USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1932 > Part 43
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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.
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.
1
RM R-302
AV. D .- WALLE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE MARGIN DECEDVEN PAN DINE
PLACE OF DEATH
Lssex (County) Danvers
(City or Town) Ndanvers State Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No.
102
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Henry Callahan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
166 Bordoin
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
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
widowed
5a If married, widowed, or divorcednnot be leamed
HUSBAND of (Give maiden name of wife in full)
(or) WIFE of (Husband's name in full)
6 IF STILLBORN, enter that fact here.
63
7 AGE Years Months Days
If less than 1 day Hours Minutes
OCCUPATION|
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ...
Warehouse man
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ..
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
Henry Callahan
PARENTS
15 MAIDEN NAME
OF MOTHER
Julia ----
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Gertrude F. Smith,
Hathorne .......
Informant (Address)
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
6/27/32
DATE FILED 19
19 I HEREBY Dec.
CERTIFY, That I attended deceased from
June
19
to
Je15,32
......
death is said
I last saw h
alive on
1.451
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: Arteriosclerosis 1927 Dateofonset
Chr. myocarditis 1928
Contributory causes of importance not related to principal cause:
Alcoholic psychosis
Alcoholic de rioration
Nov .. 1930
Gastro-enteritis
June 1932.
Name of operation
Date of
no
What test confirmed diagnosis?
Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify .. Solomon Gagnon
(Signed)
Hathorne
6/21/32, M. D.
19
(Address)
Date
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Cemetery 32
Holy Cross
Malden
DATE OF BURIAL
19
22 NAME OF
John F. O'Halley
UNDERTAKER
Winthrop
ADDRESS.
Received and filed
JUL 1 1 1932
19
(Registrar of City or Town where deceased resided)
important.
50m-2-30. No. 7997- 1
(a)
Residence. No.
(Usual place of abode)
1
5
16
18 DATE OF
June 13, 1932
DEATH
(Month)
(Day)
(Year)
13 .
52
19
this occupation (month and
year)
14 BIRTHPLACE OF
FATHER (City)
Ireland
(State or country)
(City or town)
1
.St.,
.......... .... Ward {
(If U. S. War Veteran, specify WAR)
20
June 13, ) 932
M R-301A
1
(County)
Winthrop
.......
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 .. 103
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Charles O. Whitney
(If deceased is a married, widowed or divorced woman, give also maiden name.)
267 Washington ave St.,
(a)
Residence.
No ..
Ward,
(Usual place of abode)
Length of residence in city or town where death occurred 35 m.
days.
mos.
How long in U. S., if of foreign birth?
yTS.
(If nonresident. give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
2 SEX
Whale
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Quarried
5a If married, widowed, or divorced
HUSBAND of
(XGive maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE ...
60
Years \
3
Months
20 Days
If less than 1 day Hours. Minutes
OCCUPATION
8 Trade, profession, or particular
kind of work done, as spinner Letved
sawyer, bookkeeper, etc.
9 Industry or business in which
work was done, as silk mill,
saw mill, bank, etc.
Garage Proprietor
10 Date deceased last worked at
this occupation (month and
year)
1929
Cambridge
11 Total time (years)
spent in this
occupation
15 yrs.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Charles D. 2 litrey
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Cambridge
(State or country)
mass
15 MAIDEN NAME
OF MOTHER
Mary Eaton
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
mass!
17 Mrs. C. O. Whitney
Informant
(Addre 1267 Washington and Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Im. & Culdress (Signature of Agent of Board of Health or other) Dealle Officer (Official Designation) (Date of Issue of Permit)
6/15/32
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June
15
1932
(Year)
(Month)
(Day)
19)
I HEREBY CERTIFY , That ! attended deceased from
1,1932
19.3.2 to top 15
19.3.1
! last saw h .¿..... alive on ... ,
19.3 .. 2 ... death is said
to have occurred on the date stated above, at. The principal cause of death and related causes of importance in order of onset were as follows:
Thematic I heart Almeno ( Explicarditi
Date of Onset 150 ago
Contributory causes of importance not related to principal cause:
Hyporeal
men
Name of operation
200000
Date of.
What test confirmed diagnosis? cannage
Was there an autopsy ?......
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
BunTem Como Date free /5 1932
(Address)
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Lakeside
DATE OF BURIAL
(Cemetery)
Que 18
22 NAME OF
Short Williamson , Inc .
UNDERTAKER
ADDRESS
173 Brighton ave allston
Received and filed
JUN 20 1932
19
(Registrar)
AV AUINIU DLALA INA-THIS IS A PERMANENT RECORD. Every item of
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 is very important. See instructions and extracts from the laws on back of certificate.
100m-0-'30. No. 9954.
PLACE OF DEATH
(City or Town) No. 267 Washington Ce St.,.
Ward
If U. S.
specify WAR)
Margaret Vac Quarice
11.30 AM
M. D.
Wakefield (City ordown) 19:32
Revised United States Standard Certificate of Death
the
15,1932
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 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 donc.
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," ete. 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
1015
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 deatlı 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 deccased, 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 secn 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 deccased 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.
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 is very important. See instructions and extracts from the laws on back of certificate.
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No.
I7 Edgehill Road
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.
104
(If death occurred in a hospital or institution,
.... ........ .Ward give its NAME instead of street and number)
2 FULL NAME
Charles V Elliott
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.I .?..... Edgehill Road.
(Usual place of abode)
.St., .............
Ward,
(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
Male
-
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widower
5a If married, widowed, or divorced
dw. Marsh.
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
AGE .. 63
Years
3
25
Days
If less than 1 day
.Hours.
Minutes
OCCUPATION:
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ....
Fish Dealer
9 Industry or business in which
work was done, as silk mill,
Fish Market
saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
this occupation (month andApril 1933pent in this
occupation
40
year)
12 BIRTHPLACE (City)
Wellfleet
(State or country)
Mase.
13 NAME OF
FATHER
John R.Elliott.
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Truro
(State or country)
15 MAIDEN NAME
OF MOTHER
Jerusha B.Ryder.
16 BIRTHPLACE OF
MOTHER (City)
Truro.
(State or country)
17 John R.Elliott.
Informant (Address) 49 Pinckney St Boston Va
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the butlal or transit permit was issued: N.m.D. Childress (Signature of Agent of Board of Health or other) Health Aplicar 6/18/32 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June 15 1932
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from march 1
I last saw hAm alive on
, 193
gumm 150
-
death is said
Date of Onset 1939 to have occurred on the date stated above, at. The principal cause of death and related causes of importance in order of onset were as follows: Cardiac Hypertrophy chroni candiles
mitral dieses
1927 1425
Contributory causes of importance not related to principal cause:
Name of operation
What test confirmed diagnosis? XRay
Date of.
Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
, M. D.
(Address)
72C/Sametoga
Date Taan 19
.....
21 PLACE OF BURIAL.
CREMATION OR REMOVAL
Woodlawn
Everett
(Cemetery)
(City or town)
DATE OF BURIAL
Sat.June18
19.33
22 NAME OF
UNDERTAKER
ADD
300 Meridian At. E. Boston.
Received and filed
JUN 20 1332
19
(Registrar)
100m-9-'30. No. 9954
WWWUND ATEAMMANNENI KECORD. Every item of
M R-301 A
1
Registered No
St.,
(If U. S. War Veteran, specify WAR)
1932, to
9mm 15
1932
8Pm. .m.
m
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 whosc 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.
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 dicd; 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.
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