USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 48
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14 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Mary Lambert
16 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
5m-12-'34. No. 2938-g
17
Mrs. W. D. Maclean (Sister)
Informant (Address) 18 Hovey St, Watertown, Mass.
I HEREBY CERTIFY that a satisfactory atandard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wms. Children .. (Signature of Agent of Board of Wrath other) Health Officer (Official Designation) (Date of Issue of Permit) 6/18/38
Received and filed
19
.....
43
(Registrar)
=
(See reverse side for description for unknown person )
20 IN WHAT CITY OR TOWN
WAS INJURY SUSTAINED?
22.
(Signed)
Or A. Suckling
M. D.
(Address)
Burton
Mbate-17-1938
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ForestHills
Boston
(Cemetery)
(City or town)
DATE OF BURIAL !.
June 20
19.3.8
22 NAME OF
UNDERTAKER ..
anthublackwell
ADDRESS
45 Mit. Auburn St., Watertown, Kass.
information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF A 19 4444 3 -341 399
Every ILUIll VI N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENNI ALLUND. of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes
PLACE OF DEATH
1
(City or Town)
No en route to Northrop Community Hospital Ward
118
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
mos.
days.
(write the word)
Female
19 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) acute Cardiac Failure . O besite Probably Fatte myocardetes
Collapsed & died quickly
EXTRACTS
FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with. after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age. the disease of which he died, defined as required by section one, where same was con- tracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health. or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence. the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the common- wealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as re- quired by section ten of chapter forty-six. that the deccased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Chap. 114, Sec. 45, G. L. (Tercentenary Edition.)
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made ....- Chap. 114, Sec. 46. G. L. (Tercenten- ary Edition.)
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;...- General Laws, Chap. 38. Sec. 6.
... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
... The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized discase unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia). and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For cxample: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to inedico-legal inquiry. For example: "Hemorr- hage spontaneous, of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.) "
DESCRIPTION (for unknown person).
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
1301
Suffolk ·
(County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
(City or town making return)
No Winthrop Community Hospital St. Edward W. DougBao.
Ward
give its NAME' instead of street and number)
(If U. S.
War Veteran
specify WAR)
(a) Residence.
No.
110 Loring Road
St.,
Ward,
(If nonresident, give city or town and state)
months
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widowed
18 DATE OF
DEATH
June
21
1938
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
Emma .... Damon
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
73
11
15
If less than 1 day
.Hours ..
.Minutes
OCCUPATION
sawyer, bookkeeper, etc ....
9 Industry or business in which
work was done, as silk mill,
Buildings
saw mill, bank, etc ....
10 Date deceased last worked at
11 Total time (years)
this occupation (month and June 1938 spent in this
40
year)
occupation .....
12 BIRTHPLACE (City)
Charlottetown
(State or country)
Prince Edward Island
FATHER
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Prince Edward Island
15 MAIDEN NAME
OF MOTHER
Hetty Cook
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Prince Edward Island
17 Carolyn Rayner daughter (Address) 27 M Spring St. West Banningt on22 NAME OF
R.I.
I HEREBY CERTIFY, that a satisfactory standard certificate of death was filed with me BEFORE the burial or fransit permit was issued: N. M. D. Chil dress Health Olice 6/22/38
... (Signature of Agent of Board of Health or other)
(Oficial Designation) (Date of Issue of Permit)\
19 I HEREBY CERTIFY, That I attended deceased from
22
1922, to June
21
1938
I last saw him
.allve on.
021
1938, death is said
to have occurred on the date stated above, at & A .m. The principal cause of death and related causes of importance in order of onset Date of Onset were as follows: 1
..... Chimie Imparardata
Jun 1928
auch delikat of Hout
June 2/1938
Contributory causes of Importance not related to principal cause:
Name of operation
Date of.
What test confirmed diagnosis? abwarten.
Was there an autopsy ? no.
