Town of Winthrop : Record of Deaths 1939, Part 100

Author: Winthrop (Mass.)
Publication date: 1939
Publisher:
Number of Pages: 560

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1939 > Part 100

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'lo be filed for burial permit with Board of Health or its Agent.

Registered No.

(If death occurred in a hospital or institution,

St.,

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

2 FULL NAME

Betty Anderson Larson

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

(a) Residence.

No.

29 Plummer Ave Winthrop

(Usual place of abode)

Length of residence in city or town where death occurred 39

years

months

days.

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

49 years

months

dayı.

PERSONAL AND STATISTICAL PARTICULARS

5 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCED

Married

(Give maiden name of wife in full)

(Husband's name in full)

If less than 1 day Hours .. ......... Minutes

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

O Industry or business in which

work was done, as silk mill,

At. Home

11 Total time (years)

spent in this

occupation ..

year)

12 BIRTHPLACE (City)

(State or country)

.- Swedan Sweden

13 NAME OF

FATHER

Peter Anderson

(State or country)

-Swe dơn

Sweden

15 MAIDEN NAME

OF MOTHER

Laurens Larson ox

16 BIRTHPLACE OF

MOTHER (City)

(State or country)

Sweden Sweden

Relation, if any

Daughter

Informant

(Address)

29 Plummer Ave Winthrop

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the butial or transit permit was issued:

(Signature of Agent of Board of Health of other)

Health officer 12/12/38 Official Designation) (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

Dec. 9 1939

(Month)

(Day)

(Year)

19 I HEREBY CERTIFY, That I attended deceased from

, to

1939

I last saw her

alive on.

19.3.2 .... death is sald

to have occurred on the date stated above, at5:30 Am The principal cause of death and related causes of Importance la order of onset were as follows:

Date of Onset IMPORTANT

Chemic Myocardet

Qc 31 1936

Contribatory causes of importance not related to principal cause:

Name of operation

Date of.

What test confirmed diagnosis absente

Was there an autopsy? Ja

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

200

If so, specify ..

(Signed) .....

M. D.

Data lec 12 1939

Winthrop

Place of Burial, Cremation,

Dec 12 fggg

(City or Town)

DATE OF BURIAL

22 NAME OF

Richard 16 White

FUNERAL DIRECTOR

ADDRESS

... 147 ... Winthrop .... St ...... Winthrop

Received and filed .. 19

(Registrar)

100m-9-'37. No. 1859-i.

Winthrop

(City or Town)

3 SEX

Female

4 COLOR OR RACE

White

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

CarleLarson

6 IF STILLBORN, enter that fact here.

7.74

AGE

.Years

Months

Days

saw mill, bank, etc.

10 Date deceased last worked at

this occupation (month and

14 BIRTHPLACE OF

FATHER (City)

OCCUPATION

PARENTS

Laura Larson

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

tion should be carefully supplied. Age suouid be stated LAHviLt. TITISICIANS should state CAUSE OF DEATH

.......................

in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very

(If U. S. War Veteran

specify WAR)

St.,

.Ward,

(If nonresident, give city or town and state)

...

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- ZER, 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 Omset

Arteriosclerosis ...

1915

Chronic interstitial nepbritis ...

1921

Carebral 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.

GOVERNING THE

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 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 heen 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 I'nited 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 he buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . .- CHAP. 114, SEC. 46, G. L. (TERCENTENARY EDITION.)

RULES OF PRACTICE

The fulfillment of the purpose of these laws calls for the ob- servance of the following rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.

(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.

(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septi. cemia), and 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.

-301A

PLACE OF DEATH

Suffolk (County)

Winthrop (City or Town)

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.

253

(If death occurred in a hospital or institution,

St., .. Ward ( give its NAME instead of street and number)

2 FULL NAME

Edwin Luther Moore

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

(a) Residence.

No ..

