Town of Winthrop : Record of Deaths 1934, Part 87

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

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 87

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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 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.

2M R-302

PLACE OF DEATH

SUFFOLK BOSTON (City or Town)

No. Boston State Hospital

.St .;

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

(City or town making return)

Registered No.10215

(If death occurred in a hospital or institution,

Ward

give its NAME instead of street and number)

2 FULL NAME

Ella

Quinn

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

(a) Residence.

No.

(Usual place of abode)

Winthrop ... Mass

Ward,

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred

yes.

mos.

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

yTs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Nov

1934

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

Aug

19. 34 to.

........ Nov.

23.

, 19 .... 34

I last saw h ..... . eralive on ....

NOV

19.34 .. , death is said

to have occurred on the date stated above, at.1 ... P. m.

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

Dateofonset

carcinoma of breast 1.930 ...

chronic endocarditis

1.922

general arteriosclerosis

·unk

Contributory causes of importance not related to principal cause: Psychosis with cerebral arteriosc1.Aug/21

Name of operation Date of What test confirmed diagnosis? clin exam ant opsan-autopsy ?..... y.es

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

M. D.

(Signed)

L.D. Chapman

(Address)

Boston

Date 11/23 /9 .34

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Forest Hills Boston

(Cemetery)

(City or town)

DATE OF BURIAL

Nov

19.34.

22 NAME OF

UNDERTAKER

T ... F. Brady

7 ADDRESS. 2 Hyde Park Ave F H

Received and filed

Dec. 10,

19 3 cl

(Registrar of City or Town where deceased resided)

important.

50m-9-131. No. 3.38 =_~

17 laformant (Address)

Hospital records

ATTEST:

(Registrar of city or town where death occurred)

ec 3

19 34

DATE FILED

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

widowed

5a If married, widowed, or divorced HUSBAND of

(or) WIFE of

(Give maiden name of wife in full)

Henry Quinn

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 AGE. 272

. Years .Months Days

If less than 1 day

Hours

Minutes

8 Trade, profession, or particular kind of work done, as spirner, sawyer, bookkeeper, etc.

OCCUPATION

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

at home

10 Date deceased last worked at

this occupation (month and

year)

11 Total time (years) spent in this occupationamak

12 BIRTHPLACE (City) (State or country)

Concord NH

13 NAME OF

FATHER

William Clark

PARENTS

14 BIRTHPLACE OF FATHER (City)

(State or country) Brattleboro Vt

15 MAIDEN NAME

OF MOTHER

Amanda Harris

16 BIRTHPLACE OF MOTHER (City)

(State or country) Boston

tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very

8 SEX

4 COLOR OR RACE

(write the word)

(If U. S.

War Veteran,

specify WAR)

211

M R-301 A

Suffolk-

...

(County)

Winthrop

...

(City or Town)

No. 21 Hawthorne Ave.

.St.

..... Ward

give its NAME instead of street and number)

2 FULL NAME

Mary Reed

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

specify WAR)

(a) Residence. No.

(Usual place of abode)

21 ... Taulhomme ... A.ve ..

St., .............

.. Ward,

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred 0

yrs.

mos.

days. How long in U. S., if of foreign birth? 55

yrs.

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

White

(write the word) Female

5 SINGLE

MARRIED

WIDOWED

or DIVORCED Widowed

5a If married, widowed, or divorced HUSBAND of

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

74 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. Tione

10 Date deceased last worked at

11 Total time (years)

this occupation (month and-

year)

48,78

spent in this

occupation ..... 22

12 BIRTHPLACE (City)

(State or antry)

Ireland

13 NAME OF

FATHER

Timothy O'Leary

14 BIRTHPLACE OF

FATHER (City)

(State or country)

Ireland

15 MAIDEN NAME

OF MOTHER

Johannah Mccarthy

16 BIRTHPLACE OF MOTHER (City) (State er country) Ireland

Informant

Mrs. Daniel Doherty (daughter)

(Address)

21 Hawthorne Ave., introp

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal or transit permit was issued: Www. D. Childress (Signature of Agent of Board of Health on other;

Health Much (Official Designation) (Date of Issue of Permit)

11/26/34

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Non

2.4

(Month)

(Day)

(Year)

I HEREBY CERTIFY. That I attended deceased from

Nous, 20

1934to.

