USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 42
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12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
Coleman Wülkern
14 BIRTHPLACE OF
FATHER (City)
100m Il ·3% No. 9080 F
THIC IC A DEDMANENT DECODn F __ item Date of onset and exact statement of OCCUPATION are very
Age should be stated LAMCILI.
ponad
...
in plain terms, so that it may be properly classified.
SUFFOLK (County)
To be filed for burial permit with Board of Health or its Agent.
(If U. S.
War Veteran
specify WAR) World War
(a) Residence.
No.
271 Galvin Blvd
(Usual place of abode)
3 SEX
Male
4 COLOR OR RACE
White
18 DATE OF
DEATH
(Month)
iar.7.38
Retired M.Sgt US Army
Unknown ( Galway
If so, specify ..
Paul N. Learn
M. D.
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 everv 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- incss, 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." ctc. Find out the partic-j ular kind of work done and return that, as SKINNER, WEAVER, etc.}
In stating the industry or business. avoid the use of such gen-i eral terms as "store." "factory." ." "mill." etc. State the particulari kutdl of store, factory, mill, etc., a> 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;
Dste 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.
with. aiter t
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 afaresaid 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- vidled. 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. sball upon application make the certificate required of the attend- ing physician. If death is caused by violence, the medical examiner 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 certihcate of death made as above provided shall make such certificate. 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 certificatc, 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 peintits, 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.
(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, (dlings or poisons). thermal. or electrical agent's, and deaths following ahortion, but also death; 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.
FN R-302
Middlesex (County)
Cambridge
(City or Town) No .... Holy ... Ghost.Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Cambridge
(City or town making return)
Registered No.
672
(If death occurred in a hospital or institution,
............. ... St., ................... .Ward give its NAME instead of street and number)
2 FULL NAME
Mary Louise Baker
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a)
Residence. No495.Pleasant .... S.t.
(Usual place of abode)
.St.,.
Ward,
Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCEDSingle
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 64 Years 9 Month 21 Days
If less than 1 dey Hours. Minutes
OCCUPATION
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
Housework
9 Industry or business in which
work was done, as silk mill,
saw mill, bank, etc.
Own home
10 Dete deceased last worked at
this occupation (month ang 937
year)
11 Total time (years) spent in this 40 yrs occupation
12 BIRTHPLACE (City) Boston
(State or country)
Maga
13 NAME OF
FATHER
Charles Richmond Baker
14 BIRTHPLACE OF
FATHER (City)
Hartford
(State or country)
Conn.
15 MAIDEN NAME
OF MOTHER
Eliza Jane Fairchild
16 BIRTHPLACE OF
MOTHER (City)
Hartford
(State or country)
Conn
17 Walter G Baker
Informdaut
(Address)
495 Pleasant St. Winthrop
A TRUE COPY.
ATTEST:
May teredesigh H. Burke
(Registrar of city or town where death occurred)
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
May 221938.
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY, That I attended deceased from
T TaSt saw h
alive on
19/38", to
May 22
1938"
to have occurred on the date stated above, at ..
m.
The principal cause of death and related
Jalses Af importance in order of
onset were as follows:
Dateofonset
"Myocarditis Cerebral
1934
...
Hemorrhage Arterio
Sclerosis
Contributory canses of importance not related to principal ceuse:
Name of operation
Date of.
What test confirmed diagnosis?
Wes there an eutopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
no
(Signed)
M. D.
(AddresDaniel Mackillop
Dete
19
21 PLACE OF BURTAE.
Cambridge
5/22
38
19
CREMATION OR REMOVAL
Winthrop Cem (Cemetery) Winthroptown)
DATE OF BURIAL
May 24 1938
22 NAME OF
UNDERTAKER
Charles R Bennison
ADDRESS
Winthrop MOAR
JUN 1 1 1938
19
Received and filed
(Registrar of City or Town where deceased resided)
important.
50m-9-'31. No. 3385-g
.....
1
PLACE OF DEATH
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
PARENTS
brother
(If U. S.
War Veteran,
104
death is said
er
May 22
38
OM R-301 A
7 OCCUPATIONI 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 75m-2-30. No. 7997-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS
PLACE OF DEATH
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. 105
Registered No.
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Baby Boy Barnee
(If deceased is a(fried, widowed or diyorced woman, give also maiden name.)
(a)
Residence. No ..
(Usual place of abode)
Length of residence in city or town where death occurred
1
yrs.
-
mos.
-
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divorced
HUSBAND of
ive maiden name of wife In full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE Years. Months
.Days
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.
"
10 Date deceased last worked at
1 1 Total time (years)
spent in this
occupation.
12 BIRTHPLACE (City)
(State or country)
mars
13 NAME OF
FATHER Herbert Barnes
14 BIRTHPLACE OF
FATHER (City)
mare
15 MAIDEN NAME
OF MOTHER
Emeline E divario
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Giorgia
17 Herbert
Informant (Address)
23 Endicott an. Teorie Juves.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www.D. (fuldrun & (Signature of Agens of Board of Health or other)
31/38 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
May
26th
1938
(Month)
(Day)
(Year)
19 I HEREBY
CERTIFY, That I attended deceased from
May 26
3F
Thay
26
19
38
I last saw alive on
May 26
, 1938
death is said
544 A. m.
to have occurred on the date stated above, at The principal canse of death and related causes of importance in order of Dateofonset onset were as follows: attelectario
Contributory canses of importance not related to principal cause: Dox sura of pregnancy
(from 4(por)
Name of operation
What test confirmed diagnosis unrelation Was there an autopsy? no
....
200
20 Was disease or injury in any way related to occupation of deceased?
If so, specify,
(Signed)
(Address)
620 Beachof Given ate 5726 /38.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Garden
Chilaba
(Cemetery) Ya
(City or town)
1938
22 NAME OF
UNDERTAKER
Georg & P. Merci
ADDRESS
Previne-mare.
Received and filed
19
JUN ... 1 1938
(Registrar)
1
equithiop
(City or Town) No Winthrop Quinuty Hospital
.Ward
(If U. S. War Veteran,
none
2 FULL NAME
23 Coudreatt an St.,
Ward,
specify WAR)
Beachmont-Pauvre
(If nonresident, give city or town and state)
(write the word)
If less than 1 day.
Hours
this occupation (month and
year)
winthrop
Date of.
7
(State or country)
Barnex (father)
DATE OF BURIAL
may 27
GUMMIVNY
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits ean 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 "employec," "worker," "operative," ctc. 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," ctc. 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 sccured. 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 deatlı. 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
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, atter the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belicf the name of the deceased, his supposed are, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last secn 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 buricd, 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 elcrk of the town where the person died; and no undertaker or other person shall exhumc 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 elerk of the town where the body is buricd. 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 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 appear upon the permit. The board of health, or its agent, upon receipt of such state- ment 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., as amended.
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, Scc. 46, G. L. as amended.
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.
JE1 R-302
Every item or inrorma- KELURD. tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE BAIN RESERVED FOR FINDING
PARENTS important. 50m-9-'31. No. 3385.₪ N. B. WRITE PLAINLY, WITH UNFADING INK-THIS IS A FERMVIANENNI OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very OCCUPATION!
PLACE OF DEATH
(SUFFOLK
(County) BOSTON
(City or Town) Beth Israel Hosp No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
4615
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Jacob Blumonthol
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence.
No.
(Usual place of abode)
271 Shirley
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
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