Town of Winthrop : Record of Deaths 1933, Part 59

Author: Winthrop (Mass.)
Publication date: 1933
Publisher:
Number of Pages: 520

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(Official Designation) (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

July

1933

AMonth)

(Day)

(Year)

I HEREBY CERTIFY. That i attended deceased from

I Jast saw h ..

alive on ...

death is said

to have occurred on the date stated above,

12:30P .m. The principal cause of death and related causes of importance in order of Date of Onset IMPORTANT onset were as follows: natural Causes Probably

acute Dil. vation of theart. July 20 143)

Contributory causes of importance not related to principal cause:

Name of operation.

Date of

What test confirmed diagnosis? huerta atom.

.Was there an autopsy? o

20 Was disease or injury in any way related to occupation of deceased?

If so, specify B

(Signed)

(Address Writing Brack Fit

Date

M. D.

27.19 33 ..

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Holy Cross - Malden,

(metery)

(City or town)

19 33

DATE OF BURIAL July 24

22 NAME OF

UNDERTAKER

Kup Castillo

ADDRESS

54 chambres de Biston

Received and filed

(Registrar)

St.,

Ward

(L U. S.

War V

specify WAR)

St.,

Ward,

(If nonresident, give city or town and state)

at home

Revised villea Jies Sinuaru ceriicare vi veau

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 of 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 fast 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

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 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 onse 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, trom one town to another within the common- wealth cannot be obtained early enough for the purpose, thé certificato 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 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.

M R-302

SUFFOLK

(County)

BOSTON

(City or Town)

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

BOSTON 149

(City or town making return)

Registered No ...

.6433

(If death occurred in a hospital or institution,

give its NAME instead of street and number)

2 FULL NAME

Mollie

Spector

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

(a)

Residence. No ..

(Usual place of abode)

15. Towksbury. . St ...... WinthropSt.,

Ward,

Length of residence in city or town where death occurred

yrs.

如0S.

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

yTs.

mos. days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

married

5a If married, widowed, or divorced

HUSBAND of

Morris Spector

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 AGE 32 Years Months Days

If less than 1 day Hours . Minutes

8 Trade, profession, or particular

kind of work done, as spinner,

sawyer, bookkeeper, etc.

9 Industry or business in which

work was done, as silk mill,

saw mill, bank, etc.

at home

10 Date deceased last worked at

this occupation (month and

year)

11 Total time (years) spent in this occupation ..

yr's

12 BIRTHPLACE (City)

New Bedford

Mess

Joseph Taylor

14 BIRTHPLACE OF

FATHER (City)

(State or country)

Russia

15 MAIDEN NAME

OF MOTHER

Sadio Cohen

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Russia

Informant

(Address)

87 Deering Rd Dor

ATTEST:

James J. Mulvey

(Registrar of city down where death occurred

July

Received and filed

19.

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

July

.23

.1933

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

July ...

.. 17

19 33 to July

2.3

19.33

1 last saw h.ex ...... alive on

July

19 ... 33., death is said

to have occurred on the date stated above, at 8 A. m. The principal cause of death and related causes of importance in order of onset were as follows:

metastatic carcinoma

Dateofonset 30 .. mos

Contributory causes of importance not related to principal cause: Left ... hydrothorax

2-3 .. wks

Name of operation

Date of.

What test confirmed diagnosis? ....

olin

Was there an autopsy ?.. no

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

(Signed)

LV Ragsdale

M. D.

(Address)

Boston

Date ..

7/23/19 33.

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Kerneseth Israel Woburn

(Cemetery)

(City or town)

DATE OF BURIAL

July

.23

19.3.3

22 NAME OF

UNDERTAKER

M Stanetsky

ADDRESS

Boston

AUG 1933

(Registrar of City or Town where deceased resided)

1 3 SEX F OCCUPATION 13 NAME OF FATHER PARENTS A TRUE COPY. tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE important. DATE FILED 50m-2-'30. No. 7997-d 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 (State or country)

PLACE OF DEATH

No. Mass ... General ... Hospital.

St.,

Ward

(If U. S. War Veteran,

specify WAR)

(If nonresident, give city or town and state)

Isadore Taylor

M R-301A

PLACE OF DEATH

Suffolk. (County) Skauttrop (City or Town) Sanderof Community

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 150 or its Agent.

Registered No. 3378

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

male Joch

(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?

Jrs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

Single

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 he Stillborn

If less than 1 day

Years Months Days

Hours. Minutes

nonce

10 Date deceased last worked at

this occupation (month and

year)

Winthrop

11 Total time (years) spent in this occupation

(State or country) mass.

13 NAME OF

FATHER

It Permeth toch

14 BIRTHPLACE OF

FATHER (City)

Brookline

15 MAIDEN NAME

OF MOTHER

thely In . Menzie

nicaragua

(State or country)

Central America

17 Kenneth Ina

! HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: M. A. Childresse (Signature of Agent of Board of Health or other).

(Date of Issue of Permit)

129/09

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That i attended deceased from

7-27

19.3.3, to

I last saw h .......

alive om

19.

death is said

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

Comente

Contributory causes of importance not related to principal cause:

Name of operation.

What test confirmed diagnosis?

Was there an autopsyr .......

20 Was disease or injury in any way related to occupation of deceased?

If so, specify

(Signed)

M. D.

(Address)

Date

27:19.60

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

DATE OF BURIAL July 20.

(Cemetery)

(City or town) 1933

22 NAME OF

UNDERTAKER

ADDRESS

cast Bouton

Received and filed

AVG & 1933

(Registrar)

3.3

(L U. S. War Veteran, specify WAR) 59 Sewall Live Kisch

St. Non Ward,

(ff nonresident, give city or town and state)

Horward {

1 No .. 2 FULL NAME (a) Residence. No .. (Usual place of abode) 3 SEX 4 COLOR OR RACE Struite male (or) WIFE of 7 AGE 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. OCCUPATION 12 BIRTHPLACE (City) PARENTS 16 BIRTHPLACE OF MOTHER (City) Informant (Address) 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. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state /(Official Designation) 100m-9-'30. No. 9954. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country) mass

Date of.

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 "worker, " ...

us "employee, "

"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.

Example

The principal cause of death and related causes of importance in order of onset were as follows:

Date of onset

Arteriosclerosis

1915

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1027

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.

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.

(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

RM R-301

OCCUPATION| 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 is very important. See instructions and extracts from the laws on back of certificate. 200M-11-'29. No. 7180-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS

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Town of Winthrop : Record of Deaths 1933, Part 59

Author: Winthrop (Mass.) Publication date: 1933 Publisher: Number of Pages: 520

Author: Winthrop (Mass.)
Publication date: 1933
Publisher:
Number of Pages: 520