USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1937 > Part 92
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GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
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.
(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.
Cl."
-301A
Suffolk (County)
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. .....
f (If death occurred in a hospital or institution,
St., .. .... .Ward \ give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden namc.)
(a) Residence.
No.
291 River Road
St.,
Ward,
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred. O years months
days.
How long in U.S., if of foreign birth?
years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Meale
4 COLOR OR RACE
Muito
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed er divorced/
HUSBAND of
Bridger Jeary
(Give melden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 46 Years Months Days
If less than 1 day Hours Minutes
8 Trade, profession, or particular
kind of work done, as spinner Insecten Samlar Least
sawyer, bookkeeper, etc .....
9 Industry or business in which
work was done, as silk mill,
lecity of Bulin Reduced
saw mill, bank, etc.
10 Date deceased last worked at
this occupation (month and
11 Total time (years)
spent in this
occupation ....
124
12 BIRTHPLACE (City)
Baltian
(State or country)
16d
13 NAME OF
FATHER
James Harrell
14 BIRTHPLACE OF
FATHER (City)
guland
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Roach
16 BIRTHPLACE OF MOTHER (City) (State or country)
guland
17 Budget travel Relation, if any wife) DATE OF BURIAL
Informant (Address) 291 Rua Rd Brookline de ai
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the butty or trapsit permit was issued:
(Signature of Agent of Board of Health or other ) te althe Office 12/6/37 (Official Designation) (Date of Issue of Permit) "
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Lec
4
1937
(Year)
(Month)
(Day)
19
0
I HEREBY CERTIFY, That i attended deceased from
C
man !
19/ v, to.
19
Liest saw b. IM alive on
December 3, 1937, death is said
to have occurred on the date stated above, at] Q. Am. The principal cause of death and related causes of Importance In order of onset were as follows:
Date of Onset IMPORTANT
Chorus Endre auditie
..........
Chaque NEphalie
Contribatory causes of Importance not related to principal cause:
Name of operation
What test confirmed diagnosis?
Date of.
Was there an autopsy ? Nu
No
20 Was disease or injury in any way related to occupation of deceased? 1
If so, specify
Cauza traqueur.
M. D.
(Signed)
(Address)
200 Wartungen De Date 12 / 1937.
Holy Hood Brooklin Nan 21
Place of BArial, Cremation or Removal.
(('ity or Town)
19,3 2
22 NAME OF
UNDERTAKER
John H. Lucy
ADDRESS 27 Haward ST Batoklan 16 ale
Received and filed.
Dec. 13,
37
(Registrar)
100m 11. 36. No 9080 F
1 (or) WIFE of AGE OCCUPATION PARENTS L tion should be carefully supplied. Age should be stated LAACILI. FISICIAND should state CAUSE Of DEATH year) 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
PLACE OF DEATH
(City or Town)
No
191 River Road
Jannes Farrell
(If U. S. War Veteran
specify WAR)
...
Kevised Un United States Standard Certaincafe of De
Statement of occupation. - l'recise 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.
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
4
Chronic interstitial nepbritis
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.
CALIn UP UMMUNW enuseHle
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
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 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 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.
R-302
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-2-'30. No. 7997-d
PLACE OF DEATH
Norfolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Quincy
(City or town making return)
1
Quincy
(City or Town)
No ...
Quinoy .... City ..... o.o.ital
.. St.,
Ward
give its NAME instead of street and number)
2 FULL NAME
.Iuch.J ..... Mutor ...... Jr
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No .. 155 ... 006side
.St.,.
......
Ward,
(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?
yTs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
(write the word)
liale
White
18 DATE OF
DEATH
Documbor 6, 1637
(Year)
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 AGE O.
Year
Months Days
If less than 1 day Hours Minutes
OCCUPATION
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) ..
11 Total time (years) spent in this occupation
12 BIRTHPLACE (City) ..... Ciney
(State or country)
13 NAME OF
FATHER
Buch J. Luntor
PARENTS
(State or country)
15 MAIDEN NAME
OF MOTHER
Florence Harnoy
16 BIRTHPLACE OF MOTHER (City) Quincy
(State or country)
17
Tuch J. Tuntor
(Address]55 woodside ft., intheop.
