USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1935 > Part 86
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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.
UM R-302
PLACE OF DEATH
SUFFOLK (County) BOSTON
(City or Town)
No. Beth Israel Hospital
St.,
.....
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No.
9107
(If death occurred in a hospital or institution,
Ward
give its NAME instead of street and number)
~
2 FULL NAME
Charlotte
Goodman
(If deceased is a married, widowed or divorced woman, give also maiden name.)
-
specify WAR)
.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
3 SEX
F
4 COLOR OR RACE
W
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
widow
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
Abraham Goodman
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE . 51 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 .....
housework
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)
Russia
13 NAME OF
FATHER
Jacob Parker
PARENTS
15 MAIDEN NAME
OF MOTHER
Jennie -
16 BIRTHPLACE OF MOTHER (City) (State or country)
Russia
17 Son- Max Goodman
Informant
(Address)
above
A TRUE COPY
ATTEST:
Heida Ofeditions Quirks
(Registrar of city or town where death occurred)
DATE FILED
Oct 24
.19.3.5
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Oct 22
1935
(Month)
(Day)
(Year)
35
19 I HEREBY CERTIFY, That I attended deceased from
Oot
20
35
Oct 22
., to.
19
[ last saw h .alive on.
er
19.
Oct
22
35 death is said
19
5.20A
m.
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:
Dateofonset
tumor of mediastrum
arteriosclerotic heart disease
congestive heart failure
5 yrs umk 3 wks 1
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy? ... no
20 Was disease or injury in any way related to occupation of deceased?
no.
If so, specify
(Signed)
B.Alexander
(Address)
Boston
Date
10/224 35
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Everett ... Jewish
Everett.
(Cemetery)
(City or towa)
.19.35
22 NAME OF
UNDERTAKER
M Stanetsky
ADDRESS
Boston
Received and filed
19.
35
NOV 8
1935
(Registrar of City or Town where deceased resided)
1
(
important.
50m-9-'31. No. 3385-g
OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
1
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 from of informa-
1
Contributory causes of importance not related to principal cause:
14 BIRTHPLACE OF
FATHER (City)
Russia
(State or country)
M. D.
DATE OF BURIAL
Det
22
(IF U. S.
War Veteran,
202
(a)
Residence.
No.
(Usual place of abode)
50 Cutler
M.
- --
IR-301
LvCây ICHII VI
1
PLACE OF DEATH
Suffolk .........
(County)
Winthrop
(City or Town)
No. 54 Highland Avenue
......
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
203
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Margaret Jane Bailey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence. No ..
54 Highland Avenue
Ward,
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred 30 yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a If married, widowed, er 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 75
Years 7 Months 20
Days
If less than 1 day .Hours Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Book keeper
9 Industry or business in which
work was done, as silk mill,
Office
saw mill, bank, etc ..
10 Date deceased last worked at
11 Total time (years)
1917
spent in this
occupation.
12 BIRTHPLACE (City)
East Boston
(State or country)
Massachusetts
18 NAME OF
FATHER
James Bailey
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
15 MAIDEN NAME OF MOTHER Hannah C. McGaw
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
17 Mrs. E. J. McDonald
Relation, if any niece
(Address) 119 Saratoga St. East Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or fransit permit was issued: www.D.Cularex.O. Signature of Agent of Board of Health or other) Thatthe Quier 11/26/35
7(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Oct
(Month)
(Day)
1935 (Year)
--
I HEREBY CERTIFY, That I attended deceased from
19_ oct 14 1985, to Bct, 241, 1935
I last saw ... alive on Bet, 24 19.c., death Is said to have occurred on the date stated above, at&2.3.5.00 m. The principal cause of death and related causes of importance In order of onset were as follows:
arteriosclerosis Defrance myocardin
1925 1930
Contributory causes of importance not related to principal @use: Chronic archillis
1910
What test confirmed diagnosis?
Was there an autopsy ?...
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
Saulie w Dickinson M. D.
(Signed)
(Address)
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Woodlawn
Everett
(Cemetery)
(City or town)
DATE OF BURIAL
October 27, 1935
19
22 NAME OF
UNDERTAKER
Charles R. Bennison
ADDRESS
Winthrop Mass
Received and filed.
APT 31 1535
19
A TRUE COPY, ATTEST:
(Registrar)
100m-12-'34. No. 2938-e
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. PHYSICIENS should state is very important. See instructions and extracts from the laws on back of certificate.
Name of operation
Clinical
Date of Onset
AGE
this occupation (month and
year)
...... .Ward
(If U. S.
Atvlieu Unter 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 aocount 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 aa 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-privcis family, cook-hotel, etc. For a person who had no occupation what- ever write nene.
:
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
rors
Chronic interstitial nephritis
1921
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 cither first, second, or third position. The principal cause in the above example happens to be the second cause given.
...
OF THE
COMMONWEALTH O ASSACHUSETTS
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 thy 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 scen 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, ce 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, shail 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 shail 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 thercafter 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 tha 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.
1
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 electrics] agents, and deaths following abortion, but also deaths from discaso 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
(County)
1 Hoxlow (City pr Town) State Marital No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Foxboro (City or town making return) 121
Registered No (If death occurred in a hospital or institution, give its NAME instead of street and number)
204
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No ..
