Town of Winthrop : Record of Deaths 1934, Part 85

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

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 85

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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:

(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 clectrical 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.

IM R-302

PLACE OF DEATH

SUFFOLK EUSTON

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

BOSTON

(City or town making return)

Registered No .....

9983

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

Kahn

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

79 .... Grover's Ave

.St., .......

Ward,

Winthrop

(If nonresident, give city or town and state)

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

noI.

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

days.

PERSONAL AND STATISTICAL PARTICULARS

(write the word)

married

5a If married, widowed, or divorced HUSBAND of Marie ... Barron (Give maiden name of wife in full)

If less than 1 day

Hours

Minutes

pharmacy

11 Total time (years) spent in this occupation.

yrs

Boston Mass

17 Informant father-in-law Henry Barron (Address)

A TRUE COPY.

Predation Quing

(Registrar of city or town where death occurred)

NOF.

.19 ... 34

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Nov. 20 1934

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

Oct

19.3.4, to

Nov

I last saw h .. i.m.alive on .... Now.

34death is said

to have occurred on the date stated above, at.B .. 50A .. m.

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

Dateefonset

subacute bacterial endocarditis (strept. viridous)

3 mos

Contributory causes of importance not related to principal cause:

Name of operation

Date of.

What test confirmed diagnosis?

autopsy

Was there an autopsy? yed

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 11/20 19.34.

21 PLACE OF BURIAL

CREMATION OR REMOVAL

Adath Jeshurn

W Rox

DATE OF BURIAL

NOV

(Cemetery)

(City or town) 19.34

22 NAME OF

UNDERTAKER

M Stanetsky

ADDRESS

Boston

Received and filed.

DEG 10 .1934

(Registrar of City or Town where deceased resided)

1 (City or Town) 2 FULL NAME Joseph W (a) Residence. No. (Usual place of abode) 3 SEX 4 COLOR OR RACE M 5 SINGLE MARRIED WIDOWED W or DIVORCED (or) WIFE of (Husband's name in full) 6 IF STILLBORN, enter that fact here. 7 AGE 25 Years Months Days 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 OCCUPATION year) May 1934 12 BIRTHPLACE (City) (State or country) 13 NAME OF FATHER Morris Kahn 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME OF MOTHER Ida Tuck PARENTS 16 BIRTHPLACE OF MOTHER (City) (State or country) Russia above ATTESTS . tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. DATE FILED 50m-9-'31. No. 3385.4 N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- (State or country) Russia

No. Mass General Hospital

.St.,

.....

Ward

(If U. S. War Veteran,

206

specify WAR)

5卡

IM R-301 A

Suffolk

PLACE OF DEATH

(County) Hinthoras (City or Town) Northern Community Habitats .St.

12 - 10 - 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.

{H death occurred in a hospital or institution,

.. Ward give its NAME instead of street and number)

(If U. S.

War Veteran,

specify WAR)

(a)

Residence.

(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

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

november 2%

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

vý.

I last saw h

alive on

death is said

to have occurred on the date stated above, at.

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

Prematurity 7% mer Prolapalios nut cont Vrausverse presentation

Contributory causes of importance not related to principal cause:

Name of operation

Crimestory

"Date 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 Haroto Muccagrain (Signed) , M. D. (Address) 63 Beacht Where Date 11/20 1934

21 PLACE OF BURIAL,

CREMATION OR REMOVAL ALI

(Cemetery)

(City or town) 19

DATE OF BURIAL

22 NAME OF

UNDERTAKER

ADDRESS

Received and filed

Dec. 10, 1934

(Registrar)

4 COLOR OR RACE

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

5a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 AGE 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.

Stillborn

10 Date deceased last worked at

this occupation (month and

year) ..

11 Total time (years)

spent in this

occupation

12 BIRTHPLACE (City)

Henthnap

maso

13 NAME OF

FATHER

Heil.

mary 20

Olin 22

Hoffman

16 BIRTHPLACE OF MOTHER (City) (State of countryauch Sacton Mas?

17 Keil.

Informant (Address) 128 Harabur Come

I HEREBY CERTIFY that a satisfactory standard certificate of death was

filed with me/BEFORE the burial or transit permit was issued:

Hm- W Children

(Signature of Agent of Board of Health or other)

40 Dee- 6/34

(Official Designation) (Date of Issue of ermit)

1 2 FULL NAME 3 SEX (or) WIFE of OCCUPATION| (State or country) 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME OF MOTHER PARENTS 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 is very important. See instructions and extracts from the laws on back of certificate. 75m-2-'30. No. 7997-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of (State or country)

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

N208 Washburn Quy

.St., ..

Ward,

(If nonresident, give city or town and state)

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

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 MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death .. .. Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body, which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or . from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health" or its agent aforesaid or from the clerk of the town where the body, is buried. No such permit shall be issued until there shall have been- delivered to such board, agent or clerk, as the case may be a satis-' factory written statement containing the facts required by law to. be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate . as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending . physician. If death is caused by violence, the medical examiner shall make such certificate. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such state- ment and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., as amended.

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

.... 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.

RM R-301 A

OCCUPATIONI 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 75m-2-'30. No. 7997-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS

PLACE OF DEATH

Suffolk Hinthoop (County)

Revere nonfume 12 - 10-34 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.

209

(If death occurred in a hospital or institution,

give its NAME instead of street and number)

Olivi & Witheno-

(If deceased is a married, widowed er divorced woman,give also maiden name.) Residence. No. 118 H isklum Rose, (a) (Usual place of abode) Length of residence in city or town where death occurred yYs.

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

108. days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

Lemale

4 COLOR OR RACE

2kilo

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

mare

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

(Husband's name in full)

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

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

10 Date deceased last worked at 1934 this occupation (month and year) Southeastom

12 BIRTHPLACE (City)

(State or country) mass

13 NAME OF

FATHER

William

Hoffmans

14 BIRTHPLACE OF FATHER (City) (State or country)

new York

15 MAIDEN NAME

OF MOTHER

Connie Doherty

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

17 Informant (Address) 1/28

Ikitchen

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

40 Ale. 6/34

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That ! attended deceased from august 15 1984 .. , to 193 %

I last few h alive on

1934, death is said

to have occurred on the date stated above, at .... .. m.

The principal cause of death and related causes of importance in order of onset were as follows; acute Cardiac dilatation

acute bronchitis Pregnancy 1 1/2 mos

Dateofonset 11/2/31 11/11/24

822 Contributory causes of importance not related to principal cause:

Felony Train pres

11/20/34

Name of operation

What test confirmed diagnosis?

Was there an autopsy? X

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

If so, specify.

(Signed)

M. D.

(Address)

670 Bouchot Gerven Date 11/2/1904

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

(Cemetery)

(City or town) 1954

DATE OF BURIAL

22 NAME OF

UNDERTAKER

thomas + Canale

ADDRESS

Received and filed

Dec. 10,

19.

(Oficial Designation)

(Registrar)

2 FULL NAME

(If U. S. War Veteran, specify WAR) Revere

Ward,

(If nonresident, give city or town and state)

Date of

East Caminas

11 Total time (years)

spent in this

occupation ..

Revised United States 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.

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:

EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the 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.

No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be a satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such state- ment and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., as amended.

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Town of Winthrop : Record of Deaths 1934, Part 85

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

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