Town of Winthrop : Record of Deaths 1934, Part 79

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

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 79

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Father

11 Total time (years)

م.

1 R-301 A

is very important. See instructions and extracts from the laws on back of certificate.

100m-9-'33. No. 9321-a

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: William D. Children (Signature of Agent of Board of Health or other)

agent

Mon. 8/34

(Official Designation) (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

DEATH

(Month)

(Day)

(Year)

HEREBY CERTIF

That I attended deceased from

193 x

I last saw him alive on

GP.

to have occurred on the date stated above, at.

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

11/5/34

Contributory causes of importance not related to principal cause:

Pepita Ellow (Night) 11/2/34)

Name of operation

What test confirmed diagnosis? Relation Was there an autopsy? Ho

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

If so, specify ..

word celou while working

(Signed)

238 Driveril

Date

11/7/1994

(Address)

21 PLACE OF BURIAL, CREMATION OR REMOVAL

ovatoly Ross malden

¿Cemetery

(City or tow !! )

DATE O for. 34

22 NAME OF

UNDERTAKER

Patsy Rapino

ADDRESS

9 Chelsea A EB stor

Received and filed 19

1934

Bumped & scrape(Vi)

(Registrar)

high elbow, while working in a ditch

Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state , Wiin ONFADING BLACK INK-THIS IS A FERMANENI KECUKD.

CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION

PLACE OF DEATH-

(County) Winthrop

Quelo Katyperry 12-6-34 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)

2 FULL NAME.

Ernesto Célata

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

75 Lubec

.St., ..

War

(If nonresident, give city or town and state)

mos.

days.

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

yrs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Male Mute

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word) Marieq

5a If married, widowedr of divorced HUSBAND of Delia

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 28. 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 ..........

1ª General Labores

9 Industry or business in work was done, as silk saw mill, bank, etc.

ilRoad Construction

10 Date deceased last worked at

11 Total time (years)

this occupation (month and

spent in this 5

Occupation 3 years

year)

no02-1934

12 BIRTHPLACE (Cify) (State or country)

Boston

13 NAME OF

FATHER

Michele Relata

PARENTS

15 MAIDEN NAME

OF MOTHER

Giuseppina Rizzo

16 BIRTHPLACE OF MOTHER (City) (State or country)

Italy

17 alfonso Celata Brother

Informant (Address) 75 huber RL EB ston

e of 11/4/340 Phys ..

14 BIRTHPLACE OF

FATHER (City)

(State or country

Itily

... , M. D.

i request of sec. office

information asecured from

18 DATE OF

how. 6, 1934

ihn. 2. 1934,

(If U. S.

Wat

War Veteran,

specify WAR)-

(a) Residence. No ...

(Usual place of abode)

Length of residence in city or town where death occurred

yrs.

4 COLOR OR RACE

Fuccillo

1934

death is said.

AGE.

(City or Town) No Winthrop Com, 2402) St

Ward

Revised UnisStates 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, 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 dalesman 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.

Examplo

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

Date of onset

Arteriosclerosis

Chronic interstitial nephritis

1921

Cerebral hemorrhage

July 5, 1929

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 VS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... . .

Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred from one town to another within the common- wealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as re- quired by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk

of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deccased, 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.

IR-301 A

Suffolk

(County)

(City of Town) No56 Wash Give

Str

Ward

give its NAME instead of street and number)

2 FULL NAME Catherine @ lyman(mu gyer)

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

No 156 Wash Que

.St., ..

.Ward,

(a) Residence.

(Usual place of abode)

Length of residence in city or town where death occurred 0 yrs.

mcs.

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

yrs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE

(write the word)

married

5a If married, widowed, or divorced HUSBAND of

(or) WIFE .

(Give maislen name of wife in full)

aller y Unman

(Husband's name in fyll)

6 IF STILLBORN, enter that fact here.

AGE

7 54 Years.2 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 ..

as Home

10 Date deceased last worked at

11 Total time (years)

spent in this La

this occupation (month Ago )4

occupation ...

12 BIRTHPLACE (City)

(State or country)

mans

13 NAME OF

FATHER

Patrick gyer

14 BIRTHPLACE OF

FATHER (City)

(State or country)

Ireland

15 MAIDEN NAME

OF MOTHER

LE Maria Mc Mahon

16 BIRTHPLACE OF MOTHER (City) (State or country)

17 allen 9 Ummary

Informant

(Address)

156 wash care

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

(Signature of Agent of Board of Health or other)

Vrealthe Ilecek 11/9/34

(Official Designation) ; (Date of Issue of Permits

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

un.

(Month)

(Day)

193

(Year)/

19 I HEREBY CERTIFY, That I attended deceased from

13 4

., 19.3.

I last saw h .... In alive on

to have occurred on the date stated above, a 40m The principal cause of death and related causes of importance in order of onset were as follows:

Refusent Ciona

Contributory causes of importance not related to principal cause:

Name of operation ...

Carcinoma la Dat

of Feb. 1934

What test confirmed diagnosis ?.

Was there an autopsy ?.. ...

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

(Signed)

M. D.

(Address)

Date 11/7 1939

21 PLACE OF BURIAL,

CREMATION OR REMOVE Inthe

(Cemater

(City or town)

DATE OF BURIAL

1974

22 NAME OF

UNDERTAKER

Jos & Bunke

ADDRESS

075 Chamber 11 Beton

Received and filed. .19

₦04-15.1334

(Registrar)

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 ...

OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. PARENTS

100m-9-'33. No. 9321-a

PLACE OF DEATH

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.

191

Registered No.

(If death occurred in a hospital or institution,

(If U. S.

War Veteran,

specify WAR)

(If nonresident, give city or town and state)

MARRIED

WIDOWED

or DIVORCED

Housework

mr.6

193;

death is said

Date of Onset IMPORTANT

Revised United Dites Standard Certificate of Death

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.

Example

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

Date of onset

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 LATOR OF THE

COMMONWEALTH OF MASSACHUSETTS GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

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 deccased 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.

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.

R-301 A

(County)

Washington

D.C.

(City or Town) No. 1726 m. n.W.

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,

195

Registered No.

(If death occurred in a hospital or institution,

give its NAME instead of street and number)

2 FULL NAME.

Helen A Horan

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

galbert are Winthrop

.St., ..

Ward,

(If nonresident, give city or town and state)

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Town of Winthrop : Record of Deaths 1934, Part 79

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

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