USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 47
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.St.,
.Ward ( give its NAME' instead of street and number)
2 FULL NAME
James Joseph Driscoll
(If deceased is a married, widowed or divorced woman, give also maiden nar e.)
specify WAR)
(a) Residence.
No.
32 Crystal Cove Ave.
St.
.Ward,
(If nonresident, give city or town and statc)
months
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or-divorced :
HUSBAND of
(Give maiden name of wife in full)
era
. Morlock
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 57
AGE.
.Years.
Months
.Days
If less than 1 day
Hours.
.......
.. Minutes
OCCUPATION
8 Trade, profession, or particular
kind of work done, as spinner,
Engineer
sawyer, bookkeeper, etc ....
9 Industry or business In which
work was done, as silk mill,
Heating
saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
spent in this
30
this occupation, (month and
1938.
occupation ...
...............
12 BIRTHPLACE (City)
Brookline
(State or country)
Vossachusetts
13 NAME OF
FATHER
James Driscoll
14 BIRTHPLACE OF
FATHER (City)
Brookline
(State or country) Meaza chusetts
15 MAIDEN NAME
OF MOTHER
Annie Do mey
16 BIRTHPLACE OF
MOTHER (City)
St
Join
(State or country)
Relation, if any
Informant ........
(Address)
Crystal Cov AVS
I HEREBY CERTIFY that a satisfactory standard certificate of death was Ned with me BEFORE the buyal or Hansit permit was Issued: Wm. D. Childress8
(Scnature of Agent of Board of frealth of other)
Health officer (Official Designationf (Date of Issue of PermitY ...........
6/17/38
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
June
16
1938
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
June 13
1938, to June 16
1938
I last saw him allve on
June 16
1938.
death Is sald
to have occurred on the date stated above, at .... Y .......... m. The principal cause of death and related causes of importance In order of onset were as follows:
Date of Onset IMPORTANT
Hypertex orie hant award dans
...
Công nie heart paramesmonich
Contributory causes of Importance not related to principal cause:
Name of operation none
Date of
What test confirmed diagnosis?
Was there an autopsy? no
20 Was disease or Injury in any way related to occupation of deceased? no
If so, specify ..
arthur C. incurran
(Signed)
M. D.
(Address) Wanthof, Mas Date
6/17 1948
21,
Holyhoog
Brookline
Place of Burial, Cremation of Removal (City or Town)
June 18.
38
DATE OF BURIAL
John J. D
19 ..
22 NAME OF
UNDERTAKER
ADDRESS
throw. Massachusetts
Received and filed 19
(Registrar)
tion should be carefully supplied. in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very Ago should De suALcu MIA. ....
See instructions and extracts from the laws on back of certificate.
No. 6156F
important.
100mm 12 '35
PLACE OF DEATH
Suffolk (County)
(If U. S.
War Veteran
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
days.
How long in U.S., if of foreign birth?
years
17
Tilhemina Driscoll
(
it ron
PARENTS
year)
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
Dste 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.
with, aiter the death of
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 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 hoard 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 permit shall be issued until there shall have been delivered to such board, agent or clerk. as the casc may be, a satisfactory written statement con- taining the facts required by law to he 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 If such a permit for the removal shall make such certificate. 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 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 sball 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 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.
F301A
PLACE OF DEATH
(City or Town) 155 River Att. Vinctrop Brass No .. Minis Lambro
(If deceased is a married, widowed or divorced woman, give also maiden name.)
15-5 River Rett Herchop
Length of resideoce in city or town where death occurred
months
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.
117
Registered No. § (If death occurred in a hospital or institution,
Ward give its NAME' instead of street and number)
(If U. S.
War Veteran
specify WAR)
(If nonresident, give city or town and state)
months
days.
PERSONAL AND STATISTICAL PARTICULARS
(County)
1
2 FULL NAME
(a) Residence.
No.
(Usual place of abode)
8 SEX
male
4 COLOR OR RACE
white
(or) WIFE ol
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
78
AGE
Years
Months
.Days
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,
10 Date deceased last worked et
this occupation (month and.
OCCUPATION
13 NAME OF
FATHER
fuch
14 BIRTHPLACE OF
FATHER (City)
(State or country)
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17
Juformaat
(Address)
WHILE PLAINLI. WIIn UNFAVING BLACK INA-THIS IS A PERMANENT KLUND. EVETY Tom of mylife
year)
denne 1938
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
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorced
HUSBAND of
Eva Mayer
(Give maiden name of wife in full)
If less than 1 day Hours ..... .Minutes
estist
saw mill, bank, etc .... is Home-
11 Total time (years)
spent in this
occupation.
50
12 BIRTHPLACE (City)
(State or country)
Landar England
15 MAIDEN NAME
OF MOTHER
Many Heilbron
100m 11 36 No. 9080 F
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued:
.. Health 6/17/38 (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
6
(Month)
17
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
6/12
6/17
195 б.
1232, 1
i last saw h.
.allve on
6/16
19-3 0, death is said
to have occurred on the date stated above, at .......... H.m.
The principal cause of death and related causes of Importance In order of onset
were as follows:
Date of Oneet IMPORTANT
6/12 ...
Contribatory causes of Importance, not related to principal cause: Elusuis Dephotos
:
2
Name of operation
What test confirmed diagnosis?
Was there an eutopsy ?.
20 Was disease or Injury in any wey related to occupation of deceased? If so, specify
(Signed)
(Address).
Date
16/7/1935
.. , M. D.
West Racking \ Nand ini tand Jean 21
Relation, if any Place of Burial, Crematfh or Removal. (City or Town)
DATE OF BURIAL. true 19 1938
22 NAME OF
UNDERTAKER
Bergamo 7 Solomon
ADDRESS
420 Haward- Brookline
Received and filed ....
JUN 2.0 1938
. 19
(Registrar)
/ (Official Designation)
70 years
St., Ward,
days.
How long in U.S., if of foreign birth?
years
38
Date of
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. 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, name other important diseases.
Example
'The principal cause of death and related causes of importance in order of onset were as follows:
Date ol Onset
Arteriosclerosis ....
1915
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.
With,
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 tlate 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 therefromn 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 he 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 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 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. 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 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.
-
1
RI R-303 B
Sulluck (County)
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.1.6.85.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME.
Julia I. Stiles
(White).
(If deceased is a married, widowed or divorced woman, give also maiden name.) Nachmatin Chambers Written
Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred 40 yrs. mos. days. How long in U. S., if of foreign birth? yrs.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widowed
18 DATE OF
June -17-1938
DEATH
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Benjamin Stiles
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE
80
Years.
6
Months .. 9
Days
If less than 1 day Hours ......... .. Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner. 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
year)
1 1 Total time (years) spent in this occupation.
12 BIRTHPLACE (City)
Boston
(State or country)
Mass.
13 NAME OF
FATHER
John L. White
PARENTS
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