(Usual place of abode)
Length of residence in city or town where death occurred
12
yTs. 7
mos.
5 days. How long in U. S., if of foreign birth? JTs.
mes.
days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Simple
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 73
AGE 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. ..
Homebrefan.
10 Date deceased last worked at this occupation (month and year)
11 Total time (years) spent in this occupation cence
12 BIRTHPLACE (City)
(State or country)
Man.
13 NAME OF
FATHER
John Eatough
14 BIRTHPLACE OF
FATHER (City)
(State or country) England.
15 MAIDEN NAME
OF MOTHER
Euphemis & Monarch
16 BIRTHPLACE OF
MOTHER (City)
(State or country) Scotland
17 Record Forhow State
(Address)
A TRUE COPY.
ATTE port. Dechardta
(Registrar of city or town where death occurred)
DATE FILED
oct
31
1935-
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Det
24
1930-
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That | attended deceased from Sept 1 19.3.3, to .. Qnt24 1985%
I last saw h ...... ... alive on ort 23 1935, death is said
to have occurred on the date stated above, at 212 . 1 Ml.
order The principal cause of death and related causes of importance in onset were as follows:
Datesfonset
and Ke
1984
Contributory causes of importance not related to principal cause: Diabetes Mellitin
1992
... Senile Psychose
1913
Name of operation
Date of
What test confirmed diagnosis lab
Was there an autopsy? yes.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
San lord Plovon.
M. D.
(Signed)
(Address).
Fixlow Man- Date10-2×-1934-
21 PLACE OF
AL May flower Taunton
CREMATION OR REMOVAL
(Cemetery) (City or town)
DATE OF BURIAL
Cont 27
193
22 NAME OF
Conturight+ Hurley.
UNDERTAKER
ADDRESS
Received and filed.
19
N.O.V 5
1935
(Registrar of City or Town where deceased resided)
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS shouANstate CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very OCCUPATIONI important. 50m-9-'31. No. 3385-g N. B .- WRITE PLAINLY,WIITH UNFADING INK-THIS IS A PERMANENT RECORD. Every i: 4 of informa- PARENTS
...
2 FULL NAME
Alice Eatough
St.,
Ward
(If U. S.
War Veteran,
-
specify WAR)
Winthrop Man.
St.,.
Ward
(If nonresident, give city or town and state)
If less than 1 day Hours. Minutes Carcino 1 left Breast
lavendon
MM R-301A
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-12-'34. No. 2938-f N. B .- WRITE PLAINLY,WIITH UNFADING BLACK INK-THIS IS A PERMANENT RECOR, E Every item of PARENTS
PLACE OF DEATH
Suffolk
The Commawealth 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.
Tamo If death occurred in a hospital or institution. WWard give its NAME instead of street and number)
2 FULL NAME.
June Marie Frazier
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of residence in city or town where death occurred
JT8.
mos.
8
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
urgie
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.
4
.Months
3
Days
If less than 1 day .Hours .. .. 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
this occupation (month and
year)
Winthrop
11 Total time (years)
spent in this
occupation.
12 BIRTHPLACE (City)
(State or country)
mass
18 NAME OF
FATHER
Arthur S. Frazier
14 BIRTHPLACE OF
FATHER (City)
Erst Bolton
(State or country) Mass
15 MAIDEN NAME
OF MOTHER
Marie Fennell
16 BIRTHPLACE OF
MOTHER (City)
Sagt Baton
(State or country)
- Mass
17
Arthur S Frazier (Father
Informant
(Address)
40 igames Are. 6.13.
1 HEREBY CERTIFY that a satisfactory standard certificate of death was Med with me BEFORE the bunal or transit, permit was issued: m. D. Juldress (Signature of Agent of Board of Health or othery Healthe Pieces 10/20/35 / (Official Designation) (Date of Issue of Permit),
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Octobre
25
1935
(Month)
(Day)
(Year)
I HEREBY CERTIFX, That I attended deceased from
October 14, 1931
I last saw h .......... allve on
Cert 2+
19.3 ..... death is said
to have occurred on the date stated above, at .! 12.10/Fr.
The principal cause of death and related causes of importance in order of onset were as follows:
Dale of Onset NA: ORTANT
Infections Diarrhea
Get 10.55
Contributory causes of importance not related to principal cause:
Brandy precum
a+ 24.33
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.
And Sales
(Signed)
(Address) 16 LAC But
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Holy Orosa Mullen
DATE OF BURIAL
October
gretery) 26
1935
22 NAME OF
UNDERTAKER
11 Meridian JA 1, 5.13.
ADDRESS
Received and filed.
DUTY 1935
.19
(Registrer)
M. D.
Date .......
.19
(City or town) 1
Relation, if any
1
(County) Winthrop (City or Town) No. Winthrop Community
(I U. S.
War Veteran,
40 Barnes.
Are
St.,
1
Ward,
East Boston
(If nonresident, give city or town and state)
Git " )
19 .. 3.3
GUMMUNWEALTH OF MASSACHUSETTS GOVERNIN HE
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.
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