USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 46
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RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
7 (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 discaso resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
.
DRM R-302
SUFFOLK
(County) BOSTON
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
6119
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Jacob
Bix, Alias, "Jake Bix"
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No ..
46 Nevada Ct.
.St.,.
............ Ward, Winthrop, Mass
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX M
4 COLOR OR RACE
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced HUSBAND of
Minnie Brother
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE 66 Years Months Days
If less than 1 day
Hours
Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Tailor
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
For Himself
10 Date deceased last worked at this occupation (month and year)
11 Total time (years)
4/'34
spent in this occupation. Yrs.
12 BIRTHPLACE (City) (State or country) Russia
13 NAME OF
FATHER
Pinkus Bix
14 BIRTHPLACE OF FATHER (City) (State or country) Russia
15 MAIDEN NAME
OF MOTHER
Bessie -
16 BIRTHPLACE OF MOTHER (City) (State or country) Russia
17 Peter Bix
Informant (Address) 46 Nevada Ct., Winthrop, Mass
A TRUE COPY.
ATTEST:
Heida Ofedition Quing
(Registrar of city or town where death occurred)
DATE FILED
July 62 .19 34
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July 3
1934
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from June 16 1934 .. , to ....
I last saw h.
im alive on
July 3
19.3.4., death is said
to have occurred on the date stated above, at .. 5 .. 10P. m. The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
pulmonary ... embolism
Min
Contributory causes of importance not related to principal cause:
carcinoma of sigmoid
·mos.
cecostomy
6/ 17/34
Name of operation resection of sigmoid Date 6 /30/34
What test confirmed diagnosis?
operation
Was there an autopsy! no"
20 Was disease or injury in any way related to occupation of deceased?
no
If so, specify.
(Signed)
W.W .Knowlton
M. D.
(Address)
Boston
Date
7/3/
19.3.4
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Anshel Libaritz. .... Woburn
(Cemetery)
(City or town)
July .. 4
19.34
22 NAME OF
UNDERTAKER
M Stanetsky
ADDRESS
Boston
Received and filed
AUG S 1934.
19
Registrar of City or Town where deceased resided)
OCCUPATION 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. 50m-2-'30. No. 7997-1 N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Even tem of informa- PARENTS
MARGIN RESERVED FOR BINDING
PLACE OF DEATH
1
(City or Town) No. Peter Bent Brigham Hospitalt.,
Ward
(If U. S.
114
War Veteran,
specify WAR)
July 3 ..... , 19 ..... 34
DATE OF BURIAL
٢
RM R-301
Every item of N. B .- WRITE PLAILLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECG. 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. PHYSI ANS should state
PLACE OF DEATH
Suffolk (County)
Tinthrop.
(City or Town)
No. 390 Winthrop St
St.,
.......
Ward
give its NAME instead of street and number)
2 FULL NAMEHelena V Burke Downie
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No ..
390 MIinthrop ... St.
.St.,.
......
Ward,
(Usual place of abode)
Length of residence in city or town where death occurred yrs.
mos.
days. How long in U. S., if of foreign birth? yrs.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
OF DIVORCED Married
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Jasper DaWATge
(Husband's name in full)
6 IF STILLBORN, enter that fact here
AGE
7 46 Years Months Days
If less than 1 day
Hours.
Minutes
OCCUPATION:
8 Trade, profession, or particular , hind of work done, as spinner, sawyer, bookkeeper, etc ..
,
Housewife
9 Industry or business in which
work was done, as ailk mill,
saw mill, bank, etc ....
Own Home
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation.
11
this occupation month
year)
o drenth and9 26
12 BIRTHPLACE (City)
Boston
(State or country)
Massachusetts
13 NAME OF
FATHER
Michael Burke
14 BIRTHPLACE OF
FATHER (City)
(State or country) Ireland
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Treland
100m-9-'31. No. 3385-f
17 Jasper ... Downie
Informant
(Address)
390 Winthrop St, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Childress
Signature of Agent of Board of Health or other)
Wealth Slicer
7/5/34
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July
3
(Month)
(Day)
1934
(Year)
19 I HEREBY CERTIFY, That I attended daceased from
19 34
1924, to July
3
I last saw her alive on fue 3 19 34, death is said to have occurred on the date stated above, at 9:15 P .. m.
The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset
Chrome heredita.
Jan 1924
Contributory causes of importance not related to principal cause:
Chimie sheraton
19.20
oster arthritis
home
Date of
What test confirmed diagnosis: Celeration.
