Town of Winthrop : Record of Deaths 1935, Part 82

Author: Winthrop (Mass.)
Publication date: 1935
Publisher:
Number of Pages: 524


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1935 > Part 82


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(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-301A


Suffolk


(County)


Winthrop


(City or Town)


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


Goorge .. Whitaon .. Cook


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


(a) Residence. No ... Station.Hospital ... Fort ... Benkm ... St., ......... (Usual place of abode)


.Ward,


(If nonresident, give city or town and state)


Length of residence in city or town where death occurred JTS. ILOS.


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


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Male


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


Single


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


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


7 AGE


Years ... Months 8 ... Days


If less than 1 day) Hours Minutes


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


OCCUPATION


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


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


11 Total time (years) spent in this occupation.


12 BIRTHPLACE (City) .. (State or country)


Fort.Banks


assech


13 NAME OF FATHER


Jesse S. Cook


14 BIRTHPLACE OF FATHER (City)


Bergen .........


(State or country) Kentucky


15 MAIDEN NAME OF MOTHER


Betty Rosenborg


16 BIRTHPLACE OF MOTHER (City)


Hayward,


(State or country) California


Relation, if any


.... Cook (. Father.


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)


(Official Designation)


(Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


October 10


1935


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from October 2 19.55, to. October 10 ,19 35 I last saw h ... ... alive on October 10 19.5.6., death Is sald to have occurred on the date stated above, at ... L.Q .: 15m. P.II. The principal cause of death and related causes of importance in order of onset were as follows:


Congenital malformatimm of with .. absence ... of. upper two thirds inter ventricular sepiam.


Birth Oct.2.35


Contributory causes of importance not related to principal cause:


Name of operation


What test confirmed diagnosis ?..


Date of


.Autopay


Was there an autopsy?


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


If so, specify.


aplica


(Signed)


GLt . C . M. D.


(Address). Sta ,Hosp ani Date Oct ... 10 ...... 35


21 PLACE OF BURIAL, CREMATION OR REMOVAL


(Cemetery) (City or town)


DATE OF BURIAL


19


22 NAME OF UNDERTAKER


ADDRESS


Received and filed


19


...


(Registrar)


NN. D .- WRITE PLAINL


100m-12-'34. No. 2938-f


SeANS should state 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 showW' be carefully supplied. AGE should be stated EXACTLY. PHYSIC WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of


1


PLACE OF DEATH


NoStation.Hospital,.Fort Banis. .... .St.


....... .Ward


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


Data of Onset IMPORTANT ...


.heart


PARENTS


17 Informant J (Address) 306 Huron Are Cambrido


(write the word)


FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS


GOVERNIN MÌHE


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 will, 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.


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


1021


Cerebral hemorrhage


July 9, 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


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 deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)


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, Chat. 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 .. .. Chop. 114. Sec. 46, G. L., (Tercentenary Edition.)


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.


1


1


1


RM R-302


N. B .- WRITE PLAINLdYWITH UNFADING INK-THIS IS A PERMANENT RECORD. Ever; bem 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


PLACE OF DEATH


SUFFOLK (County)


BOSTON


(City or Town)


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


BOSTON (City or town making return)


Registered No.


8844


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


2 FULL NAME


Ida


Abrams on


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


specify WAR)


(a)


Residence. No.


(Usual place of abode)


171.Shore.Prive


St.,


.....


Ward, Winthrop


(If nonresident, give city or town and state)


Length of residence in city or town where death occurred


TTI.


mos.


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


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


W


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


married


5a If married, widowed, or divorced HUSBAND of


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


7 50


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 ..


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


11 Total time (years)


this occupation (month and


year)


Oct .1.1935


spent in this occupation 32


12 BIRTHPLACE (City)


(State or country)


Russia


13 NAME OF


FATHER


Sydney Simons


14 BIRTHPLACE OF


FATHER (City)


(State or country)


15 MAIDEN NAME


OF MOTHER


Cyril -


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Russia


17


Husband- Morris Abramson


Informant


(Address)


above


A TRUE COPY


Aceda Ofedition Quick


ATTEST:


(Registrar of city or town where death occurred)


DATE FILED Oct 15


193.5


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Oct 11


1935


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY. That I attended deceased from


Oct ... 1


1935., to.


