Town of Winthrop : Record of Deaths 1937, Part 42

Author: Winthrop (Mass.)
Publication date: 1937
Publisher:
Number of Pages: 532

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 42

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10 Date deceased last worked/ at .

11 Total time (years)

this occupation

year)

abril 22.1937

spent in this occupation.

12 BIRTHPLACE (City)

(State or country)

cheland

13 NAME OF

FATHER

Patrick Hagan

14 BIRTHPLACE OF

FATHER (City)

eluland

(State or country)

15 MAIDEN NAME

OF MOTHER

WE Cannot be Learned

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Cheland

100m-12-'35. No. 6156F

I HEREBY CERTIFY that a satisfactory standard certificate of death was med with me BEFORE the burim or transit permit was issued:

(Signature of Agent of Board of Healthfor other) Healthy Officer 5/1/37

(Oficial Designation) (Date of Issue of Permity

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

abril

29, 1937

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That i attended deceased from april 24 1:37, 10. april 29

I lagt saw her alive on.

april 25

19 ... ... , death is sald

to have occurred on the date stated above, at. t 912m ....

The principal cause of death and related causes of Importance la order of onset were as follows:

Date of Onset IMPORTANT

neumonia

Abril 25/37

Contributory causes of importance not related to principal cause:

Name of operation

What test confirmed diagnosis? clinical

Date of

Was there an autopsy?

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

(Signed)

.....

(Address)

Italyhard

Brookline

Place of Byfial, Cremation or Removal

may

1937

(City or Town)

22 NAME OF Juderick manath UNDERTAKER . 64 mendiar Sh JE Boston ADDRESS

Received and flied MAY 2 MIL

2 FULL NAME

Margaret Hagan

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

3 Jeaver.

St.

.Ward

(If nonresident, give city or town and state)

ALI PHYSICIANS should state CAUSE OF DEATH N. B .- WRITE PLAINLY.TR UNFADING BLACK INAULAACILI. 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

17 Philip Hagan Relation if any nephew DATE OF BURIAL ......

Isformant (Address) 3 Slaver At East Boston

PARENTS

Date 4/30/039 M. D.

(Registrar)

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:

Date of Onset

Arteriosclerosis

1915

Chronic interstitial nepbritis

1921

Carebral 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.

A physician or registered hospital medical officer shall forth- with, alter 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 sup- posed 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 satisfactory written statement con- taining 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 re- quired by law, or in lieu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot be obtained early enough for the pur- pose, 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 attend- ing 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 an- other within the commonwealth 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 a reinoval shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was re- moved 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 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 ap- pear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith counter- sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician cer- tifying 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. (TER- CENTENARY 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 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 cemetery 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 ob- servance 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 unrelated to any form of injury, have died without recent medical attendance 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 septi- cemia), 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.

R-301

PLACE OF DEATH

Suffolk (County) Winthrop (City or Town) Winthrop Comm. Hoss No ...

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

(City or town making return) .....

STANDARD

CERTIFICATE OF DEATH

Registered No.

106

§ (If death occurred in a hospital or institution, .Ward \ give its NAME' instead of street and number)

Sacks

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

(a) Residence.

No ..

1049

(Usual place of abode)

BOUDton

Bronx Day

(If nonresident, give city or town and state)

months

days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

Married

6a If married, widowed, or divorced HUSBAND of

(or) WIFE of

Solomon

Sacks

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE 28 Years Months .Days

If less than 1 day

Hours .. Minutes

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

Housewife

Ø Industry or business in which work was done, as silk mill, nw mill, bank, etc ..

At home

10 Date deceased last worked at

this occupation (month and

year)

Feb-1937

11 Total time (years) spent in this Occupation Samthe

12 BIRTHPLACE (City) (State or country)

Boston

13 NAME OF

FATHER

Theodore Kachelnick

(State or country)

Russia

15 MAIDEN NAME

OF MOTHER

Katherine Kachelnick

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Russia

17 Soloinen Sachs (Husband)

Helations if any

Ivfermant (Address) 1049 Bousiton St. Der

I HEREBY CERTIFY that a sausfactory standard certificate of death mas Man. D. Children (Signature of Agents of Board of Herin onother)

5/1/37

(Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

abril

(Month)

30 1937

(Day)

(Year)

I HEREBY CERTIFY, That | attended deceased from

I last saw e .... .. alive on april 30, 1937, death is said to have occurred on the date stated above, at 3,50Pm. The principal cause of death and related causes of Importance la order of onset were as follows;

Bicommute Uterus

Premating Birch (6/2 month anul 25-37

Contributory causes of Importance not related to principal cause: Retained Placenta

Lapremia

Name of operation

What test confirmed diagnosis?

