Town of Winthrop : Record of Deaths 1937, Part 53

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

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 53

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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 nave 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 Schall 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 borlv 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.

Edu - 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.

-301A

Suffolk

(County)

Winthrop

(City or Town)

No.

225 River Rd.

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. 140

Registered No.

§ (If death occurred in a hospital or institution,

St.,

Ward ( give its NAME instead of street and number)

2 FULL NAME

Gerard Boutin

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

(a) Residence.

No.

225 River Rd.

(Usual place of abode)

St.,

Ward,

(If nonresident, give city or town and state)

Length of residence in city or town where death occurred 20years

months

days.

How long in U.S., if of foreign birth? 50

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

14 $7 (Year)

(Month)

(DAy)

6a If married, widowed, or divorced

HUSBAND of

Ella Lavoie

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

Years Months Days

If less than 1 day Hours. Minutes

OCCUPATION

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

Tower .. man

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

B.B. .. B .. &L.R.R ..

10 Date deceased last worked at

this occupation (month and

year,

11 Total time (years)

March 19 3czupation ...... 45

12 BIRTHPLACE (City)

Napierville

(State or country)

Canada

13 NAME OF

FATHER

Isaac Boutin

14 BIRTHPLACE OF

FATHER (City)

Napierville

(State or country) Canada

15 MAIDEN NAME

OF MOTHER

Unknown

16 BIRTHPLACE OF MOTHER (City) Napierville.,

(State or country) Canada

17 Mrs. Ella Boutin

Relation, if any .wife

Informant (Address) 225 River Rd., Winthrop

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

( Spalite of Agent of Board of Health of of her )

(Date of Issue of Permit) 6/1/9/37

(Qedcial Designation)

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 PARENTS

36. No. 9080 F

100m 11

Received and flied. 19

JUN 2.2 1937

(Registrar)

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

(Signed)

M. D.

(Address)

1 liFlyg Date 6/16 1987

21 Holy Cross, Malden

Place of Burial, Cremation Removal. 17.1937 19

(('ity or Town)

DATE OF BURIAN ARDO

22 NAME OF UNDERTAKER

oston ADDRESSMetropolitan Funeral Service

6/14

19.3.7 .. , death is sald

I last saw b ... Lag .. alive on

to have occurred on the date stated above, at 4pm The principal cause of death and related causes of Importance in order of onset were as follows: Date of Onset IMPORTANT Dentatura of Heart

3/7/87

Contributory causes of importance not related to principal cause:

PLACE OF DEATH

3 SEX Male

4 COLOR OR RACE

White

5 SINGLE

MARRIED

WIDOWED

Or DIVORCEDMarried

(write the word)

(If U. S. War Veteran specify WAR)

6/14

19 I HEREBY CERTIFY, That I attended deceased from

3/17

,193.7, 10

, 198.7 ..

wstelle

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 :

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 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.

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.

O1A

PLACE OF DEATH

Suffolk County Winthrop (City or Town

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

To be filed for burial permit with Board of Health or its Agent.

141

Registered No. f (If death occurred in a hospital or institution,

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

2 FULL NAME

Lawrence 2 Welcher

(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

years

months

days.

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

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

male

4 COLOR OR RACE

5 SINGLE

MARRIED

WIDOWED

Or DIVORCED

(write the word) married

5a If married, widowech omhvorced

HUSBAND of

Usan

Sexto

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

Years

.Months

Days

If less than 1 day

Hours.

Minutes

OCCUPATION

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

Ciler

9 Industry or business in which

, as s East Beton Ferry saw mill, bank, etc ....

10 Date deceased last worked

11 Total time (years)

spent in this 25 year) Gapril 1925 occupation.

12 BIRTHPLACE (City)

(State or country)

East Boston

..............

mass

13 NAME OF

FATHER

Laurence & Keleher

14 BIRTHPLACE OF

FATHER (City)

(State of country)

cheland

15 MAIDEN NAME

OF MOTHER

Margaret Barry

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

cheland

17 Susan Kilcher

Relation, if any

Informant (Address) 202 Julin At East Botox

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE thedial ge transit permit was issued: um D Children 20

18.8

()(Signature of Agent of Board of Health or other) fine-18/3%

(Official Designation)

(Date of Issue of Permity

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

(Month)

(Day)

19 I HEREBY CERTIFY, . That I attended deceased from May 1 1935, to June 17, 1937

I last saw Le ...... alive on. June 170 193.7., death Is sald

to have occurred on the date stated above, at 7 4 m. The principal cause of death and related causes of importance In order of onset were as follows: Chronic Myocarditis Date of Onset IMPORTANT

1933

Contribatory causes of importance not related to principal cause: Chronic cystite arteriosclerosis

1935

Name of operation

Cystatoury

What test confirmed diagnosis?

Date of

Was there an autopsy? 00

20 Was disease or injury in any way related to occupation of deceased? If so, specify (Address) (Signed) M. D. Fred D Pegan 690 SaratogaST Date .. 6/17 1937

21 Italy temps

malden

Place of Buyod, Cremados or Removal.

DATE OF BURIAL

22 NAME OF

UNDERTAKER

Erdenk

& manack

ADDRESS

64 mendian Lt JE. Boston

Received and flied

JUN-2-2-1937

(Registrar)

) ›

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

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

No .. Y

Winthrop Community Hack.

202 Jahr AF

St.

Ward,

(If U. S. War Veteran specify WAR) Each Boston

(If nonresident, give city or town and state)

17 1937 (Year)!

6/15/37

(City or Town) 19 1937

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

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 în 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.)

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Town of Winthrop : Record of Deaths 1937, Part 53

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

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