USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 80
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Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, ctc. 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 of onset
Arteriosclerosis
1015
Chronic interstitial nephritis
I021
Cercbral hemorrhage
July 5, 1927
Contributory causes of importance not related to principal cause:
In a group of eauses containing the principal cause and related eauses, 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 eause in the above example happens to be the second eause given.
A physician or registered nospital in
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 registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deccascd, his supposed 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 disposo 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 tho 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 inedical 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 cnough 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 hercunder. 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.)
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.
.... Hc 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. Lows, 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 ... . Chop. 114, Sec. 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 iliness 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 causcd 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 discase, and those of persons found dead.
O1A
Suffolk (County)
Winthrop (City or Town) 44 Irwin
No.
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. 200
Registered No. § (If death occurred in a hospital or institution, St., ....... .Ward \ give its NAME' instead of street and number)
2 FULL NAME
Caroline Peck Dowd
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
44 Irwin St
(Usual place of abode)
.St.,
Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
6
years
months
days.
How long in U.S., if of foreign birth?
years
months
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
GeSig gaiden naps of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fect here.
86
?
?
Days
If less than 1 day Hours. .Minutes
At Home
9 Industry or business in which work was done, as ailk mill, saw mill, bank, etc ..
10 Date deceased last worked at
this occupation (month end
year)
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
Bristol
(State or country)
Conn
13 NAME OF
FATHER
Hiram Peck
14 BIRTHPLACE OF
Burlington
FATHER (City)
(State or country)
Conn
15 MAIDEN NAME
OF MOTHER
Wheathy Hart
16 BIRTHPLACE OF
MOTHER (City)
Burlington
(State or country)
Com
Relation, if any Daughter
17 Helen Edgett
Informant (Address) 44 Irwin St Winthrop Mass
I HEREBY CERTIFY that a satisfactory stendard certificate of death was Afred with me BEFORE the burjal, or transit permit wes Issued: W/m.E. Chil dress x Signature of Agent of Board of Heat Heath or other) ..... Health Officer 10/10/38
(Oficial Designation) ....
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
October
Seven
1938
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That i attended deceased from
Lep T
7
1938
1937, to Get
>
I last saw h ............ allve on.
Sept
29
38 death is sald to have occurred on the date stated above, 18:10Pm. The principal cause of death and related causes of Importance la order of onset were as follows:
Date of Onset IMPORTANT
Chemic
fur T7/37
Contributory causes of Importence not related to principal cause:
fy+7/37
Name of operation.
Date of
What test confirmed diagnosis Claudia
Was there an autopsy ?.
20 Was disease or Injury in eny way related to occupation of deceesed? 200 If so, specify farmand Blake M. D.
(Signed)
(Address)
Winthrop man
DateGet 8 1938
21
Winthrop
Winthrop
Mass
Place of Burial,
Creination or
october
16°v1948(City or Town)
19
DATE OF BURIAL
22 NAME OF
P.H. Weiteren
UNDERTAKER
ADDRESS
147 Winthrop St Winthrop Mass
Received and filed.
OCT 01 1938
19
(Registrar)
OCCUPATION See instructions and extracts from the laws on back of certificate. PARENTS
important. 100m 11. 36. No. 9080 F
PLACE OF DEATH
1
1
(If U. S. War Veteran
specify WAR)
7 AGE Years. Months
8 Trede, profession, or particuler
kind of work done, as spinner,
sawyer, bookkeeper, etc ....
Statement of occupation .-- l'ecise 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- iness, report the occupation prior to retirement. Children not gainfully employed may be returned as AT SCHOOL Or AT HOME. For a woman whose only occupation was that of home housework, write HOUSEWORK in answer to Question 8 and OWN HOME in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as HOUSEKEEPER-PRIVATE FAMILY, COOK-HOTEL, etc. For a person who had no occupation whatever write NONE.
To be complete, an occupation return must state :
8 .- The trade, profession, or particular kind of work done.
9 .-- The industry or business in which the work was done.
10 .- The mouth 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, ctc., a> 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 securcd. 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. I'nder 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:
Date of Onset
Arteriosclerosis
1915
Chronic interstitial nepbritis
1921
Cerebral hemorrhage
July 5. 1927
Contributory causes of iniportance not related to principal cause :
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second. or third position. The principal cause in the above example happens to be the second cause given.
