USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 5
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To be complete, an occupation return must state :
8 .- The tradc, 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 causc, 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.
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, alter the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the 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 hy 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 hoard of health or its agent aforesaid or from the clerk of the town where the hody is buried. No such permit shall be issued until therc 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 he returned and recordcd. which shall be accompanied, in case of an original interment, hy 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 obtained hereunder. If the death certificate contains a recital. as required by section ten of chapter forty-six. that the deceased served in the army. navy or marine corps of the United States in any war in which it has been engaged. such recital shall ap- pear upon the permit. The board of health. or its agent, upon receipt of such statement and certificate, shall forthwith counter- sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased. or as to the manner or cause of the death. which the clerk or registrar may require .- CHAP. 114. SEC. 45, G. L. (TER- CENTENARY EDITION.)
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. -GEN. LAWS. CHAP. 38. SEC. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- GEN. LAWS, CHAP. 38, SEC. 7.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the 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 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 ahsent 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 hy 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.
I R-301A
PLACE OF DEATH
(County)
Winthropo -----.....
manden molitve 2/9/38 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.
10
Registered No.
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME.
Frank Origo
(If deceased is a married, widowed or divorced woman, give also maiden name.)
467 Ferry
St., ..............
.. Ward,
qualder
(a) Residence.
Nc ..
(Usual place of abode)
Length of residence in city or town where death occurred
mos.
3
days.
How long in U. S., if of foreign birth?
yrz.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Tuale White
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
tingle
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
Years .Months
23
.. Days
lf less than 1 day
.. 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
11 Total time (years)
spent in this
occupation.
this occupation (month and
year)
Winthrop
Contribatory causes of importance not related to principal cause:
compulsions.
Name of operation
Pourser
.... Date of ...
ofman
20 Was disease or injury in any way related to occupation of deceased?
If so, specify grand 7 Sande
M. D.
(Address) ..
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ...
Hogy Gross malden
(City or town)
38
22 NAME OF
UNDERTAKERS
ADDRESS_
568 main
Guerett
19
Received and filed.
JAN
Health Officer (Official Designation) (Date of Issue of Permit)
1/20/98
MEDICAL CERTIFICATE OF DEATH
0
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY,
1938, 10
1938
That I altended deceased from
I last saw h ........
allve on
Janis
1938 death Is sald to have occurred on the date stated above, at 2:15 Pm. The principal cause of death and related causes of Importance In order of onset were as follows: Date of Onset IMPORTANT Congenital Syphilis
Jan 16-38
13 NAME OF
FATHER
Joseph Origo
Italy
15 MAIDEN NAME
OF MOTHER
Lena Quattrocchio
(AddressY 467 July 2ST Malden
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the bygal or transit permit was issued: Www. D. Children (Signature of Agent of Board of Health or other)
1 (or) WIFE of 7 AGE OCCUPATION 12 BIRTHPLACE (City) (State or country) (State or country) PARENTS 16 BIRTHPLACE OF MOTHER (City) (State or country) 17 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 is very important. See instructions and extracts from the laws on back of certificate. 100m-12-'34. No. 2938-f N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 14 BIRTHPLACE OF FATHER (City) ..........
(City or Town) No. Winthrop C. Hospital
Ward
(If U. S. War Veteran,
specify WAR)
(If nonresident, give city or town and state)
18 DATE DE
DEATH Jan 18
1938
What test confirmed diagnosis?
......
was there an autopsy?
Date Jan 20 1034
Relation, if any (Father DATE OF BURIAL Frederick gado
(Registrar)
ACTS FROM.
Kevisea United Jules viauuuu u Vw.
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section fer 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 occupatien what- ever write nonc.
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 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 "storc," "factory," "mill," ctc. State the particular kind of store, factory, mill, etc., as grocery store, soup factory, cotton mill, ctc.
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 secured. Do not use the word " mechanic, " but give the cxact 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 causc 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
Chronic interstitial nephritis
Cerebral hemorrhage
July 5, 1927
...
Contributory causes of importance not related te 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 secend cause given.
GOVERNING iHE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, after the death of a person whem 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 bclicf the name of the deceased, his supposed age, the discase of which he died, defined as required by section one. where same was contracted, the duration of his last iliness, 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 er otherwise dispose of a human body in a town, or remeve 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 thero 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 ant 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 cxaminer shall make such certificatc. 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 certificata 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 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 appcar 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, Scc. 45, G. L., (Tercentenary Edition.)
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Sec. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made .. .. Chap. 114, Scc. 46, G. L., (Tercentenary Edition.)
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 diseaso resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
R-301
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
No ...
935 Shirley
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
11
(If death occurred in a hospital or institution,
St., ....................
.Ward
give its NAME instead of street and number)
2 FULL NAME ..
Robert .... Kempton .... Tenner
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No .......
935 Shirley
.St., ...
.Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred 27
yrs.
mos.
days
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
Rose
illa Mcfarland
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
81
9
3
Years.
Months
Days
If less than 1 day
Hours.
Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ... Repairman
9 Industry or business in which
as silk mail
Elevated railroad
saw mill, bank, etc.
10 Date deceased last worked at
this occupation (month and
year)
Dec. 193
tal time (years) 7 7spent in this occupation
12 BIRTHPLACE (City)
Roxbury
(State or country)
Massachusetts
13 NAME OF
FATHER
Robert Kempton Jenner
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Safronia Miller
16 BIRTHPLACE OF
MOTHER (City)
Yarmouth
(State or country)
Maine
17 Mrs. Rose E. Jenner
Relation, if any
wife
(Address) 935 Shirley St Winthrop Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit neront was issued:
,
Signature of Ageny of Board of Health or othery Health Officer /20/34
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
Jan
18
1938
(Year)
(Month)
(Day)
19
I HEREBY CERTIFY, That i attended deceased from
Jan 3
1936, to.
0 Jan15
, 1938
I last saw h ...... alive on
Jan 150
19.3 ..... , death is said to have occurred on the date stated above, at 2,15/m. The principal cause of death and related causes of Importance in order of onset were as follows:
Date of Onset
Mr 1937
Contributory causes of importance not related to principal cause:
Nema Como
Jam 16.38
Name of operation.
What test confirmed diagnosis ?.
Xray
Date of
Was there an autopsy? hr
20 Was disease or injury in any way related to occupation of deceased?
If so, specify ......................
(Signed)
Frank 7 Sandles
M. D.
(Address) 16 Slut the Plane
..........
Date:11/4 19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
(Cemetery)
Bradley
Maine
DATE OF BURIAL
January 21,
(City or town)
19 .. 3.8
22 NAME OF
UNDERTAKER
Charles R. Bennison
ADDRESS
Tinthrop Mass
Received and filed. 19
(Registrar)
A TRUE COPY, ATTEST:
(If U. S.
War Veteran,
specify WAR)
(Usual place of abode)
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)
1 3 SEX Male (or) WIFE of AGE. OCCUPATION PARENTS Informant .. 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 is very important. See instructions and extracts from the laws on back of certificate. (Oficial Designation) 100m-12-'34. No. 2938-e N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of 14 BIRTHPLACE OF FATHER (City)
...
Revised United States Standard Certificate of
Statement of cccupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits 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 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 nonc.
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 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," "inill," ctc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
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