Town of Winthrop : Record of Deaths 1934, Part 89

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 89


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(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.


M R-301


Suffolk


(County)


Winthrop


(City or Town) No. .Winthrop Communi ty Hospital St.,


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


Winthrop, Mans (City or town making return)


Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)


2 FULL NAME ..


Howell.C.Wardwell


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


(a) Residence. No ...


114 .. Pleasant


.....


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


Ward,


(Usual place of abode)


Length of residence in city or town where death occurred 22


yrs.


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


Widowed


or DIVORCED


5a If married, widowed, or divorced HUSBAND of


Ida (Barrett) Wardwell


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


Years 3 Months 8Days


If less than 1 day . Hours .Minutes


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


Salesman


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


Clothing Store


10 Date deceased last worked at


11 Total time (years)


spent in this


occupation.


this occupation (month andgay .1931


year)


12 BIRTHPLACE (City)


Stoneham


(State or country) Massachusetts


13 NAME OF


FATHER


David K. Wardwell


14 BIRTHPLACE OF


FATHER (City)


Olsfield


(State or country) Maine


Susan Briggs


16 BIRTHPLACE OF


MOTHER (City)


Paris


(State or country) Maine


17 Record of Welfare Dept.


Town of Winthrop


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)


Realthe 13/7/35


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


December


Fifth


(Day)


19.34


(Month)


(Year)


19


HEREBY CERTIFY, That I attended deceased from


-


V تعري 19


I last saw h Lalive on


1937 to Un 5 19 ..... 7., death is said


10 Pm.


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


Contributory causes of importance not related to principal cause:


Name of operation


What test confirmed diagnosis?


Date of


Was there an autopsy?


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


If so, specify


(Signed)


nhatran Date 12/191


M. D.


(Address)


Lindenwood


Mass ...


(City or town)


DATE OF BURIAL


December


7th.


19.3.4


22 NAME OF


Richard H ... White


UNDERTAKER


ADDRESS


147 Winthrop St. Winthrop, Mass


Received and filed


DEC 1-2 1934


19


A TRUE COPY, ATTEST: (Registrar)


١


Ward


War


(If U. S.


War Veteran,


specify WAR)


(If nonresident give city or town and state)


4 COLOR OR RACE


Whi te


PLACE OF DEATH


1 3 SEX Male 7 AGE 77 OCCUPATION PARENTS (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 N. B .- WRITE PLAII, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 15 MAIDEN NAME OF MOTHER 100m-11-'30. No. 605-b


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


(Cemetery)


Stoneham


Revised United States Standard Certificate of Death


Statement of occupation .- Precise statement of occupation is ervy 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: Arteriosclerosis


Date of onset


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.


IM R-302


ISU!


(Countr) BOSTON


(City or Town)


No. Strong. Hospital


St.,


..... Ward


BOSTON


(City or town making return)


Registered No.


104.7.2


(If death occurred in a hospital or institution,


give its NAME instead of street and number)


2 FULL NAME


Jackson


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


(a)


Residence. No.


(Usual place of abode)


1.08 ... Brookfield ... Rd


St.,


Ward,


(If nonresident, give city or town and state)


Length of residence in city or town where death occurred


утв.


mos.


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


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Dec 6 1934


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from Dec 6 19.34, to.


Dec 6 19 ... 34


I last saw


im alive on


Dec


6


19


34death 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:


Dateofonset


premature birth


7.mos pregnancy


Contributory causes of importance not related to principal cause:


Name of operation


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


(Signed)


JH Strong


M. D.


(Address)


Boston


Date12/7/ 19 34


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Winthrop


Winthrop


(Cemetery)


(City or town)


DATE OF BURIAL


D.ec


8


1934


22 NAME OF


UNDERTAKER


C ... R.Bennison


ADDRESS


Winthrop


Received and filed JAN 9


1535


(Registrar of City or Town where deceased resided)


important.


50m-9-31 No. 3385_₪


17 Informant (Address)


Mrs. Carl ... Olafsson WA beop


A TRUE, COPY.


ATTEST.


(Registrar of city or town where death occurred)


DATE FILED


Dec


11


19.34


(write the word)


3 SEX


M


4 COLOR OR RACE


W


5 SINGLE


MARRIED


WIDOWED


OF DIVORCED


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


AGE .Years. Months Days


If less than 1 day


Hours .... 1.5 Minutes


OCCUPATION


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


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


10 Date deceased last worked at


11 Total time (years)


spent in this


occupation.


this occupation (month and


year)


12 BIRTHPLACE (City)


E Boston Mass


(State or country)


13 NAME OF


FATHER


Nels C Jackson


14 BIRTHPLACE OF


FATHER (City)


PARENTS


(State or country) Sweden


15 MAIDEN NAME


OF MOTHER


Pura Olafsson


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


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 tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE


1


PLACE OF DEATH


JEFOLK


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


(If U. S.