A physician or registered hospital medical officer shall forth-
wuh. aller 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- posed age, the disease of which he died, defined as required hy section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the dlate of his death. .. . GEN. LAWS, CHAP. 46, SEC. 9.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not been buried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetcry, 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 buried. No such permit shall be issued until there shall nave 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 be returned and recorded. which shall be accompanicd, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as re. quired by law. or in lieu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot he obtained early enough for the pur- pose. or is insufficient, a physician who is a member of the board of health, or employed by it or 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 he returned to the town from which it was re- moved within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has 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 «hall thereafter furnish for registration any other necessary information which can he obtained as to the deceased, or as to the manner or cause of the death. which the clerk or registrar may require .- CHAP. 114. SEC. 45. G. L. (TER- CENTENARY EDITION.)
Medical examiners shall 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 he, 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 peinits, 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 aupposably 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.
O1A
See instructions and extracts from the laws on back of certificate.
important. 100m 11 36. No. 9080 F
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial og transit permit was Issued: William D, Childress (Signature of Agent of Board of Health or other)
agent
Och, 9/38
(Official Baignation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
October
8
1938
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
August ... 8.
19.38., to ... October 8
19 ... 38
I last saw b.er
.afive on.
October .... 8.
19.38., death Is sald
to have occurred on the date stated above, at1 : 55.P .. m. The principal cause of death and related causes of Importance In order of onset were as follows: Dale of Onset IMPORTANT Carcinomatosis,abdominal,with
ascites.
Unknown
Contributory causes of Importence not related to principal cause:
Name of operetion. Abdominal .... paracenbate of .Sept .... 9/38 .. What test confirmed diagnosis ?. esis Was there an autopsy ?... Yes
Autopsy
20 Was disease or Injury in any wey related to occupation of deceesed? NO
If so, specify ...
None
(Signed)
JOSEFA RICH, Ist Lt. M. C. Oct 8 19 38
(Address)
Station Hospital It Banks Hass.
21
Place of Banal, Cremation or Removal.
(City of Town)
DATE OF BURIAL UCT.11
1938
22 NAME OF
7. Power O'Connor
UNDERTAKER
ADDRESS
Hauchile Masz.
Received and flied.
OCT 1.0 1938
19
.....
.....
Il Ringeton Com., Pingstão, YA
(If U. S. War Veteran specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden namc.)
(a) Residence.
No.
30 Lewis
(Usual place of abode)
.St.,
Ward,.Haverhill, Mass
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred ~ years 2
months
days.
How long in U.S., if of foreign birth? - years
months=
days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
(write the word)
5a If married, widowed, or divorced
HUSBAND of
William Rogers
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE 59
Years 2 .Months.28 .. Days
If less than 1 dey ...... .. Hours ............ Minutes
OCCUPATION
8 Trade, profession, or perticuler kind of work done, as spinner, sawyer, bookkeeper, etc .... Housekeeper
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc. Own ... home
10 Date deceased last worked at
1 1 Total time (years)
spent in this
occupation
42
this occupation (month and
year) ...... August ......
1938
12 BIRTHPLACE (City).
Unknown
(State or country)
Vermont
13 NAME OF
FATHER
Frank Simes
14 BIRTHPLACE OF
FATHER (City)
Unknown
(State or country)
IInknown
15 MAIDEN NAME
OF MOTHER
Unknown
16 BIRTHPLACE OF
MOTHER (City)
Unknown
(State or country)
Unknown
17 Relation, if any Informant Registrar., S.t.a ... Hosp .. Et ... Banks., Mass .......... (Address)
PLACE OF DEATH
SUFFOLK (County)
11/9/38
WINTHROP (City or Town)
The Commonwealth of Alassachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 201
Registered No.
f (If death occurred in a hospital or institution,
No.Station Hospital,Fort Banks,Mass ..... St., ..
.......... Ward give its NAME' instead of street and number)
2 FULL NAME
MRS. ANNIE L. ROGERS, nee SIMES
1
PARENTS
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 seenon 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-
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 ternis, 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 donc. 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, avonl 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, n'ame 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:
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