USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1933 > Part 35
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(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.
ORM R-302
PLACE OF DEATH
SUFFOLK (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No ..
353.7
(If death occurred in a hospital or institution,
Ward give its NAME instead of street and number)
......... ....
Robertson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
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
(write the word)
married
Cordelia Wheeler
If less than 1 day
Hours
. Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. stenographer
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
10
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
April
13.
19.33
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
Oct
7
,1991.7 to ... April
13 ...... , 19 ... 33
I last saw h ...
im alive on
April
.12.
.3.3 ., death is said
to have occurred on the date stated above, at.3 ... 3.0A .m.
The principal cause of death and related causes of importance in order of
onset were as follows:
Pategtogset
myocarditis
10/1/17
Contributory causes of importance not related to principal cause:
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy? no.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
G.M. Muttart
M. D.
(Address)
East Boston
Date 4/13 / 19 33
22 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthrop
(Cemetery)
(City or town)
DATE OF BURIAL
April
15
19.33 ..
22 NAME OF
118 Princeton St EB
UNDERTAKER
J.F. ... OMaloy.
ADDRESS
Winthrop
Received and filed
APR 19 1933
19
(Registrar of City or Town where deceased resided)
BOSTON 1 (City or Town) No .. 118 Princeton 2 FULL NAME Hermon.Byron (a) Residence. No. 7.8 .. Atlantia (Usual place of abode) 3 SEX 4 COLOR OR RACE M W 5 SINGLE MARRIED WIDOWED or DIVORCED 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 AGE 30 Years 10 Months Days 9 Industry or business in which work was done, as silk mill, this occupation (month and year) day 1931. 12 BIRTHPLACE (City) (State or country) East Boston Mass 14 BIRTHPLACE OF FATHER (City) (State or country) New Brunswick 15 MAIDEN NAME OF MOTHER Ella Ward PARENTS OCCUPATION 16 BIRTHPLACE OF MOTHER (City) (State or country) 17 Informant Mrs ... A Robertson (Address) A TRUE COPY. ATTEST: James important. DATE FILED April 15 50m-2-'30. No. 7997-đ N. B .- WRITE 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 saw mill, bank, etc. Edison Elee.
MARGIN RESERVED FOR BINDING
13 NAME OF
FATHER
Artemas Robertson
New Brunswick
A. Mulvey
(Registrar of city
Town where death occurred
19 33
(If U. S. War Veteran, specify WAR)
84
St.,
Ward,
Winthrop
(If nonresident, give city or town and state)
St.,
DRM R-301A
Suffolk /(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.
85
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Chimie Olive Pearett Hodyden
(If deceased is a married, widowed or divorced woman, give also maiden name.)
4 Prescinist
St.,.
yTs.
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)
elfamid
5a If married, widowed, or divorced
HUSBAND of
Jeche Plodydon
(or) WIFE of
Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
63
AGE
Years.
3
Months
21
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.
Etenerife
at There
10 Date deceased last worked at is occu
11 Total time (years)
20Nov 1932 spent in this year)
occupation ..
Sacco
12 BIRTHPLACE (City) (State or country) Elfaire
13 NAME OF
FATHER
Junge A. Jeanett
14 BIRTHPLACE OF
FATHER (City)
Bostan
elfam
(State or country)
15 MAIDEN NAME OF MOTHER Sarah Olive Lombard
Sacco
16 BIRTHPLACE OF MOTHER (City) (State or country) esfaire
17 George E gladzden
Informant (Address)
I HEREBY CERTITY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other) april 17/33
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
april
14
1933
(Year)
19
I HEREBY CERTIFY, That i attended deceased from
July
1934 to Cfr. 14
1953
I last saw her alive on ofer 014 19.33, death is said to have occurred on the date stated above, at 4/125 G m.
The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset IMPORTANT
Carcinoma- reliopentonel glands.
about
Sept .193L
Contributory causes of importance not related to principal cause:
secondary anaemia
Date of. Que-1952 Name of operation lash aughmalignant. What test confirmed diagnosis? Lab
Was there an autopsy? 200
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
i Wanton
M. D.
(Address) 270CommanntilLin
Date 4/15
19 33
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winter - Winterh
DATE OF BURIAL
(Cemetery)
April 17
(City or town)
19 33
22 NAME OF
UNDERTAKER
Richard H. White
ADDRESS
151 Pleuras
Received and filed.
19
: X 21 1933
(Registrar)
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.
75m-5-'32. No. 5469
information 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
1
PLACE OF DEATH
No
(City or Town) 4 Primit ST St., .Ward
Ward,
(u U. S. War Veteran, specify WAR)
(a) Residence.
No ..
