USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 60
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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 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 iffterment, 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 if 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 borly 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.
M R-302
PLACE OF DEATH
Middlesex
(County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Melrose
(City or town making return)
159
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
FredL. Witherell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
5 Sumit Ave.
.St.,.
Ward,
Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
14
yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
(write the word)
18 DATE OF
DEATH
July 13, 1937
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That i attended deceased from
July 13/37
. to.
19
July 7/37
19
I last saw him .alive on
July 13/37
19 death is said
to have occurred on the date stated above, at.
11:30 P. M.
The principal cause of death and related causes of importance in order of onset were as follows: Gastric Ulcer Dateofonset
Contributory causes of importance not related to principal cause:
Myocarditis
7/10/37
7/11/37
Renal Suppression
Name of operation
Gastro-enterotomy
Date of7 /9/37
What test confirmed diagnosis? Operative
Was there an autopsy? no
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
Roscoe D. Perley
M. D.
(Address
Melrose, Mass.
Date7 /14/33
2 . PLACE OF BURIAL.
CREMATION OR REMOVAL
Winthrop
Winthrop
(Cemetery)
(City or town)
22 NAME OF
UNDERTAKER
Richard H. White
ADDRESS
Winthrop, Mass.
Received and filed JUL 15 1933 19
(Registrar of City or Town where deceased resided)
1
Laura Warner Witherell
(Give maiden name of wife in full)
(Husband's name in full)
Years
7
Months
11 Days
if less than 1 day Hours Minutes
Lumberman
9 Industry or business in which
work was done, as silk mill,
Lumber Yard
11 Total time (years) spent in this occupation 45
FATHER John H. Witherell
Nahant
| 15 MAIDEN NAME
OF MOTHER
Alice E. Johnson
Nahent
5 Sumit Ave. , Winthrop
A TRUE COPY
Croymond Sf. Freculow.
(Registrar of city of town where death occurred)
DATE FILED
July 16, 1937
19-
MEDICAL CERTIFICATE OF DEATH
Melrose
1
(City or Town)
2 FULL NAME
(Usual place of abode)
3 SEX
Male
4 COLOR OR RACE
White
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 IF STILLBORN, enter that fact here.
7
AGE
65
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
saw mill, bank, etc.
10 Date deceased last worked at
this occupation, (month and
year
1937
Lynn
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
14 BIRTHPLACE OF
FATHER (City)
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
Informant
ATTEST:
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE
important.
OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
OCCUPATION
50m-2-30. No. 7997-d
N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa-
(State or country)
Mass.
No.
Melrose Hospital
St.,
Ward
(If U. S.
War Veteran,
specify WAR)
17
Mrs. Laura Witherell
.(wife)
DATE OF BURIAL
July 16, 1937
19
1
M R-301
OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 100m-12-'34. No. 2938-e N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS
PLACE OF DEATH
Suffolk
...
(County)
Winthrop
(City or Town) 113 Rovere St
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
159
Registered No. (If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Isabelle ( McDougal ) McDonald
(If deceased is a married, widowed or divorced woman, give also maiden name.)
113 Revere St
St., ...............
.. Ward,
(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
8 SEX
Female
4 COLOR OR RACE
Thite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Tidowed
5a If married, widowed, er divorced HUSBAND cf
(or) WIFE of
Alla Give maiden name pf w
e in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE
7
71
Years
.. Months
Days
If less than 1 day Hours. Minutes
8 Trade, profession, or particular
kind of work done, as spinner,
Housewife
sawyer, bookkeeper, etc ...
9 Industry or business in which
work was done, as silk mill,
Own Home
saw mill, bank, etc ....
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation.
50
12 BIRTHPLACE (City) (State or country) Prince Edwards Island
13 NAME OF
FATHER
McDougal
14 BIRTHPLACE OF
FATHER (City)
(State of country) Prince Edwards Island
15 MAIDEN NAME
OF MOTHER
Dennot be Leurmed
16 BIRTHPLACE OF
MOTHER (City)
(State or country) Prince Bowords Island
17 Informant (Address) Hovere 20
Joseph Flowmert & uchten
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burtel or tyghsit,permit was issued: Wmt bluedress (Signature of Agent of Boardof Healthyor other) July 16/37 ..
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
15
1937
(Year)
19 I HEREBY CERTIFY That I attended dsceased from
I last sam h ..... . alive on. .....
to have occurred on the date stated above, at 30 2 The principal cause of death and related causes of Importance In order of onset were as follows:
Dais of Onset
3
7
Contributory causes of importance not related to principal cause:
Name of operation.
What test confirmed diagnosis ?.
.Date of.
Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
M. D.
(Address)
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Tinthron
DATE OF BURIAL
22 NAME OF
UNDERTAKER
John F. Oualey
ADDRESS
Received and filed. 19.
JUL 1 9 1937
A TRUE COPY, ATTEST:
(Registrar)
1
...
No
.St., ...................... Ward
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No
(Usual place of abode)
Length of residence in city er town where death occurred
mos.
(write the word)
10.3.2 ... to ..
July 15
,19.30
19.6 ... 2, death Is sald
2009.3.2
(Cemetery)
9637
(City or town) 19
Relation, if any
this occupation, 1month and z 6
year)
tandard verticale of Deatu
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee, " "worker." "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store," "factory. " mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows: Arteriosclerosis
Date of onset
Chronic interstitial nephritis
1021
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 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., (Tercentenary 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 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.
301A
1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Towy)
never notified $/9/37 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. 150
Registered No. § (If death occurred in a hospital or institution, . Winthrop Community 00. No.
Ward \ give its NAME' instead of street and number)
2 FULL NAME
(Baby) mercurio
(If U. S. War Veteran
specify WAR)
67 Tuttle It. Devere Ward,
(If nonresident, give city or town and state)
days.
How long in U.S., if of foreign birth?
years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
OF DIVORCED
18 DATE OF
DEATH
July
27
13937
(Month)
(Day)
(Year)
1
5a If married, widowed, er divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here. Stillborn
7 AGE.
Years Months Days
.Hours .......... .. Minutes
OCCUPATION
8 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)
Nutter of, Mas
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Chica mercurio
14 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
15 MAIDEN NAME
OF MOTHER
Julia Fixo
16 BIRTHPLACE OF MOTHER (City) (State or country)
Chris mercurio
Relation, if any (father)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
William D. Childress (Signature of Agent of Board of Health or other)
agent July 31/37
(Oficial Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
19 I HEREBY CERTIFY, That I attended deceased from
19
×7
.. , 19.6 .7. 10
I last saw . come alive on back"
27
19 .- 2 -, death is said
to have occurred on the date mated above, at The principal cause of death and related causes of importance in order of onset Date of Onset IMPORTANT were as follows: Still
7.27.37.
Contributory causes of Importance not related to principal cause:
1
Name of operation.
What test confirmed diagnosis?
chance Was there an autopsy?
20 Was disease or Injugein any way related to occupation of deceased?
If so, specify
(Signed) (Address) 62 Run di Date 1/3/ 1237.
21
Michael Cemetery Boston Max.
Place of Burial, Cremation or Removal.
City of Town)
DATE OF BURIAL
frig 31
19.3 ... 7
22 NAME OF
UNDERTAKER Charles Bruna x
ADDRESS
Received and flied. 19
AUG
(Registrar)
important.
1.0 1 12. 35
in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very See instructions and extracts from the laws on back of certificate.
Vo. 61501.
17 Informaat (Address) 67 Tuttle &t.
Boaton,
11 Total time (years)
spent in this
occupation.
PARENTS
Date of
If less than 1 day
(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
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.
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