USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1932 > Part 63
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year)
Halifax,
(Address)
"Registrar of City or Town where deceased resided)
Sept. , 81932
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
is very important. See instructions and extracts from the laws on back of certificate.
100m-9-'31. No. 3385-f
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
(Signature of Agent of Board of Health or other) Dalthe Officer (Official Designation) (Date of Issue of Permits
9/03/2
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
Sept.
(Month
20,1932 (Year) (Day)
19 I HEREBY CERTIFY, That I attended deceased from Jeft, 18 , 19324 JELP-201032
I last saw h. alive on
Sept 201932, 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: Vraiemia A
Cate of Onset Sept18 1932
Contributory causes of importance not related to principal cause:
- 1
Отчика руосенино
10 years.
Name of operation.
What test confirmed diagnosis? Clinical on
Date of.
Was there an autopsy ?...
20 Was disease or injury in any way related to occupation of deceased?
If so, specify ..
quant. Bauru
(Signed)
M. D.
(Address).
E, Berlin, Nicas
Date diff 22 1952
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop Tintura
(Cemetery)
DATE OF BURIAL
9/23/32
(City or town) 19
22 NAME OF
UNDERTAKER
5/t leasant It L'iniltural
ADDRESS-
Received and filed
SEP S
19
A TRUE COPY, ATTEST:
(Registrar)
1
PLACE OF DEATH
Suffolk
(County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
160
(If death occurred in a hospital or institution, give its NAME instead of street and number?
2 FULL NAME
Jennie Sophia Sivencer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence.
No ...
5 Vina Cuiè
(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?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
temulite Lite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widow
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Latas Grensen
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE 7- / Years
.. Months
9
Days
If less than 1 day Hours. Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ....
Kansimile
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ....
at
came
10 Date deceased last worked at this occupation (month and year) ..
11 Total time (years) spent in this occupation.
12 BIRTHPLACE (City)
Kalmar
(State or country) wedin
13 NAME OF
FATHER
Tard Jonasson
PARENTS
14 BIRTHPLACE OF FATHER (City) (State or country)
15 MAIDEN NAME
OF MOTHER
not known
16 BIRTHPLACE OF MOTHER (City) .. (State or country) weder
Informant .....
(Address)
St.,
Ward
(If U. S. War Veteran,
St., ..........
Ward,
(If nonresident, give city or town and state)
(City er Town)
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
R-301
Sept. 201932
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 mer chants 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 modc 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
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 eause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
GOVERNING
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 thercfrom 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 cerietery 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. Ir 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 malre the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, trom one town to another within the common- wealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as re- ! quired by section ten of chapter forty-six, that the deccased 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 statement 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 by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.
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.
R-302
Norfolk
(County)
Medfield
(City or Town)
No. State Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Medfield
(City or town making return)
125
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Charles T. Ellis
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No ..
81 Court Road
St.,.
.....
Ward, Winthrop
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred 0 yrs. 2 mos.21
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
Sept.
20.
1932
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
Helen C .Cochrane
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
53
AGE
Years
1
Months
6 Days
If less than 1 day
Hours.
Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ....
Cigar salesman
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ..
Cigar
manufacturing
10 Date deceased last worked at
this occupation (month and
year)
1929
11 Total time (years)
spent in this
occupation.
12 BIRTHPLACE (City)
Boston,
(State or country)
Mass.
13 NAME OF
FATHER
Frank J. Ellis
PARENTS
(State or country)
Mass,
15 MAIDEN NAME
OF MOTHER
Anne May Herne
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
17
State Hospital Records
Informant
(Address)
Medfield, Mass.
A TRUE COPY.
ATTEST:
William H. Everett
(Registrar of city or town where death occurred)
DATE FILED
10/1/32
19
19 I HEREBY CERTIFY, That I attended deceased from
Sept. 15.
19.3.2to
Sept. 20,, 19 32
I last saw h.
im alive on
Sept. 19,
......
, 19.3.2., death is said
to have occurred on the date stated above, at 4.00 A. M.
The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
Ileo-colitis
9/15/32
Contributory causes of importance not related to principal cause:
Senility
Name of operation
None
What test confirmed diagnosis? P.h.y.s ..... &Labwas there an autopsy? } ...
1
20 Was disease or injury in any way related to occupation of deceased?
No.
If so, specify
(Signed)
Erel L. Guidone
M. D.
(Address) ... Medfield , ... Mass.
Date 9/.20/ 19.3.2.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthrop
(Cemetery)
(City or town)
DATE OF BURIAL
9/23 32
19
22 NAME OF
Charles A. Rolling
UNDERTAKER
ADDRESS
300 MeridianSt E Boston
Received and filed
OCT 1 .1932
....
19
(Registrar of City or Town where deceased resided)
important.
50m-2-30. No. 7997-d
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
1
PLACE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
St.,
Ward
(If U. S.
War Veteran,
specify WAR)
161
Date of
14 BIRTHPLACE OF
FATHER (City)
Boston.,
harles bleus Sept. 20, 19 32
M R-302
Middlesex
(County) Somerville
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
merve
(City or town making return)
Registered No.
684
(If death occurred in a hospital or institution, give its NAME instead of street and number)
162
2 FULL NAME
Alonzo A .Brooks
(If deceased is a married, widowed or divorced woman, give also maiden name.)
105 Grovers Ave. ,
St.,
Ward,
.... Winthrop
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Sept .25,1932.