War Veteran,


specify WAR) Winthrop


19


M R-302


PLACE OF DEATH


SUFFOLK BOSTON (City or Town)


No. Infants ... Hospital


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


(City or town making return)


Registered No.


10497


(If death occurred in a hospital or institution,


give its NAME instead of street and number)


Jackson


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


108 Brookfield Rd


.St.,


Ward,


Winthrop


(If nonresident, give city or town and state)


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


mos.


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


yrs.


mos. days.


PERSONAL AND STATISTICAL PARTICULARS


(write the word)


(Give maiden name of wife in full)


If less than 1 day


Hours


.Minutes


11 Total time (years) spent in this occupation.


E Boston Mass


Niels Jackson


Tora Olafson


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


Grandmother T Olafson above


(Registrar of city or town where death occurred)


Dec 11 19.34


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Deo 8


1934


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


Dec


6.


19 .. 3.4 to


Dec


8


19 ...


3.4


I last saw h ..


.......... alive on


19


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: prematurity


Date of onset


12/8/34


Contributory causes of importance not related to principal cause:


ateleclasis


Name of operation


What test confirmed diagnosis?


Date of


Was there an autopsy?


no


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


(Signed)


M Gill


M. D.


(Address)


Boston


Date


12/8/ 19.34 ..


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Winthrop


Winthrop


Cemetery)


(City or town)


DATE OF BURIAL


Dec


10


19 ..... 34


22 NAME OF


UNDERTAKER


C ... R.Bennison


ADDRESS


Winthrop


Received and filed


JAN 9


1935


19


(Registrar of City or Town where deceased resided)


1 2 FULL NAME (a) Residence. No. (Usual place of abode) 3 SEX M 4 COLOR OR RACE W 5a If married, widowed, or divorced HUSBAND of (or) WIFE of (Husband's name in full) 6 IF STILLBORN, enter that fact here. 7 AGE Years Months .2 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) 12 BIRTHPLACE (City) (State or country) 13 NAME OF FATHER 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME OF MOTHER PARENTS 17 Informant (Address) A TRUE COPY. ATTEST: 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_ N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- (State or country) Sweden


.St.,


.....


Ward


(L U. S.


War Veteran,


218


specify WAR)


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


M-


2


M R-301


Suffolk


(County)


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


(City or town making return)


Registered No.


219


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


2 FULL NAME.


Harriet (Owen) Winter


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


(a) Residence. No ..


483 ... Shirley.


.St., ..


..........


.Ward,


(If nonresident give city or town and state)


Length of residence in city or town where death occurred


I 8 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


Dec.


9


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from January 8 1932 to December 4, 1934


Mast saw her


... alive on


December 9, 1934 death is said


6:30Am.


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


Chronic Myocardial Degeneration 1931


Contributory causes of importance not related to principal cause: arteriosclerosis


1930


Senility


1934


Name of operation


What test confirmed diagnosis Cancelx


Labrary


none


Date of


Was there an autopsy 220


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


M. D.


If so, specify.


(Signed) Jacobo abiqua 100


(Address) 562 Stanley


Date: Dec 10 9 34.


21 PLACE OF BURIAL,


CREMATION QR-REMOVAL


Forest Hills Boston


(Cemetery)


(City or town)


DATE OF BURIAL


Dec. 12 /34


19


22 NAME OF


Richard H. White


UNDERTAKER


ADDRESS


147 Winthrop St. Winthrop


Received and filed 19


A TRUE COPY, ATTEST:


DEC 12 1934


(Registrar)


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Widowed


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


Charles G. Winter


(Husband's name in full)


If less than 1 day


Hours. .Minutes


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


10 Date deceased last worked at


11 Total time (years)


spent in this


occupation


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


Health Khivier 7 (Official Designation) V


(Date of Issue of Permit)


12/10/34


St.,.


.......... Ward


PLACE OF DEATH


Winthrop 1 (City or Town) No. 483 Shirley (Usual place of abode) 3 SEX 4 COLOR OR RACE Femsle White (or) WIFE of 6 IF STILLBORN, enter that fact here. 7 AGE 75 Years. 7 Months 3 .Days 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc. this occupation (month and OCCUPATION year) 12 BIRTHPLACE (City) Manchester (State or country) England 13 NAME OF FATHER Elias Owen 14 BIRTHPLACE OF FATHER (City) (State or country) Wales PARENTS 16 BIRTHPLACE OF MOTHER (City) (State or country) England 17 Son Harold R. Winter Informant 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-11-'30. No. 605-b N. B .- WRITE PLAINSY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 15 MAIDEN NAME OF MOTHER Jane Barnett


(Address) 15 Elliott St. Winthrop Mass.


(If U. S.


War Veteran,


specify WAR)


34


Revised United States Standard Certificate of Death


Statement of occupation .- Precise statement of occupation is ervy 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: Arteriosclerosis


Date of onset


1015


Chronic interstitial nephritis


1021


Cerebral hemorrhage


July 5, 1927


Contributory causes of importance not related to principal cause:


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




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