28 Pico Avenue

(Usual place of abode)

Leneth 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

3 SEX

Male

4 COLOR OR RACE

White

5 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

Married

5a If married, widowed, or divorced Marietta S. White

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

6 IF STILLBORN, enter that fact here.

7 75

AGE

Years.

Months

270

Days

if less than 1 day

.Hours.

Minutes

8 Trade, profession, or particular

kind of work done, as spinnerCommercial artist

sawyer, bookkeeper, etc ...

9 Industry or business In which

work was done, as silk mill,

Office

saw mill, bank, etc ..

10 Date deceased last worked at

11 Total time (years)

this occupation (month end

1936

spent in this

year)

occupation.

12 BIRTHPLACE (City)

Lynn

(State or country)

Massachusetts

13 NAME OF

FATHER

Luther D. Moore

14 BIRTHPLACE OF

Newburyport

FATHER (City)

(State or country)

Massachusetts

15 MAIDEN NAME

OF MOTHER

Susan (Maiden name unknown') so, specify w pickuplow

16 BIRTHPLACE OF

MOTHER (City)

Unable to obtain

(State or country)

Informant ...

Marietta S. W. Moore ( wife

(Address)

28 Pico Ave. Winthrop l'ass

I HEREBY CERTIFY that e satisfactory standard certificate of death was filed with me BEFORE the burial Or transit permit was issued: I. D. fieldrey & (Signature of Agents of Board of Health onother) The althe Officer 13/13/39

1 .. (oficial Designation) (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATHI

18 DATE OF

DEATH

Dec.

(Month)

(Day)

1939

(Year)

19 I HEREBY CERTIFY That I attended deceased from

mo-3

19.3.9 .. , to

19.

Dec. 11

I last saw have alive on

Dec. 10

....

1939, death is sald

L 5.m.

to have occurred on the date stated above, at.

Dete of Onset

IMPORTANT

The principal cause of death and related causes of Importance la order of onset

were as follows:

arteriosclerosis

1929

Contributory causes of importance not related to principal cause: Gornary occlusion - Gneumonia gangrene & left foot.

, 2013, 39 Dec 8, 39.

Name of operation. What test confirmed diagnosis ?. Clinical Was there an eutops? no

Date of.De .... y.

20 Was disease or injury in any way related to occupation of deceased? no

M. D.

(Signed)

(Address).

Lop, maso Date 12-12 1939.

Winthrop Cemetery Winthrop

Relation, if any

Place of Burial,

Cremation or Removal

(City_or

Town)

DATE OF BURIAL December 13, 1939

22 NAME OF

Charles R. Bennison

FUNERAL DIRECTOR

ADDRESS

Winthrop Mass

Received and filed. 19

(Registrar) V

100m-9-'37. No. 1859.i.

OCCUPATION 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 PARENTS

(If U. S. War Veteran

specify WAR)

Ward,

(If nonresident, give city or town and state)

No ... Winthrop Community Hospital

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 ot 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.

.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.

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

...

Carebral 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 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.

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 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- 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 bodies of only such persons as are supposed to have died by violence. . .- GEN. LAWS, CHAP. 38, SEC. 6.

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 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.

R-301

PLACE OF DEATH

Suffolk (County) Winthrop

(City or Town)

2IO Somerset Ave

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

CERTIFICATE OF DEATH

Registered No.

[ (If death occurred in a hospital or institution,

.St.,

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

2 FULL NAMEMargaret Mary

.... Bennett

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

(If U. S. War Veteran

specify WAR)

(a) Residence.

210 Somerset ave.

(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

MEDICAL CERTIFICATE OF DEATH

18 DATE OF

DEATH

(Month)

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Town of Winthrop : Record of Deaths 1939, Part 100

Author: Winthrop (Mass.) Publication date: 1939 Publisher: Number of Pages: 560

Author: Winthrop (Mass.)
Publication date: 1939
Publisher:
Number of Pages: 560