Non 24. 1934

I last saw h

.alive on

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:

Date of Onset

Chronic marcas lits Blau Nichtis

.. IMPORTANT.

NON 2 34. Contribatory causes of importance not related to principal cause: Quenous

NO0 6, 34

Name of operation What test confirmed diagnosis ?.. clinical Was there an autopsy?

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

If so, specify.

putinson

(Signed)

(Addressb

M. D. 122 Date ROD +4 19 8 4

21 PLACE OF BURIAL,

CREMATION OR REMOVAL Winthrop. ..... Winthrop

(Cemetery)

(City or town)

DATE OF BURIAL- NOV. 26. 1934

22 NAME OF

UNDERTAKER

Richard Curly

ADDRESS

Last Boston

Received and filed

NOV 27 1934

(Registrar)

OCCUPATION 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 PARENTS

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.4.3.73

(If death occurred in a hospital or institution,

PLACE OF DEATH

(If U. S.

War Veteran,

212

1934

(Give maiden name of wife in full)

Nov, 28

19.3 .... . death is said

. F

Revised United

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

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,

'mili. ", 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

10IS

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 LAW 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 Sof 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,

;* 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 nysame 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 JObe 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 Ulsufficient reasons, his certificate cannot be obtained early enough Syfor 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. Unnot previously interred, from one town to another within the common-

wealth cannot be obtained early enough for the purpose, the certificate Oof death made as above provided and in the possession of the undertaker codesiring 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 Ha permit in the usual form for the removal of such body has been sooner Cobtained 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.

.... 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.

LIHAA

family, cook-hotel, etc. For a person who had no occupation what- Flor if there is no such board, from the clerk of the town where the ever write none.

M R-301 A

suffolk

PLACE OF DEATH

(City or Town) 32 Marshall St.

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

Charlotte Emma Gurke

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

32 Marshall

.St.,

.....

.Ward

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred

12yrs.

mos.

days.

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

yrs.

mos. days.

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

Widowed

(Husband's name in full)

If less than 1 day Hours. .Minutes

Housewife

Own home

11 Total time (years) spent in this occupation.

William Schalppe

Wilhelmina

17 Informant Mrs ..... Anna Woods

32 Marshall St. Winthrop

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

(Signature of Agent of Boardof Health or other) Dec. 1/34

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF DEATH November 29

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from august 25 192. 3

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

chuonic Myocardial

Degeneration

1932

Contributory causes of importance not related to principal cause: arteriosclerosis

1930

Civility

1933

Name of operation.

What test confirmed diagnostique gel x

Date of.

Was there an autopsy

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

If so, specify ...

(Signed)

(Address) 562 Aleveles.

Watching it Dateur. 30034

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

(Cemetery)

Winthro Winthrop

DATE OF BURIAL ..

Dec. 1

22 NAME OF

UNDERTAKER

Q. E. Long quin -

ADDRESS

77 Summer St., Malden

(City or town) 19 .. 34

Received and filed

DEC 3 1934

(Registrar)

(County) 1 .Winthrop No. (a) Residence. No ... (Usual place of abode) 3 SEX 4 COLOR OR RACE PoMalo White 5a If married, widowed, or divorced HUSBAND of (or) WIFE of 6 IF STILLBORN, enter that fact here. 7 74 5 AGE 8 Trade, profession, or particular 29 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) New York 13 NAME OF FATHER 14 BIRTHPLACE OF Saxony, FATHER (City) (State or country) Germany 15 MAIDEN NAME OF MOTHER 16 BIRTHPLACE OF PARENTS MOTHER (City) Berlin (State or country) Germany (Address) 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 ! (Official Designation) N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 12 BIRTHPLACE (City) (State or country) New York 100m-9-'33. No. 9321-a'

St., .....................

Ward

(If U. S. War Veteran,

specify WAR)

1934

eath is said to ..... Morceau 29, 19356 Member 20 1934 49: m.

Years Months Days

Revised United Suces Standard Certificate of Death

EXTRACTS FROM THE LAW IF THE COMMONWEALTH OF MASSACHUSETTS .

GOVERNING THE

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 státing 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

Chronic interstitial nephritis

1021

Cerebral hemorrhage

July 5, 1027

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.

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

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Town of Winthrop : Record of Deaths 1934, Part 87

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

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