USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 58
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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. (Tercenten- ary 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. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;...- General 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; other- wise a description as full as may be, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfilment 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 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 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.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." " Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
301
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.
100m-12-'35. No. 6156E
I HEREBY CERTIFY that a satisfactory standard certificate of death was ted with me BEFORE the burial ør transit permit was issued:
(Signature of Agent of Board of Healey of order)
Wealth Ricer 7/9/37 (Date of Issue of Pepinity
7(Official Designations
18 DATE OF DEATH July
7th 1937
(Month)
(Day)
(Year)
Ba If married, widowed, or divorced
HUSBAND of
Mrs.Em M. Merrick (Maiden name un
(Give maiden name of wife in full)
known)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE
40
Years 5 Months
.26.
Days
If less than 1 day Hours. Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Officer (Military)
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc .......
Captain, Cavalry
United States Army.
10 Date deceased last worked at
this occupation (month and
year) ....... Je
1.937
spent in this
occupation ....
21
Contributory causes of importance not related to principal cause:
12 BIRTHPLACE (City)
Unknown
(State or country) Ohio
13 NAME OF
FATHER
U
14 BIRTHPLACE OF N FATHER (City)
(State or country) K
15 MAIDEN NAME
OF MOTHER
O
N
16 BIRTHPLACE OF W MOTHER (City) (State or country) N
17 Relation, if any Wwforment Registrar.,Station.Hospital,Ft Banks) (Address)
20 Was disease or ipjury-in any way related to occupation of deceased?
If so, specity
(Signed)
ROBERT ......... THOMAS,LtCol, M.C.
., M. D.
(Address)
Fort Banks Lass
Date
19
21
Cheyenne Wyoming
DATE OF BURIAL
July 13 Or 14
1937
22 NAME OF
Charles R. Bennison
ADDRESS
Winthrop Mass
Received and filed. 19
A TRUE COPY ATTEST JUL 1 1937
(Registrar)
1
WINTHROP
(City or Town)
Brookline notify 8/9/37 The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
Burton notifica 7, 8/37
(City or town making return)
153
Registered No.
§ (If death occurred in a hospital or institution, Ward \ give its NAME' instead of street and number)
2 FULL NAME
ROBERT J. MERRICK
(If deceased is a married, widowed or divorced woman, give also maiden name.) Bank petits WAR)
(a) Residence.
No ..
66 Chiswich Road
(Usual place of abode)
St.,
Ward, Brookline Massachusetts
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
years
months
6
days.
How long in U.S., if of foreign birth?
years
months days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
8 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Married(Legal
MARRIED
WIDOWED
or DIVORCED
Separation)
>
19 I HEREBY CERTIFY, That I attended deceased from July 1st 19.37 1 July 7th 19 ... 37 i last saw h.i.m ..... alive on July 7th 19.37 , death is said to have occurred on the date stated above, at ... 11 .: 22m. PM The principal cause of death and related causes of Importance in order of onset were as follows: Cerebral hemorrhage old moderate Epilepsy grand mal severe
Date of Onset Qct 1935 Jul 1937
Name of operation
What test confirmed diagnosis ?..... Autopsy.
Was there an autopsy ?... Yes
Date of
PARENTS
PLACE OF DEATH
SUFFOLK (County)
STANDARD
CERTIFICATE OF DEATH Winthrop, Mass
NoStation Hospital Fort Banks
St.,
(If U. S. War Veteran
11.111 (City or Town)
UNDERTAKER
11 Total time (years)
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: Arteriosclerosis
Date of Onset.
1915
...
Chronic interstitial nephritis ...
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, 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.
.... 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.
(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.
.
1921
hiswick Road is in Brighton not Brookline. would therefore advise you to send the nclosed death certificate to the City Clerk, n Boston.
Withung Shinweis
Town Clerk Brookline, Mass.
A
٠
٠
٠
٠
٦
٠٠٠
-
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
important.
50m-9-'31. No. 338_₪
17
Informant Louis Gasule 9husband )
(Address;
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred) y
DATE FILED July 7,1227 .19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July
1937
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from 36 Jetcher 18
ly 7
37
., 19
I last saw h ............ alive on.
19.
death is said
to have occurred on the date stated above, at. 7:45.A.M.
