USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 20
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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 discase 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.
IM₹-301A
SUFFOLK (County)
WINTHROP
(City or Town)
merfand nella 4/9/38 The Commonwealth of Alassachusetts 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. 44
1
Registered No. [ (If death occurred in a hospital or institution,
St. Ward \ give its NAME instead of street and number)
65 albion it
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Infant
St.,
Ward,
hrs
1 days. 17
How long in U.S., if of foreign birth?
years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
Thite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, er divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, antar that fact hare.
7
AGE
Years.
Months
....... Days
f less than 1 day
.17
8 Trade, profession, or particular
kind of work done, as spinner,
Infant
sawyer, bookkeeper, etc ..
9 Industry or business in which
work was done, as silk mill,
10 Date deceased last worked at
1 1 Total time (years)
this occupation (month and
spent in this
occupation.
12 BIRTHPLACE (City)
Station Hospital, Ft Ranks
(State or country)
Winthrop, Mass
13 NAME OF
FATHER
Torrence Quayle
14 BIRTHPLACE OF
FATHER (City) ...
Carrollton, No
15 MAIDEN NAME
OF MOTHER
Helen Louise Catherine Cuilfoil
16 BIRTHPLACE OF
MOTHER (City)
Clinton
(State or country)
Massachusetts
17 Informant . St Set Querle, 65
Father
(Address) Allien St. Medford, Mass
I WEREBY CERTIFY that a satisfactory standard cartificate of death was filed with me BEFORE the burial or transit permit was issued:
· Culares x
(Signature of Agent of Board of Health or other)
3/8/38
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March
7 th
1938
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That i attended daceased from
March 5
19 ... 38, to March 7
19.3.8 ..
t last saw h .. i.m .... allve on .. March.
19 ... 33, death is said
to have occurred on the date stated above, at.2 .: 25Pm
The principal cause of death and related causes of Importance lo order of onset
were as follows:
.. Minutes
Date of Onset IMPORTANT
Patent ductus Arteriosus
Concen:
... Aboboetesis .. of ... lungs
Contributory causes of importance not reiatad to principal causa:
Name of operation
What test confirmed diagnosis ?.... Autopsy.
Was thera an autopsy ?. .. e.s.
Date of.
20 Was disease or Injury in any way relatad to occupation of deceased?
If so, specify
chpunder
(Signed)
Movender O. Haff Conto 0
M. D.
(Address) ... Ft ... Banks,, ... Lass.
Date.Jar .. 81938
21Fort .... Devens,
Military Reservation,Ma
Relation, if any
Place of Burial, Cremation or Removal.
March
6.
(City or Town)
DATE OF BURIAL
22 NAME OF fiquei Terrano Lunge UNDERTAKER
ADDRESS Stale irupory, Carefour
Received and flied ... 19 ..........
(Registrar)
N. B .- WKIIC ILMINLI)
100m 11 '36. No. 9080 F
tion should be carefully supplied. Age should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEAIn year)
r
1 2 FULL NAME 8 SEX Male (or) WIFE of OCCUPATION (State or country) PARENTS 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 saw mill, bank, etc.
PLACE OF DEATH
No. Station Hospital, Ft Barks, Mass
CHARLES SIDNEY QUAYLE
(If U. S.
War Veteran
specify WAR)
(a) Residence.
No ...
(Usual place of abode)
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
0
years
months
(write the word)
{Oficial Designation)
19.38
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 heen 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, ctc.
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, a 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 compleation which causes death, NOT the mode of dying. E. G., heart failure, asphyxia, asthenia, etc. . Is 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
1921
....
July 5. 1927
Cerebral hemorrhage
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 offic
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 late of his death. GEN. LAWS, CHAP. 46, SEC. 9.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody 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 huried. No such perinit shall he 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 wrequired 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 he obtained early enough for the purpose, the certificate of death made as ahove 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 he 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 heen 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 he 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 makc 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 peintits, or if there is no such board, from the clerk of the town where the"hody is to be huried 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 cemia), and hy the action of chemical (drugs or poisons). thermal. directly or indirectly by traumatism (including resulting septi- or electrical agents, and deaths following ahortion, 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.
