USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1932 > Part 12
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Example
The principal cause of death and related causes of importance in order of onset were as follows:
Date of onset
Arteriosclerosis
1015
Chronic interstitial nephritis
1021
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 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.
DRM R-301A
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. 7997-7 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS
Suffolk.
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.
28
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Offre Marilla Sarle.
(If deceased is a married, widowed ør divorced woman, give also maiden name.)
49 hostet Que
St.,
Ward,
(a) Residence.
No ....
(Usual place of abode)
Length of residence in city or town where death occurred
Z
yrs.
2
mos.
days. How long in U. S., if of foreign birth? yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Garde
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
82
Years
Months
4 Days
If less than 1 day
.. Hours
Minutes
OCCUPATION'
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
9 Industry or business in which
work was done, as silk mill,
saw mill, bank, etc .....
at home
10 Date deceased last worked at
this occupation (month and
year) ..
Rutland
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
John Stones
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Estirsham
Mass
15 MAIDEN NAME
OF MOTHER
Dorcas S Perry
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass
17 Mys Charles G. Cook,
Informant ..
499 restrict au Mlinitheof
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: W m. E. hildring (Signature of Agent of Board of Health or other)
Healthe Office (Official Designation) (Date of Issue of Pepmit)
2/19/32
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
19 I HEREBY CERTIFY, That I attended deceased from
Fely 13
19.5.2 ... to
Fely 18
19 6 2
18
1 last saw h ........... alive on
1932 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 of onset were as follows: Cerebel lic meulage Fy Dateofonset 13-1982
Contributory causes of importance not related to principal cause:
year
Cerberio selcasio years
duration.
Name of operation
What test confirmed diagnosis?
chinees Was there an autopsy?
...
20 Was disease or injury in any way related to occupation of deceased?
Di0
If so, specify_
(Address)
21 PLACE OF BURIAL
CREMATION OR REMOVAL .
Ruaul Forcesten Mass
DATE OF BURIAL.
Sub21
(City or town)
1932
22 NAME OF
UNDERTAKER
Mr E.t. Season.
ADDR
385 Mastunglow St Varchuster
Received and filed
19
FEB 2.5 1932
gistrar )
1
PLACE OF DEATH
(County) Manthish
(City of Town) No. 49 Ersofet aux. St., ...
Ward
(If U. S.
War Veteran,
Lagt HAR Mass
(If nonresident, give city or town and state)
(Cemetery)
Date of
(Signed)
1232bewerbung St
Date
Fely18932
M. D.
18
1932
(Year)
AGE
Revised United States Standard Certificate of Death Ach, 18,1932
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 ovcr. If the occupation had been given up or changed. on account of the discase 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," "opcrative," 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.
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 be' ief the name of the deccascd, 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 ease 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 interinent, 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.
RM R-302
Middlesex
(County) Cambridge
(City or Town) Holy Ghost Hospital No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Cambridge (City or town making return)
Registered No.
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Henry L Orpin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
200 Lincoln
St., ...............
. Ward,
Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
M
4 COLOR OR RACE
(write the word)
Sin -le
5a 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.
7
63
AGE Years Months Days
If less than 1 day
.Hours
.Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ..
Electrician
9 Industry or business in which
work was done, as silk mill,
saw mill, bank, etc.
Western Electric Co
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation.
this occupation - frontmand30
year)
35
oston
12 BIRTHPLACE (City)
(State or country)
Nass.
13 NAME OF
FATHER
William
14 BIRTHPLACE OF
FATHER (City)
Ireland
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Sullivan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
John Ryan
Informant
(Address)
200 Lincoln St.
A TRUE COPY.
Frederick H. Burke
ATTEST:
Feb 20 1932
(Registrar of city or town where death occurred)
DATE FILED
19
MEDICAL CERTIFICATE OF DEATH
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from 2/1 19 32 to 2/19 19 ... 3.2
I last saw
h .... Imalive on
2/18
19.32
death is said
to have occurred on the date stated above, at.
9/201
The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
Myocarditis
6/30
Contributory causes of importance not related to principal cause:
Arteriosclerosis
19.27
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsymo
20 Was disease or injury in any way related to occupation of deceased? If so, specify.
(Signed)
Geo. Connor
M. D.
(Address)
299 Broadway
Dat21.19.
.1932.
Holyhood Cem. Brookline
DATE OF BURIAL
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Feb 22 1932
19
(City or town)
22 NAME OF
UNDERTAKER
John F O Maley
ADDRESS
Winthrop
MAR 1 4 1932
Received and filed
19
"Registrar of City or Town where deceased resided)
OCCUPATION| 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 important. 50m-2-'30. No. 799" N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- PARENTS
1
PLACE OF DEATH
St.
..... .Ward
(If U. S.
War Veteran,
specify WAR)
29
(a)
Residence.
No ..
(Usual place of abode)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
18 DATE OF
2 -19-1932
Henry & Certain Feb-19, 1932
RM R-301
PLACE OF DEATH
Suffolk County) Winthrop. (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
30
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
Walker
(If U. S.
War Veteran,
specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
49 Read
.St., ...
.. Ward,
(If nonresident give city or town and state)
Length of residence in city or town where death occurred 3 5 yrs. mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
Married.
Sa If married, widowed, or diverseti abeth Bainbridge
HUSBAND of
(Give maiden name of wife (in full)
If less than 1 day
Hours.
.Minutes
natural Com
Trop Cemetery
saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
this occupation (month and Feb.18,1932
spent in this
year)
occupation.
23
13 NAME OF
FATHER
Samuel Walker.
15 MAIDEN NAME
OF MOTHER
Unable to obtain.
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
17
Informant
(Address)
20 Center St. Winthrop.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: I m. D. Ceux dreef (Signature of Agent of Board of Health OFother)
2/20/32
(Official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
7 26
19
1932
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
1
.
·
19
1 last saw h ............ alive on 19 death is said
to have occurred on the date stated above, 9A m. The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset
Ich 19 , 1932 .
Contributory canses of importance not related to principal cause:
None
Name of operation.
What test confirmed diagnosis tweetagehen.
.Date of
Was there an autopsy? :
N
20 Was disease or injury in any way related to occupation of deceased?
f so, speci Pay B Parker
M. D.
(Signed)
Writing Brand of Health
Date 1/ 20 1932
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Mt Auburn Cambridge.
(Cemetery)
(City or town)
DATE OF BURIAL
February 21,
19.3.2
22 NAME OF
charles. R. Bennison.
ADDRESS
Winthrop. Mass
Received and filed
FEB 2: 1939
19
A TRUE COPY, ATTEST:
(Registrar)
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state MARGIN RESERVED CAP_SINDIMA
1 No 159 Winthrop Robert 2 FULL NAME (a) Residence. No. (Usual place of abode) 3 SEX 4 COLOR OR RACE White 5 SINGLE MARRIED WIDOWED or DIVORCED Male (or) WIFE of (Husband's name in full) 6 IF STILLBORN, enter that fact here. 7 65 AGE Years X .Months 25 Days 8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. ... Foreman. 9 Industry or business in which OCCUPATION 12 BIRTHPLACE (City). (State or country) England. 14 BIRTHPLACE OF FATHER (City) (State or country) England. PARENTS Ernest R. Walker. Hatte Officer N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 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 work was done, as silk mill, Winthrop 100m-11-'30. No. 605-b
St., ................ Ward
Revised United States Standard Certificate of Death Feb.19, 1932
Statement of occupation .- Precise statement of occupation is ervy 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.
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