The principal cause of death and related causes of importance in order of onset were as follows:
Pulmonary tuberculosis
1933
Contributory causes of importance not related to principal cause:
Diabetes mellitus
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)
(Address)
RutIan!, ass
Date
7"/ ry .
19
21 PLACE OF BURIAL, CREMATION OR REMOVAL inthron, Berett, ass. (Cemetery 9:37 (City or town)
DATE OF BURIAL July
19
22 NAME OF UNDERTAKER
ADDRESS 10
2
en worchester
Received and filed
9
13
19
(Registrar of City & Town where'deceased pesided)
:
2 FULL NAME
Lena ... Gasule
(If deceased is a married, widowed or divorced woman, give also maiden name.)
27 Trident
.St.,.
... Ward,
Winthrop, Mass.
(If nonresident, give city or town and state)
days. How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
'hite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced HUSBAND of Louffige maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
52
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.
Housewife
9 Industry or business in which work was done, as silk mill, saw cuil, bank, etc. .
10 Date deceased last worked at this occupation (month and year)
11 Total time (years) spent in this occupation.
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Abraham Bencovitz
PARENTS
14 BIRTHPLACE OF FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Cherin , cannot be learned
16 BIRTHPLACE OF MOTHER (City)
(State or country) Russia
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No .....
106
(If death occurred in a hospital or institution,
No ..
PLACE OF DEATH
worcester (County)
-
1
Putlond
(City or Town)
Jewish Tuberculosis Hospital
Ward
give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of residence in city or town where death occurred
yrs.
moS.
Rutland
(City or town making return)
Lowm . Hanff
AUG1019372P
MOJ
,19.
... to. July 6 37
Dateofonset
AGE
-R-302
٠٠٠
IM R-301
Laffels
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town malang return)
Registered No. 153 (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Pierce. T Passon
(If deceased is a married, widowed or divorced weman, give also maiden name.)
(a) Residence.
No ...
119 Upland
Rd St
Ward,
(If nonresident, give city or town and state)
(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.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Manuel
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY, That I attended deceased from
19
to
19
I last saw h.
allve on
19
death Is sald
to have occurred on the date stated above, at 1: 30+ m. The principal cause of death and related causes of Importance in order of onset were as follows: Date of Onset natural Causes
Probably Chronic Mayocardets Juin 1936
Contributory causes of importance not related to principal cause: Qualitas Million
1927 1427
Date of.
220
What test confirmed diagnosis? hanstato.
.Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If se, spec
Ramund B Paka
(Signed)
M. D.
Withof Brand of Huth Date July 9 1937
(Address)
21 PLACE OF BURIAL
CREMATION OR REMOVAL
Winthrop Winthrop
DATE OF BURIAL
July 10, 1937
19
22 NAME OF
UNDERTAKER
Charles P. Bennison
ADDRESS ruthrop mars-
Received and filed. 19
A TRUE COPY, ATTEST: MUL 19-1937
(Registrar)
MARGIN RESERVED FOR BINDING 7
FORD. Every item of is very important. Seo 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 Y, WITH UNFADING BLACK INK-THIS IS A PERMANENT
N. B .- WRITE PLAK
100m-12-'34. No. 2938-e
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Arent of Board of Health of dibet)
9/37
7 (Official Designation)
(Date of Issue of Permit
MEDICAL CERTIFICATE OF DEATH
8
1937
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE
Years
Months
Days
If less than 1 day
.Hours.
.Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. Salesman
9 Industry or business in which work was done, as silk mill. saw mill, bank, etc. Blood Co Liga
10 Date deceased last worked at
11 Total time (years)
spent in this
1930
occupation
20
this occupation (month and year)
12 BIRTHPLACE (City)
(State or country)
relat
13 NAME OF
FATHER
Michal. Barron
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Eilen
Powers
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 Ida Bunker
Barron-(
Relation, if any
(Address) 119 Upland Rd. Winthrop.
1
PLACE OF DEATH
(County)
... (City or Town) No. 119 Uhland Roads."
Ward
(If U. S. War Veteran, specify WAR)
me 1
Name of operation
(Cemetery
(City or town)
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 merchanis. 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.
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