USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 40
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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. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;...- General 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; other- wise a description as full as may be, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfilment 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 unrelated to any form of injury, have died without recent medical attendance 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.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident. " "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
SOP
RM R-202
SUFFOLK
(County) BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No ..
.502.8
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Christina
Bissell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAT.)
(a) Residence. No.
(Usual place of abode)
100 Quinoy Ave
St.,
Ward,
Winthrop
(If nonresident, gi
.y 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
18 DATE OF
DEATH
May
25
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That i attended deceased from
April
2
19.34, to.
May
25
1934
I last saw h. Or .... alive on
May
25
19 ... 34, death is said
to have occurred on the date stated above, at. 3.20Am. The principal cause of death and related causes of importance in order of onset were as follows:
Dateefonset
carcinoma of the breast with metastasis.to lungs
1. yr
Contributory causes of importance not related to principal cause:
Name of operation
What test confirmed diagnosis?
Date of
Was there an autopsy? NO
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
M J Rhees
M. D.
(Address)
Boston
Date
5/25/1934
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Forest Hills
(Cemetery)
May 28
Boston
(City or town)
1934
22 NAME OF
UNDERTAKER
CR Bemmison
ADDRESS
Winthrop
ATTEST: Heide Stedetions Quirks ..... Received and filed 19
(Registrar of city or town where death occurred)
May 29 34
19
JUN 8
(Registrar of City or Town where deceased resided)
-
6 IF STILLBORN, enter that fact here.
Years Months Days
If less than 1 day Hours Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
at home
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation.
40
this occupation (month and /1934
Prince Edward Is
Alexander MoLeod
Scotland
Clarence A Bissell
Winthrop
1 3 SEX F 4 COLOR OR RACE W 5a If married, widowed, or divorced HUSBAND of 7 AGE 68 year) 12 BIRTHPLACE (City). (State or country) 13 NAME OF FATHER 14 BIRTHPLACE OF FATHER (City) (State or country) 15 MAIDEN NAME OF MOTHER PARENTS OCCUPATION| 16 BIRTHPLACE OF MOTHER (City) (State or country) 17 Informant (Address) A TRUE COPY. important. DATE FILED 50m-2-'30. No. 7997- 1 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 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
PLACE OF DEATH
No ... Mass ... General .. Hospital
.St.
Ward
(If U. S.
1934
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
widowed
(or) WIFE of
Clarence H. Bissell
(Husband's name in full)
(Give maiden name of wife in full)
DATE OF BURIAL
OF WS
RM R-303 B
1
PLACE OF DEATH
Suffolk, (County) Wantmen (City or Town) Community Historial No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 1OO
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowedfor divorced woman, give also maiden name.)
specify WAR)
(a) Residence. No 24 Faun Bar Avuene
.St., ................ Ward,
(If nonresident give city or town and state)
(Usual place of abode) Length of residence in city or town where death occurred
mos.
days. How long in U. S., if of foreign birth?
yrı.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
(write the word)
Male
White
5 SINGLE
MARRIED
WIDOWED
OF DIVORCED
Single
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 24 Years .. LO ..... Months 12. .Days
If less than 1 day .Hours. Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Lynotyps ... Operator
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc. ..
Printing Plant
10 Date deceased last worked at 11 Total time (years) this occupation (month and year) Ma y. . 190.4 spent in this occupation ....... y.r.s.
12 BIRTHPLACE (City)
London England
(State or country)
13 NAME OF FATHER Sydney J. Wrightson
PARENTS
14 BIRTHPLACE OF
FATHER (City)
London England
(State or country)
15 MAIDEN NAME
OF MOTHER
Ida Blanche Smith
16 BIRTHPLACE OF
MOTHER (City)
England
(State or country)
17 Father Sydney J. Wrightson Informant ... (Address: 41 Tiles tonRd. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wm. D. invarezkg
(Signature of Agent of Board of Health or other) Healthe priceer 5/29/34
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month) /
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows:, (If an injury was involved, state fully.)
,
(See reverse side for description for unknown person)
20 IN WHAT CITY OR TOWN
WAS INJURY SUSTAINED ?A+ .....