20 Was disease or Injury in any way related to occupation of deceased?
If so, specify
(Signed)
(Address)
Winthers man Date June 2 1938
21
Winthrop
Winthrop
DATE OF BURIAL
UNDERTAKER
Charles R. Bennison
ADDRESS
.....
Winthron
Mass
Received and filed.
19
A TRUE COPY ATTEST
JUN 23. 1938
(Registrar)
--
tion should be carcruny suppusu. in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very See instructions and extracts from the laws on back of certificate.
important.
100m-12-'35. No. 6156E
1
PLACE OF DEATH
2 FULL NAME
(If deceased is .a married, widowed or divorced woman, give also maiden name.)
Registered No.
119
§ (If death occurred in a hospital or institution,
(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 hirth?
years
(write the word)
AGE .. Years. Months .Days
8 Trade, profession, or particular
kind of work done, as spinner,
Painter
13 NAME OF
William Douglas
PARENTS
M. D.
Relation, if any
Place of Burial, Cremation or
June
23. 1938
19
Removal
Sity or Town)
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 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
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.
last illness, at the request of an undertaker 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 heen 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 hody is huried. No such permit shall be issued until there shall have becu delivered to such board, agent or clerk, as the case may be, a satisfactory written statement con- taining the facts required hy 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 hodies of only such persons as are supposed to have died by violence. . -GEN. LAWS, CHIAP. 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 of 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.
(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.
1301A
--------
1
PLACE OF DEATH
No.
Suffolk (County) Whittrop (City or Town) Withop.
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. 120
Registered No. f (If death occurred in a hospital or institution, !Ward ( give its NAME' instead of street and number) to .St.,
2 FULL NAME
Elizabeth Warder
(If U. S. War
specify WAR)
Ward,
Wirthump
St.
(If nonresident, give city or town and state)
days.
How long in U.S., if of foreign birth? 3 years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
8 SEX
Hemele
4 COLOR OR RACE
5 SINGLE
(write the word)
Widow
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
(Give rfaiden name of wife in full)
recorder
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE
52 Years.
Months
.Days
If less than 1 day 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,
at Home
saw mill, bank, etc ....
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
this occupation (month and
year)
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Morris Bender
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Mollie- Cannotbe
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
hus Sarge Cally (Wanglite)
17 Informant (Address) 217 Ru col
I HEREBY CERTIFYthat a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: [(o). 1 (Signature of Agent of Board of Health or other) earth. . ... fficer 6/23/38 (Official Designation) (Date of Issue of Permat)
teame (Signed) ..
20 Was disease or Injury in any way related to occupation of deceased?
elf so, specify.
Charles Fliege
, M. D.
(Address): Wany When
........
Date 1/23/1938 Winthrop Com. Every wass 21
DATE OF BURIAL
June 2
3
(City or Town)
19 38
22 NAME OF
UNDERTAKER
manuel Stanetely
10 Work or
ADDRESS
Received and filed. 19
JUN-2-3 1938
(Registrar)
-----.
in plain torma, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very See instructions and extracts from the laws on back of certificate.
important.
100m 12 '35. No. 6156F
(If deceased is a marfied, widowed or divorced woman, give also maiden name.)
33- Cutter
(a)
Residence.
No.
(Usual place of abode)
Length of residence in city or town where death occurred
months
12 years
18 DATE OF
DEATH
JUN 2:2 1938
......
(Day)
(Year)
(Monthy
19
I HEREBY CERTIF
That I attended deceased from
Jan . 23
1938, to Jene 22,1988
last saw b .... ..... allve on June 22, 1938, death is said to have occurred on the date stated above, at 5:15 P.M. The principal cause of death and related causes of Importance in order of onset were as follows:
Date of Onset IMPORTANT
Coronary Thrombosis 1/29/38
Contributory causes of Importance not related to principal cause:
Name of operation.
What test confirmed diagnosis? EKG.
Date of.
Was there an autopsy? No
Relation, if any Place of Burial, Cremation or Removal.
PARENTS
MARRIED
WIDOWED
or DIVORCED
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.
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