Town of Winthrop : Record of Deaths 1937, Part 45

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

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 45

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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Sec. 6.

.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.

No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made ... . Chap. 114. Sec. 46, G. L., (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.

R-301 A

PLACE OF DEATH

Suffolk

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. 119

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

2 FULL NAME

Cara 3. Chase

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

9 Locust

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

(If nonresident, give city or town and state)

mos.

days.

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

Widowed

(Give maiden name of vife in full)

Lewis W Chase

If less than 1 day

Hours

Minutes

av Home

11 Total time (years)

spent in this

occupation

(State or country)

maine

13 NAME OF

FATHER

William Leighton

14 BIRTHPLACE OF

FATHER (City)

Dexter maine

15 MAIDEN NAME

OF MOTHER

Eliza Hollis

(State or country)

maine

ho John Sheppard Daughter

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

willi.

Childress

(Signature of Agent of Board of Health or other)

may 5/37

agent (Official (Designation) (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

may

1937

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from Запису 10 1926 to. 19.3 May 4

I last saw hx ........ alive on

may

.....

to have occurred on the date stated above, at 1:30 9um1. The principal cause of death and related causes of importance in order of onset were as follows: acuto Cormay Munubrain

Date of Onset IMPORTANT They 4/37

Coptributory causes of importance not related to principal cause: arterinderano

1926

Name of operation une

Date of.

.Was there an autopsy 20

What test confirmed diagnosis liquegly

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

(Signed)

M. D.

562 Study Toate May 5087

(Address)/ ....

21 PLACE OF BURIAL,

CREMATION OR REMOVAL

mt Pleasant maine

Cemetery)

(City or tow. )

DATE OF BURIAL

may

19 37

22 NAME OF

R.C. Why

UNDERTAKER

ADDRESS

1642 Commonwealth aux Bola

Received and filed

MAY 1 2 193

(Registrar)

100m-9-'33.

(County)

Winthrop

(City or Town)

No ...

9 Lacual

(a) Residence. No ...

(Usual place of abode)

Length of residence in city or town where death occurred

3 SEX

Female

4 COLOR OR RACE

White

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

Years

Months

Days

& 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)

(State or country)

PARENTS

OCCUPATION

16 BIRTHPLACE OF

MOTHER (City)

Ceter

Informant .

(Address)

No. 9321-a

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

12 BIRTHPLACE (City)

Dexter

in very important. See instructions and extracts from the laws on back of certificate.

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

(If U. S.

War Veteran,

specify WAR)

4 yrs.

mos.

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

yrs.

........

., 193 .... 7., death is said

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 ot 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 houscke per-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 terins 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.

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 , 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.

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.

-301A

PLACE OF DEATH Suffolk (County) Withhuge (City or Town)

210 Shore Drive

No.

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.

120.

§ (If death occurred in a hospital or institution,

St.,

Ward \ give its NAME' instead of street and number)

2 FULL NAME

Fred Ausfriend

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

(a) Residence.

No.

210 Shore Drive

(Usual place of abode)

Length of residence in city or town where death occurred 18 years

months

days.

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

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

May

1937

(Month)

(Day)

(Year)

19 I HEREBY

Octobre

CERTIFY, That I attended deceased from

1937

1934, to May 7

7 0

19 32 death is sald

I last saw h .. KAna .. allve on

to have occurred on the date stated above, at 10 pm. The principal cause of death and related causes of importance la order of onset were as follows:

Date of Onset IMPORTANT

carcinoma Precum

Oct 1934 march 937

Contributory causes of importance not related to principal cause:

Name of operation What test confirmad diagnosis ?.

Date of.

Was there an autopsy?

20 Was disease

related to/occupation of deceased?

If so, specify ..

(Signed)

., M. D.

(Address)

Date

May 8 1937

21 .. Winthrop tery.

Place of Burial, Cremation or Removal.

(City or Town) !

22 NAME OF

UNDERTAKER

DATE OF BURIAL

Гиган 24

1937

ADDRESS

10 wegen

Received and filed. 19

(Registrar)

100m: 12 '35 No 6156F

I HEREBY CERTIFY that a satisfactory standard certificate of death was Med with me BEFORE the burjat or transit permoft was issued:

(Signature of Agent of Board of Health or othery 1

5/8/37 (Date of Issue of Permit)

(Oficial Designation)

5 SINGLE

MARRIED

WIDOWED

Or DIVORCED

(write the word)

lamed.

5a If married, widowpdf or divorced

HUSBAND of

Manual Weichmay

(Give maiden ne me of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

7 43 Years. .Months .Days

If less than 1 day Hours Minutes

OCCUPATION

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

Electrical Lipca

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

10 Date deceased last worked at

11 Total time (years)

spent in this

occupation .....

this occupation (month and.

year)

12 BIRTHPLACE (City)

Porto, Mas.

(State or country)

13 NAME OF

FATHER

Udolph W mafriend

14 BIRTHPLACE OF

FATHER (City)

Russia

(State or country)

15 MAIDEN NAME

OF MOTHER

Rosa Hyman

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Hannof Winsfriend. Relation, if any

17 Informant (Address) 210 Storefanta

PARENTS

in plain terms, so that it may be properly classified, Date of onset and exact statement of OCCUPATION are very important. See instructions and extracts from the laws on back of certificate.

(If U. S.

War Veteran

specify WAR)

.Ward

Winthrop, Loss

St.,

(If nonresident, give city or

town and state)

3 SEX

mole

4 COLOR OR RACE

white

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.

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 nephritis

1921

Cerebral hemorrhage

July 5, 1927

Contributory causes of importance not related to principal cause :

A physician or registered hospital medical officer shall forth- with, atter 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.

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:

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Town of Winthrop : Record of Deaths 1937, Part 45

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

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