USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 14
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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 discase 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 enset
Chronic interstitial nephritis
1921
Cerebral hemorrhage
July J, 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.
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 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 certificata 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., (Torcentenary Edition.)
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by vinience .... 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 thercof 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., (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 supposebly 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 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.
R-301
SUFFOLK
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
(City or town making retura) 3T
Registered No.
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
CILARLES A. ALDPICU
(If de, eased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ........
.Cuttingsville, ... Vermont.
.St.,
.Ward,
(Usual place of abode) Length of residence in city or town where death occurred yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from January .... 19, 19.5.7, to ..... F.e.brug ........... 10 .... , 19 .... 3.7 1 last saw him ..... alive on February. 10 .. ....... , 19 ... 3 .. 7, death is said
ury ,
to have occurred on the date stated above, at. 9:45Pm. The principal cause of death and related causes of importance in order of onset were as follows: Date of Onset
Arteriosclerosis, generalized, sovor .. .
cause ... undetermined
Unknown
Arterial hypertension, .. severe,sac ....
Unlmam'
3
Troplexy
Contributory causes of importance not related to principal cause:
Fracture, simple , complete, spiral, comminated,nia third humerus,right
a coidentally incurred
due to ento accident, 3 mos por 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
alexander
(Signed)
Alexander O. Taff, Caht NC
, M. D.
(Address)
Date ..... ) 10937
21 PLACE OF BURIAL,
Cuttingsville Vermont
CREMATION OR REMOVAL
(Cemetery)
-
DATE OF BURIAL
Feb.12
22 NAME OF
UNDERTAKER
Morvan + Murray
ADDRESS
254 Beach St Revere
Received and filed 19
FEB 1º 193
A TRUE COPY, ATTEST:
(Registrar)
-
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the bayjal or Transit permit was issued:
Signature of Agent of Board of Health of Neacite Officer x9/37
100. 12'-'32.
(County) 1 3 SEX 4 COLOR OR RACE iale White 5a If married, widowed, or divorced HUSBAND of 'or) WIFE of 6 IF STILLBORN, enter that fact here. 8 Trade, profession, or particular OCCUPATION 12 BIRTHPLACE (City' 13 NAME OF FATHER 14 BIRTHPLACE OF FATHER (City, PARENTS 16 BIRTHPLACE OF MOTHER City. (State or con try) laformant (Al :ress) 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 - kind of work done, as spinner, sawyer, bookkeeper, etc. No. 7070-h
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
(Give maiden name of wife in full)
(Husband's name in full)
7 AGE ... 5.3. Years 3 Months 22 Days
If less than 1 day
.Hours. .Minutes
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ........ Civilian Conservation Cortisondary to #1
10 Date deceased last worked at this occupation (month_ and year . January 1937
11 Total time (years) spent in this occupation. 3
Icams Holly,
(State or cou :"y) Vermont
(State or country) Vermont
15 MAIDEN NAME OF MOTHER Mary Mizaboth Join our
17 Fort Banks
PLACE OF DEATH
(City or Town) No ... Sta Hospital Fort Banks Mess St.,
Ward
(If U. S. War Veteran, specify WAR)
(If nonresident, give city or town and state)
1937
2/3/37
12/21/30) trice
(City or town)
19 3. 7
Date ut 1. sav of Per .... 4
Farmer and laborer
COMMONWEALTH OF MADOMY GOVERNING THE
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee." "worker. " : "operative," etc. Find out the parti- cular kind of work done and return that, as spinner. weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store, " "factory," "mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis
Date of onset
1015
Chronic interstitial nephritis
1921
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.
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., 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 à 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.
-301A
PLACE OF DEATH
Suffolk (County) Winthrop
(City or Town)
L 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.
32
Registered No. § (If death occurred in a hospital or institution, Ward \ give its NAME' instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
183 Landen
St.,
1
Ward,
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
days.
How long in U.S., if of foreign birth?
years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Make
4 COLOR OR RACE
Abrite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, er divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of (Husband's name ip full)
6 IF STILLBORN, enter that fact here. Stillborn
7 AGE
Years Months Days
.Hours Minutes
OCCUPATION
8 Trade, profession, or particular kindof 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)
Wentura
11 Total time (years) spent in this occupation ..
12 BIRTHPLACE (City)
(State or country)
Dreico
PARENTS
15 MAIDEN NAME
OF MOTHER
yamato
16 BIRTHPLACE OF MOTHER (City) (State or country)
Italy
17 Mungel Greco future)
Informant/ (Address) 183 senden St EBoston
I HEREBY CERTIFY that a satisfactory standard certificate of death was thed with me BEFORE the burial or, transit permit was issued:
ASignature of Agent of Board of Health or other)
(Date of Issue of Permit) 2/11/37 (Odcial Designation)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
11-
1937
(Day)
(Year)
19 I HEREBY CERTIFY, That i attended deceased from
.
19
to
19
I last saw b
afive 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: Date of Onset IMPORTANT Stella
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
Charlie Melini
(Signed)
M. D.
(Address)
305 Havre 2 6 /Booty
tabul
19.07
Date
Boston Maso
Place of Burial, Cremation or Removal.
City of Town)
12
1937
2: NAME OF Hummel . Gaggiano UNDERTAKER
ADDRESS
978 Saratoga ERaria
Received and filed.
19
FEB 12 1937
(Registrar)
100m 12.º35
important. See instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very
No. 6156F
1
Monthsof Community Hoepored No. Baby Boy Erisso Freies
(If U. S. War Veteran
specify WAR)
-
If less than 1 day
18 NAME OF
FATHER
Michael Grieco
14 BIRTHPLACE OF FATHER (City) (State or country) Italy
21.5
Relation, if any
DATE OF BURIAL 94.600
Statement of occupation. - Precise statement of occupation is- very important, so that the relative healthfulness of various pur- suits 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 bus- iness, report the occupation prior to retirement. Children not gainfully employed may be returned as AT SCHOOL Of 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 whatever 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 partic- ular kind of work done and return that, as SPINNER, WEAVER, etc.
In stating the industry or business, avoid the use of such gen- eral 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 ENGIN- EER, 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
....
1921
Chronic interstitial nephritis
July 5, 1927
Cerebral hemorrhage
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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