(Signed)
M. D.
(Address)
Dat
lid dy 19 3d
21 PLACE OF BURIAL,
CREMATION OR REMOVAL Winthrop
.
Winthrop
(Cemetery)
(City or town)
DATE OF BURIAL
May 29, 1934.
19
22 NAME OF
UNDERTAKER
Richard H, White
ADDRESS
147 Winthrop St., Winthrop
Received and filed
JUN 5 1934
19
(Registrar)
MARGIN RESERVED FOR BINDINGG
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every fmfor
information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER O
DEATH in plain terms, so that it may be properly classified under the International Classification of Causes
of Death. See reverse side for extracts from the laws relative to the return of certificates of death.
5m-2-'30. No. 7997-c
St.,
Ward
(If U. S. War Veteran,
1934
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
DIVERNING 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 regis- tration 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 con- tracted, 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 under- taker 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 satisfactory 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 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.
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 cemetery or burial ground in which the interment is made ....- Chap. 114. Sec. 46, 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. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;...- General 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; other- wise a description as full as may be, with the cause and manner of death. - General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfilment 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 unrelated to any form of injury, have died without recent medical attendance 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.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause. its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
--
M R-301A
1 2 FULL NAME 3 SEX Female (or) WIFE of 7 AGE 74 OCCUPATION: 12 BIRTHPLACE (City) (State or country) 13 NAME OF 16 BIRTHPLACE OF PARENTS MOTHER (City) (State or country) 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. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION 75m-5-'32. No. 5469 (Official Designation) N. D .- WRITE PLAINEI, WITIT ONFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country)
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 229 Washington Que. No.
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 ..
(If death occurred in a hospital or institution,
.Ward give its NAME instead of street and number)
Emmies, Banner
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence.
No ..
229 Washington Que.
(Usual place of abode)
Length of residence in city or town where death occurred
7 yTs.
mos.
days. How long in U. S., if of foreign birth? Jrs. mos. days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF ·
DEATH
May
30
1934
(Month)
(Day)
(Year)
19_I HEREBY CERTIFY, That ! attended deceased from October 2 , 1928, to may 30 1934
! last saw en .alive on
may 30 0, 193%, death is said
to have occurred on the date stated above, at 10:45 R: M. The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset IMPORTANT
Cerebral Hemmarhage
May 26/34
Contributory causes of importance not related to principal cause:
arteriosclerosis
Clumic Myocardial Degeneration
1928 1930
Name of operation sunce
What test confirmed diagnosis clinical i la Date of
Was there an autopsy: 20
20 Was disease or injury in any way related to occupation of deceased? no
If so, specify (
M. D.
(Signed)
(Address) 362 Henley St.
Date May 3/9 3%
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
glewood, Everett
DATE OF BURIAL
(Cemetery)
(City or town)
19 34
22 NAME OF
A. E. Henderson Co.
UNDERTAKER
517 300
dway, Everett
Received and filed. .19
(Signature of Agent of Board of Health or other)
HO.
June 2/34
...... Date of Issue of Permin
(write the word)
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
see J.
Banner
(Husband's name in full)
6 IF STILLBORN, enter that fact here,
Years
10
Months
15
.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.
10 Date deceased last worked at
this occupation (month and
year).
you
Que 1933
11 Total time (years) spent in this occupation.
e
FATHER
Thomas Withan
14 BIRTHPLACE OF
FATHER (City)
Mario
15 MAIDEN NAME
OF MOTHER
Nancy Moulton
Marine
17
Missalice F. Banner
Informant
(Address)
229 Waslington ave, Withage
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wm. DChildress
ADDRESS.
LUV 5
1934
(Registrar)
(L U. S.
War Veteran,
Ward,
(If nonresident, give city or town and state)
4 COLOR OR RACE
weite
5 SINGLE
MARRIED
WIDOWED
Widow
at Home
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
1021
Cerebral hemorrhage
July 5. 1927
Contributory causes of importance not related to principal cause:
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
EXTRACTS FROM THE LAM 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
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