MR-301A
N. B .- WRITE PLAINLY, WITH UM ADINU SUIS in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very
1
1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 63 Lowell Road st.
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, Ward \ give its NAME' instead of street and number)
Richard neil M: Garthy
(If U. S.
War Veteran
1
specify WAR)
(a) Residence.
No.
63 Lowell Road st.
Ward,
(If nonresident, give city or town and state)
How long in U.S., if of foreign birth? (20 years ----
mouths - days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
8 SEX
4 COLOR OR RACE
Zale White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
Margaret Price
(or) WIFE of
(Husband's name in full)
-
6 IF STILLBORN, enter that fact here.
AGE
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc ....
Clerk
9 Industry or business in which.
work was done, as silk mill,
groceries & Provisions
saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
40
12 BIRTHPLACE (City)
St. John
(State or country)
New Brunswick
PARENTS
13 NAME OF
Timothy W: Earthy
FATHER
14 BIRTHPLACE OF
FATHER (City)
Kemerich
(State or country) Ireland
15 MAIDEN NAME
OF MOTHER
Mary De Forest
16 BIRTHPLACE OF
MOTHER (City)
Cork
(State or country)
Heland
17 Was Margaret W: Carthis Relation, if any wife
Informant (Address) 63 Lowvele Rd. I will,
I HEREBY CERTIFY that mnsatisfactory stendard certificate of death was Ajled with me(BEFORE the burial for transit permit was issued:
Signature of Agent of Board of Health or others Healthe Officer 3/9/38 (Official Designation) (Date of Issue of Permits
18 DATE OF
DEATH
march
7
1938
(Year)
(Month)
(Day) /
19 I HEREBY CERTIFY,
That i attended deceased from
January 30
1938, to march 7
1938
I last saw b ........ lalive on
March 4
1938, death is said
to have occurred on the date stated above, at 9:30 Pm.
The principal cause of death and related causes of importance in order of onset
were as follows:
Minutes
Dalo of Onset IMPORTANT .........
Carcinoma of Leadal Sanca ...
Dec. 1937
Contributory causes of Importance not related to principal cause:
Cholechatgastrostorms
9/23/37
What test confirmed diagnosis Operación Was there an autopsy? no.
Name of operation,
20 Was disease or Injury in any way related to occupation of deceased? no
If so, specify ..............
M. D.
(Signed) Solfra. Investor
Nintendo, Min Date 3/8 1938
21
Holy Gross,
Walden
Place 'of Buffal, Cremation or Removal.
(City or Town)
DATE OF BURIAL March 10
1938
22 NAME OF
UNDERTAKER
R. Kelly
ADDRESS
11 Medidade St. E. Bos.
Received and fl 19 ....
(Registrar)
100m 11 '36 No. 9080 F
tion should be carefully supplied. Age should be stated EXACTLY. PHYSICIANS should state CAUSE Ur DEA In See instructions and extracts from the laws on back of certificate.
important.
No ..
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(L'sual place of abode)
Leoxtb of residence in city or town where death occorred
years
months ^ days.
5a If married, widowed, er divorced
HUSBAND of
(Give maiden name of wife in full)
7 65 Years - Years. Months .. Days
If less than 1 day - ... Hours.
OCCUPATION
August 1932 Intestinal abstraction
this occupation (month and
year)
Sept. 1937
Statement of occupation. - l'recise statement of occupation is- very unportant, 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, ctc.
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, nar her important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset
Arteriosclerosis
1915
Chronic interstitial nephritis
1921
Cerebral hemorrhage
July 5, 1927
Contributory causes of importance not related to principal cause :
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
A physician or registered hospital medical officer shall forth- with, alter the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and belief the name of the deceased, his sup- poscd 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 therefroin 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 hoard 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 he 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 hy 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 ohtained 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 kurk or registrar may require .- CHAP. 114, SEC. 45, G. L. (TER- Chu .. TENARY EDITION. )
Jical examiners shall make examination upon the view of maki bodies of only such persons as are supposed to have died Try violence. . .- GEN. LAWS, CHLAP. 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 huried 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.
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