Town of Winthrop : Record of Deaths 1934, Part 45

Author: Winthrop (Mass.)
Publication date: 1934
Publisher:
Number of Pages: 500

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 45

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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Sec. 6.

.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.

No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cerne- 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 disense 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-301 A

PLACE OF DEATH

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.

112

(

'' death occurred in a hospital or institution.

(If U. S. War Veteran,

specify WAR)

(If nonresident, give city of town and state)

days.

How long in U. S., if of foreign birik?

yEL.

days.

MEDICAL CERTIFICATE OF DEATH

18 DATE CF DEATH June 28

19311.

HEREMY CERTIFY/Fat I attended deceased from

Game 28 1034

25 1934, death is vand

to have occurred on the daly stated above, alsm.

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

Date of Geset

Carcinoma of ulern

1951

Contrbatery çeuses of importance not related to principal cause:

carcinoma W Mano memorial Harp.

Cate · 02dl-1931

If so, specify Gras E. Bouvrie 2. Bonlin

Vale The 29:024

Woodlawn Everett

(CanEvery) (City (R "SAMT)

Charles R. Bennison

Winthrop. Mass

Received and filed 19

JUL 5 1034

Winthrop 1 (City or Town, No. 15 Atlantic ......... St., Ward 2 FULL NAME. Eliza Elizabeth (Welch) Dempster (If deceased is a married, widowed or divorced woman, give also maiden name.) (a) Residence. No. 15 Atlantic St., .Ward, (Usual place of abode) Length of residence in city or town where death occurred yrs. 6 PERSONAL AND STATISTICAL PARTICULARS 8 SEX 4 COLOR OR RACE (write the word) Female 5 SINGLE Married MARPIED WIDOWED or DIVORCED -- White 5a If married, widowed, or divorced HUSBAND · 19 May 31 (or) WIFE of I last saw h William J. Dempster gine (Husband's name in full) 6 IF STILLBORN, enter that fact here. 7 AGE 67 Years 6 Months 5 Days If less than 1 day Hour: Minutes 8 Trade, profession, or particular House work kind of work done, as spinner, sawyer, bookkeeper, etc. 9 Industry or business in which work was done, as silk mill, Own home saw mill, bask, etc. 10 Date deceased last worked Total time "years) this occupation (month andJime 1934 year; occupation. 12 BIRTHPLACE (City, London (State or country) England 13 NAME OF FATHER Unable to obtain 14 BIRTHPLACE OF Name of operation FATHER What test confirmed diagnosiz? Unable to obtain Biopsy 15 MAIDEN NAME OF MOTHER Unable to obtain 'Signed, PARENTS OCCUPATION 16 BIRTHPLACE OF MOTHER (CRAY) Unable to obtain (State or cour.try) 21 PLACE OF BURIAL CREMATION OR REMOVAL 17 William J. Dempster 15 Atlantic St. Winthrop Mass I HEREBY CERTIFY that a cabofactory standard cersscale of death was Hled with me BEFORE the bomal oy tradet permit was issued: ADDRESS ;ber ) CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION He alte officer 6/ 21/34 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 (trial Deugnatur, 100m-9-'J3. No. 9321-a N. B .- WRITE PLAINS. WITH UNFADING BLACK INK-THIS IS A PERMANENT REGARD. Every item of ---- DATE OF POP July 1, 1934

Revised United Si 's 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 housche per-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, sont 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 LAWN FTHE COMMONWEALTH OF MASSA CHUSETTS 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 discase 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.

physician. ff 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 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.

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.

(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

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 N. B .- WRITE PLAINS 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.

PLACE OF DEATH

Suffolk (County)

Winthrop (City or Town) No. 2 Upland Road

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

(City or town making return)

Registered No ...

113

(If death occurred in a hospital or institutio .! ,

Ward 1 give its NAME instead of street ard number)

2 FULL NAME

Mary E. Donahue Riley

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

specify WAR)

(a) Residence.

No. 2 Upland Road

(Usual place of abode)

.St.,.

.........

.Ward,

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred yrı.

mos.

days.

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

yrs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

(write the word)

Female

White

5a If married, widowed, or divorced HUSBAND of

(or) WIFE of

(Give maiden name of wife in full)

James J. Riley

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE 76

Years. Months Days

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 ..

Housewife

Own Home

10 Date deceased last worked at 11 Total time (years) spent in this occupation. 40

12 BIRTHPLACE (City)

Worcester

(State or country) Massachusetts

13 NAME OF

FATHER

Donahue

14 BIRTHPLACE OF

FATHER (City)

Brookfield

(State or country) Massachusetts

15 MAIDEN NAME

OF MOTHER

Mary

16 BIRTHPLACE OF MOTHER (City) .. Cannot be learned

100m-12-'32. No. 7070-h

17 James .J ... Riley

Informant

(Address)

2 Upland Road Winthrop

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal or transit permit was issued:

(Signature of Agent of Board of Health of other)

Health Officer 6/30/34

(Official Designation) (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

gime

(Month)

(Day)

19 I HEREBY CERTIFY, That i attended deceased from

1934, to fun

19.39

1934 death is said

I last saw h.C& ...... alive on

9 A. m.

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

Clinic, betrustikal kaphat

1938 1933.

Contributory causes of importance not related to principal cause:

Name of operation

What test confirmed diagnosis? Ubuntu

Date of

Was there an autopsy?

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

f so, s

(Signed)

M. D.

(Address).

Datafrom 29 1934.

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Winthrop

(Cemetery)

July

(City or town) 34

DATE OF BURIAL

22 NAME OF

UNDERTAKER

Winthrop

ADDRESS

Received and filed 19

A TRUE COPY, ATTEST:

JUL 5 1934

(Registrar)

St.,

(If U. S.

War Veteran,

1934 (Year)

5 SINGLE

MARRIED

WIDOWED

or DIVORCEDTidowed

If less than 1 day

this occupation, ungnth year) 7034

PARENTS

(State or country)

Revised United i wes 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 charged 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 houscke per -- 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.

Example

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

Date of onset

1015

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause:

In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.

EXTRACTS FROM THE LA -" THE COMMONWEALTH OF MAY A HUSETTS 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 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.

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 cenie- tery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L. as amended.

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Town of Winthrop : Record of Deaths 1934, Part 45

Author: Winthrop (Mass.) Publication date: 1934 Publisher: Number of Pages: 500

Author: Winthrop (Mass.)
Publication date: 1934
Publisher:
Number of Pages: 500