Town of Winthrop : Record of Deaths 1938, Part 82

Author: Winthrop (Mass.)
Publication date: 1938
Publisher:
Number of Pages: 522

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 82

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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 fortbwitb 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 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 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 example: "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 medico-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

R-301

Suffolk

(County)

Winthrop

(City or Town)

No. 322 Revere St

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD

CERTIFICATE OF DEATH

(City or town making return)

Registered No.

204

S (If death occurred in a hospital or institution,

St.,

.Ward \ give its NAME instead of street and number)

2 FULL NAME

Mary T. Driscoll Davis

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence.

No.

322

Revere 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

years

months

days.

How long in U.S., if of foreign birth?

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

4 COLOR OR RACE

White

5 SINGLE

MARRIED

WIDOWED

or DIVORCED Married

5a If married, widowed, er divorced

HUSBAND of

John (Give maijer yang of wife in full)

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

Years

Months

.Days

If less than 1 day

.Hours ..

.Minutes

8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ....... Housewife

9 Industry or business In which

work was done, as silk mill,

saw mill, bank, etc.

Own ... Hone

10 Date deceased last worked at

11 Total time (years)

this occupation (monty @15

spent in this

occupation ..

12 BIRTHPLACE (City)

(State or country)

Ireland

13 NAME OF

FATHER

Daniel Driscoll

14 BIRTHPLACE OF

FATHER (City)

(State or country) Ireland

15 MAIDEN NAME

OF MOTHER

Cannot be learned

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Ireland

Relation, if any

John F. Day!

Hus ba nã

I HEREBY CERTIFY that a satisfactory standard certificate of death was Med with me BEFORE the burial of transit permit was Issued:

(Signature of Agent of Board of health or other) /Realthe officer 10/19/38

(Oficial Designation)// (Date of Issue of Permits

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Cent

(Month)

(Day)

1938 (Year)

I HEREBY CERTIFY, That I attended deceased from

193 8. 10.

19 .. 3.£

1 last saw h .. ....... alive on.

19.3. f., death is sald

to have occurred on the date stated above, at wwPORm.

The principal cause of death and related causes of importance In order of onset

were as follows:

Date of Onset

Chimie heffuite

Contributory causes of Importance not related to principal cause:

Name of operation

What test confirmed diagnosis ?.

Was there an autopsy ?....

20 Was disease or Injury in any way related to occupation of deceased?

If so, specify

(Signed)

M. D.

(Address) ......

YWashingtoncon Date Latino 38

Holy Cross

Malden

Place of Burial, Cremation or Removal

(City or Town)

DATE OF BURIAL

(Oct. 20 11938

19.

22 NAME OF

UNDERTAKER

JohnHimala

ADDRESS

Winthrop

......

Received and filed ......... QCI 2 1 1938

A TRUE COPY ATTEST

(Registrar)

100m-12-'35. No. 6156E

PLACE OF DEATH

1 8 SEX Female (or) WIFE of 7 AGE 84 OCCUPATION PARENTS tion should be carefully supplied. Age should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH year) 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

17 Informant (Address) 322 Revere St

(write the word)

(If U. S.

War Veteran

specify WAR)

Date of.

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:

Date 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.

A physician or registered hospital medical officer SI

with, aiter 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 deceased, his sup- posed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . GEN. LAWS, CHAP. 46, SEC. 9.

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 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.

(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.

R-301A

Suffolk

(County)

Winthrop (City or Town)

No. 507 Pleasant St.

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.

Registered No. 215

§ (If death occurred in a hospital or institution,

St.,

.Ward { give its NAME' instead of street and number)

2 FULL NAME Samuel H. Mayo

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence.

No.

507 Pleasant Street

(Usual place of abode)

Length of residence in city or town where death occurred 50

years

months

days.

How long in U.S., if of foreign birth?

years

months

days.

PERSONAL AND STATISTICAL PARTICULARS

MEDICAL CERTIFICATE OF DEATH

3 SEX

Male

4 COLOR OR RACE

White

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

Widowed

5a If married, widowed, or divorced HUSBAND of

Elàen Harding Mevo

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

AGE

Years Months

.Days

If less than 1 day

.Hours

OCCUPATION

sawyer, bookkeeper, etc ....

9 Industry or business in which

work was done, as silk mill,

saw mill, bank, etc.

Railroad

10 Date deceased last worked at

this occupation (month and

year)

1928

11 Total time (years)

spent in this

occupation.

12 BIRTHPLACE (City)

Chatham

(State or country)

Mass.

13 NAME OF

FATHER

H. Samuel Mayo

PARENTS

14 BIRTHPLACE OF

FATHER (City)

Chatham

(State or country)

Mass

15 MAIDEN NAME

OF MOTHER

Not Known -- Eldridge

16 BIRTHPLACE OF

MOTHER (City)

Chatham

Writing Man Date let 19 193 F.

21 Winthrop Cem .. Winthrop Mass

Place of Burial, Cremation or Removal.

(City or Town)

Relation, if any

Daughter-Law

DATE OF BURIAL ..

October 19,

1938

22 NAME OF

UNDERTAKER

R.H. Whites

ADDRESS

147 Winthrop st winthrop Mass

Received and flled.

OCT 237.93

(Registrar)

100m 12 '35

Age should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH Date of onset and exact statement of OCCUPATION are very

See instructions and extracts from the laws on back of certificate.

in plain terms, so that it may be properly classified.

tion should be carefully supplied.

No. 6156F

important.

I HEREBY CERTIFY that e satisfactory standard certificate of death was filed withme BEFORE the bajial or transit permit was issued: VIm. D. Childress 8 (Signature of Agent of Board of Health Or other ) Healthe fficer 10/19/38 /(Official Designation) (Date of Issue of Permil )

18 DATE OF

DEATH

October

1938

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That i attended deceased from

Sen T 14

1938

let 18

1938

to.

I last saw him alive on.

lect

1938

death is sald

to have occurred on the date stated above, at 2 P.

The principal cause of death and related causes of Importance la order of onset were as follows: Minutes

Data of Onsat IMPORTANT ......

Left 14,1985+

Contributory causes of Importance not related to principal cause:

(

Name of operation

no.

Date of ...

What test confirmed diagnosis? Ellertim.

Was there an autopsy? 40

20 Was disease or Injury in any way related to occupation of deceased? 20.

If so, specify(

Gaymard B Parker

(Signed)

. M. D.

(State or country)

Mass

17 Maud Mayo

loformant

(Address)

Allen Road Billerica

mass

(If U. S. War Veteran

specify WAR)

St.

.Ward

(If nonresident, give city or town and state)

PLACE OF DEATH

8 Trade, profession, or particular

kindof work done, as spinner,

Brakeman

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.

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.

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 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 C OF CERTIFICATES OF DEAIn

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 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 scen 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 issucd until there shall have been delivered to such board, agent or clerk, as the case may bc, a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as re- ouired 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 hoard 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.)

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Town of Winthrop : Record of Deaths 1938, Part 82

Author: Winthrop (Mass.) Publication date: 1938 Publisher: Number of Pages: 522

Author: Winthrop (Mass.)
Publication date: 1938
Publisher:
Number of Pages: 522