Isfermant
A TRUE COPY
ATTEST: (Registrar of city of town where death occurred)
DATE FILED
Dec. 8
19. 37
19
I HEREBY CERTIFY, That I attended deceased from
19"Y""
I last saw
4
alive on
37 Doc. 9
-
death is said
to have occurred on the date stated above, at. m.
The principal cause of death and related causes Des ffe importance in order of onset were as follows:
marie disorse of the nowborn
Contributory causes of importance not related to principal cause:
Name of operation
What test confirmed diagnosis?t
Was there an autopsykres
Date of
20 Was disease or injury in any way related to occupation of deceasedi- If so, specify
(Signed) (Address)) Ičvard Knowlton Date 19
M. D.
21 PLACE OF BURIAL,
Ainoy
008 12-7-37
CREMATION OR REMOVALall Coagtory-aney
DATE OF BURIAL
Loc
1922.
22 NAME OF Charles ". Stono
ADDRESS
Quincy, Lass.
Received and filed 19
(Registrar of City or Town where deceased resided)
Dateofonset
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. Con
5 SINGLE
MARRIED
WIDOWED
F DIVOR
single
MEDICAL CERTIFICATE OF DEATH
(If U. S. War Veteran, specify WAR)
244
Registered Nog.27.
(If death occurred in a hospital or institution,
(Il honresidentegive bity be town and state)
37
14 BIRTHPLACE OF
FATHER (City)
Quinoy
301A
PLACE OF DEATH
Suffolk L(County) Winthrofe. (City or Town) 40 Bowdoin St. No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
245
St.,
§ (If death occurred in a hospital or institution, .Ward [ give its NAME' instead of street and number)
William & Growley
(If U. S. War Veteran
specify WAR)
St., ..
Ward,
(If nonresident, give city or town and state)
months
days.
How long in U.S., if of foreign birth?
years
months
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Die
V
(Day)
(Month)
1937 (Year)
19 I HEREBY CERTIFY, That I attended deceased from
19
to
19
I fost saw h ........... allve on
19
death is said
to have occurred on the date stated above, at 10:05 Am. The principal cause of death and related causes of importance In order of onset were as follows: Date of Onset IMPORTANT Nature Cama Cadel
Chemie Muscadet
Nov 1936
3,50 Contributory causes of importance not related to principal cause:
Name of operation
Date of
What test confirmed diagnosis? harpegatine.
. .. Was there an autopsy?
No
20 Was disease or injury in any way related to occupation of deceased? Vo. If so, specify ....
(Signed) Wmthing Brudd Had Date Sc 5 1937.
M. D.
21 Holy Cross malden.
Relation, if any Place of I'Mial, Cremation or Removal.
DATE OF BURIAL
Dec
9.
(City or Town)
1937
22 NAME OF
William Q Treanor.
UNDERTAKER/2
ADDRESS
559 Saratoga St E. B
Received and filed.
DEC
19
(Registrar)
100m-12'35. No. 6156F
1
2 FULL NAME
(a) Residence.
No.
40 Bowdoin
(Usual place of abode)
Length of residence in city or town where death occurred
years
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
White
Male
5 SINGLE
MARRIED
WIDOWED
OF DIVORCED
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
76
AGE ..
Years
.Months
.Days
8 Trade, profession, or particular
Retired
kind of work done, as spinner,
sawyer, bookkeeper, etc ....
9 Industry or business in which
work was done, as silk mill,
Waiter
saw mill, bank, etc.
10 Date deceased last worked at
this occupation (month and
1930
OCCUPATION
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
HER Carneilus Crowley.
14 BIRTHPLACE OF
Unknown
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Baldwin .
PARENTS
(State or country)
Informant
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
year)
Portland, Maine.
(write the word)
ED Widowed.
5a If married, widowed, or divorced
HUSBAND of
Unn & O' Rourke
If less than 1 day Hours Minutes
11 Total time (years)
spent in this
occupation.
16 BIRTHPLACE OF
MOTHER (City)
Portland Maine.
17
Joseph Mulher (SON IN LAW)
(Address) 40 Bowdown St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: William A. Children
(Signature of Agent of Board of Health or other)
Cegent. Dec. 8/3)
(Official Lysignation) (Date of Issue of Permit)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Revised United States Standard Certificate of Death
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.
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