Was there an autopsy?
ho
20 Was disease or injury in any way related to occupation of deceased? no
If so, specify
(Signed)
M. D.
(Address)
Date ful 4 1934
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Calvary
Boston
DATE OF BURIAL
(City or town)
19.34
22 NAME OF
UNDERTAKER
(Cemetery)
July 6
toto HO Malea
ADDRESS
Tinthrop
Received and filed .19
JUL 12 1934(Registrar)
A TRUE COPY, ATTEST:
1
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
115
(If death occurred in a hospital or institution,
(If U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
Name of operation
PARENTS
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 terni "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
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 LAWS OF THE COMMONWEALTH OF MAS - 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 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 cerietery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law. or in lieu thereof a certificate as hereinafter provided. Ir there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application maire the certificate required of the attending physician. If death is caused by violence, the medical examiner shal make such certificate. If such a permit for the removal of a human body, not previously interred, trom one town to another within the common- wealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as re- i 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.
DRM R-305
PLACE OF DEATH
Essex (County)
Danvers (City or Town) NoDan vers State Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Danvers (City or town making return)
Registered No.
116
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Anelia T .... ... Nazzaro
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a)
Residence. No .... 450 ... Pleasant
(Usual place of abode)
St.,
.Ward,
.... finfarge city or town and state)
Length of residence in city or town where death occurred
3 yrs. 5
mos.
15ays.
How long in U. S., if of foreign birth?
yTs.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or 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 36 AGE 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.
Housework
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)
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Camillo Nazzaro
PARENTS.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Filomena
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Gertrude F. Smith,
Informant
(Address)
Hathorne
A TRUE COPY.
·ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 7/9/34
........ 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Julia, 1934
(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)
Acute.dialatation ofheart
Sudden death
20 If death was due to external causes (VIOLENCE) fill in the following :
Accident,
Suicide or
Homicide ?
Date of injury.
19
Where did injury occur ?
(City or town and State)
Manner of
Injury.
Nature of
Injury
21 Was disease or injury in any way related to occupation of deceased? ... no
If so, specify
(Signed)
S ....... Chase .... Tucker
M. D.
(Address) .... P.Oa body.Denv-
Dat
7/8/19
22 PLACE OF BURIAL,
CREMATION OR REMOVALHOLY Cross Malden
(Cemetery)
(City or town)
DATE OF BURIAL
7/11/34.
19
23 NAME OF
UNDERTAKER
Angelo Jannini
ADDRESS
Boston
Received and filed
AUG 1
19
(Registrar of City or Town where deceased resided)
MARGIN RESERVED FOR BINDING
25m-2-'30. No. 7997-8
1
.St.,
Ward
(If U. S.
(write the word)
Boston
RM R-301 A
Sulfalls
(Count) Withof
Boston notified 8/13/34 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, give its NAME instead of street and number)
1
(If U. S. War Veteran, specify WAR .........
(a) Residence. No
(Usual place of abode)/
Length of residence in city or town where death occurred
yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female Sprite
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Squared
5a If married, widowed, or divorced HUSBAND of
Pilates
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 54 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.
10 Date deceased last worked at
this occupation (month and
year)
Charlottetown
1 1 Total time (years)
spent in this one
occupation.
P.E.I
Not Kurven MENEil
14 BIRTHPLACE OF
FATHER (City)
charlottetown
P.E.g.
(State or country)
ME Catturine M LEau
16 BIRTHPLACE OF
MOTHER (City)
charlotte tour
(State or country)
P. G.J.
17
E. P.Gates
17 Butaur I. S. Both
Informant
(Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued: Wim . D. Children (Signature of Agent of Board of Health or other)
Health officer (Official Designation) (Date of Issue of Permit)/
7/1/34
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Juli
70
(Month)
(Day)
1734 (Year)
19 I HEREBY CERTIFY, That Lattended deceased from 198 .. , to .... 6, 192 1984 death is said
Y last saw h.A ...... alive on.
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
IMPORTANT
Jak 3,1994
Candice decy
Contributory causes of importance not related to principal cause: Oble egalacta
afperfecta
(Porad about / dayan storms)
Name of operation
Dale 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 Coldplay
M. D.
(Signed)
(Address) 3403
Date: 200 1994
Holy Cross, malden
DATE OF BURIAL
22 NAME OF
UNDERTAKER
Frederick A Tuagratte
ADDRESS
Cant Boston
19 ..
Received and filed
JUL 1 2 1934
1 2 FULL NAME (or) WIFE o AGE OCCUPATION 13 NAME OF FATHER 15 MAIDEN NAME OF MOTHER PARENTS 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-'33. No. 9321-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 12 BIRTHPLACE (City) (State or country)
PLACE OF DEATH
Nity of Town) N. un turof Community Hospitaland Lucy Le. Gates
(If deceased ma married widowed or divorced woman, give also maiden name.)
19 Contain
St.,./.
1
.We
(If nonresident, give city or town and state)
(Registrar)
(City or town)
L
21 PLACE OF BURIAL,
-CREMATION OR REMOVEL
Luxemetering
Jan 20; 14.94
Howsempre
Revised United yates 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 houseke 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, soup 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.
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