Was there an autopsy? o

Date of.

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

So, Specie Frank Y Sandler

M. D.

(Signed)

(Address).

Date De 2019.37

International Gerne Removal. (City or Town)

21.

Made of Burfaf

Cremation

DATE OF BURIAL

Everett

Mdra 1927

22 NAME OF

UNDERTAKER

ADDRESS

Hor

Received and filed

MAY 4

A TRUE COPY ATTEST :

(Registrar)

1 2 FULL NAME 3 SEX F 7 OCCUPATION PARENTS See instructions and extracts from the laws on back of certificate. important. in plain terms, so that it may be properly classified. Date of onset and exact statement af OCCUPATION are very wan Dermation) IV. D. - WRIL TLAINLT, WITH Ofalcu LAMVILI, THISICIANS should state CAUSE OF DEATH 14 BIRTHPLACE OF FATHER (City) 100m-12-'35. No. 6156E

St.,.

Freuda

Length of residence in city or town where death occurred years

months

days.

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

years

(If U. S.

War Veteran

specify WAR)

1937, to april 30

1937

Date of Onset

april 25-37

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 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 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.

Example

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

Date of Onset

Arteriosclerosis

1915

Chronic interstitial nepbritis

1921

Cerebral hemorrhage

July 5. 1927

Contributory causes of importance not related to principal cause :

physician or registered nospawns meusves vissves

with, alter 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 sup- posed 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 satisfactory written statement con- taining 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 re- quired by law, or in lieu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot be obtained early enough for the pur- pose, 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 attend- ing 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 an- other within the commonwealth 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 a removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was re- moved 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 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 ap- pear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith counter- sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician cer- tifying 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. (TER- CENTENARY 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, CHAP. 38, SEC. 7.

RULES OF PRACTICE

The fulfillment of the purpose of these laws calls for the ob- servance 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 unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.

I R-302

PLACE OF DEATH

SUFFOLK (County)

BOSTON

(City or Town) Peter Bent Brigham 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

3739

(If death occurred in a hospital or institution,

Ward

give its NAME instead of street and number)

2 FULL NAME

Charles W

Rolling

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

(a)

Residence. No.

(Usual place of abode)

283 Court Rd

St.,

Ward,

Winthrop

(If nonresident, give city or town and state)

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

April 6

193 7

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

April ... 6.

19 .3.7, to

April ... 6.

19.3 .... 7

I last saw him alive on.

April ... 6

19 ..... 3.7, death is said

to have occurred on the date stated above, at. 4.20P.

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

Datesfonset

Hypertension

cerebral hemorrhage

4 yrs

hrs

Contributory causes of importance not related to principal cause:

Name of operation

What test confirmed diagnosis?

Date of

Was there an autopsy? yes

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

If so, specify.

W W Knowlton

(Signed)

(Address)

Boston

Date

4/7/

M. D.

19 3.7

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

Winthrop

Mass

(Cemetery)

(City or town)

DATE OF BURIAL

April

19 3.7.

22 NAME OF

UNDERTAKER

J. F .O' Maloy

Winthrop

ADDRESS

Received and filed

MAY 1 4 1937

(Registrar of City or Town where deceased resided)

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

Wife-

above

ATTEST:

Acida Ofeditions Quick

(Registrar of city or town where death occurred)

April 10

DATE FILED 19 37

(write the word)

4 COLOR OR RACE

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

married

5a If married, widowed, or divorced

HUSBAND of

Edith Goggin

(Give maiden name OFwife in full)

(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.

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Town of Winthrop : Record of Deaths 1937, Part 42

Author: Winthrop (Mass.) Publication date: 1937 Publisher: Number of Pages: 532

Author: Winthrop (Mass.)
Publication date: 1937
Publisher:
Number of Pages: 532