (County) STANDARD CERTIFICATE OF DEATH


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


198


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


2 FULL NAME Baby Pennington


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


(a)


Residence. No.


(Usual place of abode)


Length of residence in city or town where death occurred


yTs.


mos.


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


mos. days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Male


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


Single


Sa If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here


Stillborn


7 AGE O Years. 0 .Months .. O .. Days


If less than 1 day 0 .. Hours.


.Minutes


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


None


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


None


10 Date deceased last worked at


this occupation (month and


year)


Finne


11 Total time (years)


spent in this


occupation


None


12 BIRTHPLACE (City)


Fort Banks, Mass


(State or country)


13 NAME OF


FATHER


Joel Pennington


14 BIRTHPLACE OF


FATHER (City)


Decator,


(State or country)


Mfiss.


15 MAIDEN NAME


OF MOTHER


Lillian Olson,


16 BIRTHPLACE OF


MOTHER (City)


Manchester.,


(State or country)


N.H.


17 Joel. ParaLla-


Informant (Address) Женский


n.M.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal or, transit permit was issued: Man. D. Childilga (Signature of Agent of Beard of Health or other) I Health ifficer 10/13/31


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


October


(Month)


12. 19.3.1.


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


October 12,


19.3.1, to.


October 12.


......


19 ..... 31


I last saw hill ...... ativecon 19. ., death is said


to have occurred on the date stated above, at.9.2.3.0.p. m. The principal cause of death and related causes of importance in order of onset were as follows:


Date of Onset


Asphyxia birth




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