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from Sopt .19,1932 . .. 19 to Sept .25,1932 19
I last saw Bra alive on Sept . 25, 1932 ... 19 .......... death is said to have occurred on the date stated above, at1.0.10₽ The principal canse of death and related causes of importance in order ot onset were as tollows:
Dateetonset
Carcinoma rectum
June 1932.
8 Trade, protession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Foreman
9 Industry or business in which work was done, as silk mill, Smith & Weston saw mill, bank, etc .......
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation ... DO
this occupation (mont
year) June 1919
12 BIRTHPLACE (City)
Warron,
Lass .
13 NAME OF
FATHER
Charles B. Brooks
14 BIRTHPLACE OF
FATHER (City)
Tass.
Warren,
15 MAIDEN NAME OF MOTHER Esther Shaw
16 BIRTHPLACE OF MOTHER (City) (State or country) Kass.
17 Minnie S. Brooks
(Address) 105 Grovers Ave . , Winthrop, Lass 22 NAME OF
I HEREBY CERTIFY that a satistactory standard certificate ot death was tiled with me BEFORE the burial or transit permit was issued: L.S .HOWARD
Exce. Clerk B. 8 . 9/27/32
(Official Designation) (Date of Issue of Permit)
Contributory causes ot importance not related to principal cause: .... Hypostatic ... Pneumonia ... Sept.22.
Name of operation
Colostomy
all 626/32
What test confirmed diagnosis? Clinical.
Was there an autopsy? ... no
20 Was disease or injury in any way related to occupation of deceased? ... no
If so, specify
G.Stanley Miles,
(Signed)
M. D.
(Address)ore rville, lass.
Da@/2.6
19
32
21 PLACE OF BURIAL,
Springfield, Springfield,
(Cemetery)
CREMATION OR REMOVAL
Lass .
Sept .28, 1932.
19
(City or towa)
DATE OF BURIAL
Francis M.Wilson, Inc.
UNDERTAKER
Somerville, Kass .
ADDRESS
Sept.28,1932.
OCT 4 ,1932
Received and filed
A TRUE COPY, ATTEST:
(Registrar)
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
Minnie (Sweeley)
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that tact here.
Years 11 Months
27 Days
It less than 1 day
Hours
Minutes
1 3 SEX 7 AGE 85 (State or country) PARENTS OCCUPATION Informant 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. SOM-11-'29. No. 7180-b N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- (State or country)
PLACE OF DEATH
No. Somerville .... Hosp ... Crocker St .,
.St.,
......
Ward
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of residence in city or town wbere deatb occurred
yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
Congo . cooper Sept. 25,1932
سبب
A R-301 A
PLACE OF DEATH
(County) Thanthropo"
(City or Town)
No. 33 Charles
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
163
(If death occurred in a hospital or institution, give its NAME instead of street and number)
John P Harlett.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
33
Charles
St.,.
..........
Ward,
(a)
Residence.
No.
(Usual place of abode)
Length of residence in city or town where death occurred JO VIS.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Mate White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED Lengte
(write the word)
18 DATE OF
DEATH
September
26
1932
(Year)
(Month)
(Day)
19 I HEREBY CERTIFY, That I attended deceased from august 29, 1932, to Sept. 25 1932.
I last saw h .. LAnalive on ...
Sept. 25
19 32, death is said
to have occurred on the date stated above, at. 1000Am. The principal cause of death and related causes of importance in order of Dateofonset onset were as follows: Quite Congestive HeartFails 9-21-32
Chrome cardio renal degenerati hoo. 1931
Contribatory causes of importance not related to principal cause: 5mility + gen. carterioscler
Name of operation
Date of
ho.
What test confirmed diagnosis? &ab. + clinical Was there an autopsy ?..
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
Lyman R. Orton
(Signed)
M. D.
(Address)
Tho. Wilmington Man Date 9-26 1932.
21 PLACE OF BURIAL,
Lambrida, Cambridge
(Cemetery
(City or town)
DATE OF BURIAL.
Lebt 28
18 32
22 NAME OF
UNDERTAKER
John Cryants Jour
ADDRESS
15- Crushute Chasi
19
(Registrar)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wm. S. Childress ASignature of Agent of Board of Health or other) ... 7. He rette Officer (Official Designation) (Date of Issue of Permit)
9/27/32
Dealer
O Industry or business in which work was done, as silk mill, saw mill, bank, etc.
Real Estate
10 Date deceased last worked at this occupation (month and e b) 1932 year)
11 Total time (years)
spent in this (years)57
occupation.
Charlestown
13 NAME OF
FATHER
William Hazlett
16 BIRTHPLACE OF
MOTHER (City)
Charlestown
(State or country)
17 fnformant .. (Address) Mit
.
amington, Dass.
St.,
Ward
(If U. S.
specify WAR)
(If nonresident, give city or town and state)
5a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
82
Years
9
Months 2 Days
If less than 1 day .Hours ..:. .Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
1 2 FULL NAME (or) WIFE of AGE OCCUPATION| 12 BIRTHPLACE (City) (State or country) 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME THER OF MOTHER PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 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 is very important. 75m-2-30. No. 7997-a N. B .- WRITE PLAINLY. WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country)
MEDICAL CERTIFICATE OF DEATH
Received and filed
SEP 23 .4932
Revised United States Standard Certificate of Death Sept. 26,1932
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 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 ycars the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employce, ' ." "worker," "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, ctc.
In stating the industry or business, avoid the use of such general terms as "store,' "factory,' "mill." ctc. 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:
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