USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 76
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Aug 12
19
3.7to ... Aug 28
19.37
I last saw h .... 1m.alive on
Aug .28.
19.3.7., death is said
to have occurred on the date stated above, at ... 9.55Pm. The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
Obstructing prostate benign
12 yrs
Contributory causes of importance not related to principal cause:
broncho ... pneumonia
3 .. dys
Name of operation
supr.cyst.
8/19/37 Date of
What test confirmed diagnosis? olin oxam Was there an autopsy ?... no
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
M. D.
(Address)
Boston
Date ....
19.3
21 PLACE OF BURIAL
CREMATION OR REMOVAL
Winthrop
Winthrop
Aug 31"
1937
19 3
22 NAME OF
UNDERTAKER
J.F. O'Maley
ADDRESS
Winthrop
Received and filed
1931
19
(Registrar of City or Town where deceased resided)
important.
50m-9-'31. No. 3385-R
OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very PARENTS
No.
Mass ... General Hospital
St,
Ward
(If U. S.
War Veteran,
200
(write the word)
(Give maiden nam
If less than 1 day
Hours
G F Houser
[City or town)
DATE OF BURIAL
R-303 B
PLACE OF DEATH
Suffolk (County) Muthub (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent .. Registered No ..
(If death occurred in a hospital or institution, 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.
(If deceased is a married, widowed or divorced woman, give also maiden name.) 253 Shirley St. Minthese
Ward,
(If nonresident, give city or town and state)
血OS。 days. How long in U. S., if of foreign birth? yrs.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widofred, ar divorced HUSBAND of
(Give maiden nameløf wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
If less than 1 day
. Years Months Days
.. Hours. Minutes
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.
quees Hilmiself
10 Date deceased last worked at this occupation year)
11 Total time (years) spent in this \occupation .....
12 BIRTHPLACE (City) (State or country)
Russia
Solomon Ostrovit
Ainda- Canotto
Pussig
17 Lealistraub.Well
253 7
I HEREBY CERTIFY that a satisfactory standard certificate of death wes" La. filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other) other, 540
(Official Designation) (Date of Isme of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Oct
4-1932
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) 2) Maxiation due E card around neck Found dead thorning from a Ken in his farage
Suicidal ·
(See reverse side for description for unknown person )
20 IN WHAT CITY OR TOWN
WAS INJURY SUSTAINED ?.
(Signed)
Just-5- 1939
M. D.
(Address)
arbeite Ping
2PLACE OF BURIAL CREMATION OR REMOVAL (Cerfetery) (City or town)
5
4 ,19 37
DATE OF BURTAL
22 NAME OF UNDERTAKER
ADDRESS
10 look
Received and filed
OCT 11 1937
(Registrar)
Sm-12-'34. No. 2938-8
1 2 FULL NAME. B SEX Viele (or) WIFE of 7 58 AGE OCCUPATION 13 NAME OF FATHER 14 BIRTHPLACE OF FATHER (City) 15 MAIDEN NAME OF MOTHER 16 BIRTHPLACE OF PARENTS MOTHER (City) (State or country) Informant .. (Address) of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF (State or country)
No. rar 253 Shirley St. Huitfifa Lacc Ostrovity
.Ward
mos. days.
(Month)
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS 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 regis- tration 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 con- tracted, 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.)
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 ....- Chop. 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
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
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: WM.
Signature of Agent of Board of Acalth of other) We alter Officer
02/8/6/37
7 (Official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
Married
18 DATE OF
DEATH
Cect
4
(Month)
(Day)
(Year)
Sa If married, widowed, or divorced
HUSBAND of
Alice Magee
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
91
AGE
.Years
9
1
Months
Days
If less than 1 day Hours Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
Commission merchant
9 Industry or business in which
work was done, as silk mill,
Office
saw mill, bank, etc ..
10 Date deceased last worked at
11 Total time (years)
spent in this
1913
occupation.
20
12 BIRTHPLACE (City)
Boston
(State or country)
Massachusetts
13 NAME OF
FATHER
Isaac Clark Hall
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Sandwich
(State or country)
Massachusetts
15 MAIDEN NAME Susan Ryder OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
Chatham
(State or country)
Massachusetts
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthron
(Cemetery)
(City or town)
DATE OF BURIAL October 6. 1937
19
22 NAME OF
Charles R. Bennison
ADDRESS
Winthrop lass
Received and filed.
001 0
1937
19
A TRUE COPY, ATTEST:
(Registrar)
1
...
Winthrop
(City or Town)
No.
52 Atlantic
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or te .n making return)
Registered No.
202
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
I.saa.c .... Clark ... Ha.ll
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence. No
(Usual place of abode)
52 Atlantic
.St., ....
.Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred 82
yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MARRIED
WIDOWED
or DIVORCED
19 I HEREBY CERTIFY, That I attended deceased frem
15
1936, to Cect 4
1937
I last saw h VAM
allve on
Cent
4
1937, death is said
to have occurred on the date stated above, at 5:3 0Am. The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset
Fut 1936
Contributory causes of importance not related to principal cause:
of Bladder
76 1936
Name of operation.
une
What test confirmed diagnosis? Pummel How Was there an autopsy ?..
No
20 Was disease or injury in any way related to occupation of deceased?
No
If so, specify
(Signed)
, M. D.
(Address) Writing
man Dateact 5 1937
17 Alice M. Hall
Relation, if any
wife
.)
Informast
(Address)
52 Atlantic St Winthrop Mass
PLACE OF DEATH
... suffolk (County)
St.
Ward
(If U. S.
War Veteran,
1937
Myraditas
this occupation (month and
year)
Date of
UNDERTAKER
1
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 of 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, colton 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.
Example
The principal cause of death and related causes of importance in order of onset were as follows:
Date of caset
Arteriosclerosis ...
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, 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 discase 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 disposo 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. -- Chag. 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 Examinera 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.
PLACE OF DEATH
.....
(County)
(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
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
+
St., ...............
.. Ward,
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
OF DIVORCED Single
18 DATE OF
DEATH
Detaber
4
1937
(Year)
(Month)
(Day)
5a If married, widowed, or 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.
7 40
Years .. Months .. Days
Hours. .Minutes
OCCUPATION
8 Trade, profescion, or particular
kind of work done, as spinmer,
sawyer, bookkeeper, etc ...........
At Home
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 937
year)
11 Total time (years)
spent in this 3C
occupation.
12 BIRTHPLACE (City)
(State or country)
18 NAME OF
PATHER
14 BIRTHPLACE OF
FATHER (City)
Fr
(State or country)
15 MAIDEN NAME
OF MOTHER-
J. Good
16 BIRTHPLACE OF MOTHER (City) (State or country)
Bartluat
17
Informant
(Address)
7
7 7
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial por transit permit was issued:
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