Oct. 11


19 .. 35


I last saw h.


er


alive on


19


Oct 11


35


death is said


to have occurred on the date stated above, at. 1.20P.m. The principal cause of death and related causes of importance in order of onset were as follows:


Datesfonset


brain abscess


Contributory causes of importance not related to principal cause:


Name of operation


What test confirmed diagnosis?


Was there an autopsy? yes


20 Was disease or injury in any way related to occupation of deceased? ...... no.


If so, specify.


(Signed)


S.R. Kelson


(Address)


Boston


Date.


10/12.35


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Beth El Mt Lob W Rox


(Cemetery)


(City or town)


1935


22 NAME OF


UNDERTAKER


JH Levine


ADDRESS


Boston


19 35


Received and filed.


"NOV 8


1935


(Registrar of City or Town where deceased resided)


important.


50m-9-'31. No. 3385-g


1


No ... Beth Israel.Hospital


Ward


1.90


(If U. S.


War Veteran,


F


(write the word)


PARENTS


Russia


Date of


M. D.


DATE OF BURIAL


Oot


13


H


R-301A


Suffolk


(Count We inchof


(City of Town) 35 Banks


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 ..


194


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


Rose a. South


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


(a) Residence.


No.


35 Banks


.St., ...


.. Ward,


(if nonresident, give city or town and state)


(Usual place of abode)


Length of residence in city or town where death occurred


yrs.


mos.


days.


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


yTs.


mos. days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


October


12


1935


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


Mas. 1


1935, to


Oct 12, 1935


I last saw h. A ....... ailve on


1275 .... , death Is sald


to have occurred on the date stated above, at. Com. The principal cause of death and related causes of Importance In order of onset were as follows:


Date of Onset IMPORTANT ...


Cotronic Comprardeles


decompensation


1955


Contributory causes of importance not related to principal cause:


Name of operation.


Date of.


What test confirmed diagnosis? Cineal


Was there an autopsy ?...


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


If so, specify


Ena & Bourn


(Signed)


M. D.


(Address)


East Berlin


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Joly eross walden


(Cemetery)


15


(City or town) 935


22 NAME OF


David & Dooley


UNDERTAKER


135 London St


16, Boston


ADDRESS


Received and filed ...


OCT 2 1 1935


19


(Official Designation)


5 SINGLE


c(write the word)


MARRIED


WIDOWED


or DIVORCED


Widow


Ba If married, widowed, or divorced HUSBAND of Roberto maiden tomerci in full)


(or) WIFE of ...


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


7 72 .Years. Months Days


If less than 1 day


Hours.


.Minutes


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


Housework


at home


10 Date deceased last worked at


11 Total time (years)


spent in this


50 yas


12 BIRTHPLACE (City)


(State or country)


Ireland


18 NAME OF


FATHER


William Ennis


(State or country) Ireland


Margaret Show


Ireland


17 Mary A. Squiti


Informant (Address) 35 Banks #


DAUGHTER)


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)


Heute frecer 15/14/30 (Date of Issue of Permit)/


100m-12-'34. No. 2938-f


1 ... No ... 2 FULL NAME 3 SEX 4 COLOR OR RACE 20 AGE OCCUPATION 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME OF MOTHER PARENTS 16 BIRTHPLACE OF MOTHER (City) (State or country) 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 sho f be carefully supplied. AGE should be stated EXACTLY. PHYS' MANS should state WANT UNFADING BLACK INK=THIS IS A FLAMANENI KECOND. Every item of 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ...


PLACE OF DEATH


St., .................. Ward


CHE U. S.


War Veteran,


specify WAR)


(Registrar)


Date.


Del.18 1935


Relation, if any DATE OF BURIAL Oct


this occupation (month and Van 1934


year)


----


Revised United States Standard Certificate of Death


Statement of occupation .- Precise statement of occupation is very important, so that the relative healthifulness 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 trom 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 ......


Chronic interstitial nephritis


1021


Cerebral hemorrhage


July 3. 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.


KLIMAGAS FROM THE LAWS OF THE


COMMONWEALTH OF MASSACHUSETTS GOVERNING T


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, Scc. 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 appcar 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., (Tercentenary Edition.)




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