(Usual place of abode)
Length of residence in city or town where death occurred
(If nonresident, give city or town and state)
(Month)
(Day)
MARGIN RESERVED FOR BINDING
PARENTS
(Signed)
/
1
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:
Date of onset
, Arteriosclerosis
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.
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 such a permit for the removal of a human body. not previously interred from 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 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 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 os 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 .... Chop. 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.
FRM R-302
SUFFOLK
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON 86
(City or town making return)
Registered No.
3.72.1
(If death occurred in a hospital or institution,
give its NAME instead of strect and number)
2 FULL NAME
William
Luppold
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence.
No.
105 Bartlett Rd
.St., ...........
. Ward, ....
.Winthrop
(Usual place of abode)
Length of residence in city or town where death occurred уrs.
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
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorced
HUSBAND of
Anne J Power
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE 5.8 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 .. clerk
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)
this occupation
year)
April 1933
spent in this
occupation
13
12 BIRTHPLACE (City)
B.o.st.on
(State or country)
Mass
13 NAME OF
FATHER
Eugene Luppold
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Germany
15 MAIDEN NAME
OF MOTHER
Maria Engman
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
17
Informant
Mrs A J Luppold
(Address)
Winthrop
A TRUE COPY.
ATTEST :.
James J. Mulvey
(Registrar of city dfcown where death occurred
DATE FILED
April
21
19.
33
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
April
17
1933
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY, That I attended deceased from
-
19
to
19
I last saw h .......
.alive on
19
death is said
to have occurred on the date stated above, at .. 1.0.3P.m. The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
acute .. exascerbation
chronic myocarditis
postmortem opinion
yrs Contributory causes of importance not related to principal cause:
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
J J Siragusa
M. D.
(Address)
Boston
Dat
4/17/19 33.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Holy Cross
Malden
(Cemetery)
(City or town)
DATE OF BURIAL
April
20
19 33
22 NAME OF
UNDERTAKER
M.S.Caggiano
ADDRESS
Boston
Received and filed
APR 2 8 1933
19
(Registrar of City or Town where deceased resided)
50m-2-'30. No. 7997-đ
PLACE OF DEATH
(County)
1
BOSTON
(City or Town)
No. East.Boston Relief Station
St.
.....
Ward
(If U. S. War Veteran, specify WAR)
(If nonresident, give city or town and state)
MARGIN RESERVED FOR BINDING
N. B .- WRITE 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
important.
(State or country)
RM R-301
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 information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
100m-9-'31. No. 3385-f
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
{Signature of Agent of Board of Health or other)
Health Disco 4/18/33
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
3 SEX female
4 COLOR OR RACE
Whito
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Widow
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Give maiden name of' wife in full)
ver Carlos
Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 84
4
AGE
Years
250 Months Days
If less than 1 day Hours Minutes
OCCUPATION.
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
-A- home
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ..
10 Date deceased last marked at 11 Total time (years) this occupation year) spent in this occupation.
Contributory causes of importance not related to principal cause: Senility
1932
arteriosclerosis
1930.
Name of operation.
une
2.Date of.
What test confirmed diagnosi cliccal klaras there an autopsy?
20 Was disease or injury in any way related to occupation of deceased? no If so, specify.A Jacobo alugano .. , M. D.
(Signed)
(Address) 562 Hlueley
,Date 4/18/33
21 PLACE OF BURIAL CREMATION OR REMOVAL L'armuito (Cemetery
ME
DATE OF BURIAL
april 2020 1933
(City or town) 19
22 NAME OF
UNDERTAKER
Check Sammen
ADDRESS
19
A TRUE COPY, ATTEST:
Registrar)
1
PLACE OF DEATH
(County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No. 87
(If death occurred in a hospital or institution, give ita NAME instead of street and number'
2 FULL NAME
Columbia.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. Fransmatin ME
St., Ward,
(If nonresident, give city or town and state)
(Usual place of abode) Length of residence in city or town where death occurred
yrs.
mos. 12 days.
How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
18 DATE OF
DEATH
(Month)
(Day)·
(Year)
19 I HEREBY CERTIFY, ,19 april 9
That I attended deceased from
april 18
في 193
I last saw her alive on
april 18, 1933, death is said
to have occurred on the date stated above, at 1:554. The principal cause of death and related causes of importance in order of onset were as follows:
Date of Opset 4/17/33
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
George, Whitney
14 BIRTHPLACE OF
FATHER (City)
PARENTS
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
4
(State or country)
17 Yours. B. Franklin
Informant
(Address)
Farmingu
(City or Town)
No.
Ward
Tarbes
(If U. S. War Veteran, specify WAR)
18 1933
Received and filed
APR 2 1 1923
(State or country) >
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 nonc.
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 termi "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.
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