USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1939 > Part 57
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House work
9 Industry or business in which
work was done, as silk mill,
Own home
10 Date deceased last worked at
11 Total time (years)
this occupation (month aPuly 1939
spent in this
60
occupation
12 BIRTHPLACE (City)
Pembroke
(State or country)
Massachusetts
13 NAME OF
FATHER
Henry Baker
14 BIRTHPLACE OF
Duxbury
FATHER (City)
(State or country)
Massachusetts
15 MAIDEN NAMEM
OF MOTHER
Maria Drake
16 BIRTHPLACE OF
MOTHER (City)
Pembroke
(State or country)
Massachusetts
17 Hattie M Baker
(Address) 6 Jefferson St Winthrop Mass
YHEREBY CERTIFY that asatisfactory standard certificate of deeth was Mled with me BEFORE the burjaf or trensit permit was issued:
Wir D Childress (Signature of acent of Board of Health or other
Health Officer 7/8/39
(Official Designation) (Date of Issue of Permitf
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
July
7
1939
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
That I attended deceased from
January 10 1936
to
July 7
1939
1
I last saw bez alive on July 7 193 9, death is said to have occurred on the date stated above, at 1:30 Quit The principal cause of death and related causes of Importance In order of onset were as follows: Date of Onset IMPORTANT acute Cormary Throwbred July
1939
Contributory causes of Importance not related to principal cause: arteriosclervais
1938
Senility
1939
Name of operation ..
mouse
Date of ..
What test confirmed diagnosis Quecal Was there an autopsy? ?
labrador
20 Was disease or Injury in any way related to occupation of deceased?
If so, specify
Jacob
(Signed)
M. D. (Address)562 Hurley De July ? 30 1
21
Winthrop Cemetery
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
19
22 NAME OF
Charles R. Bennison
UNDERTAKER
ADDRESS
Winthrop Mass
Received and filed. 19
(Registrar)
100m 11.'36. No. 9080.F
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 saw mill, bank, etc.
PLACE OF DEATH
1
8 SEX
Female
7
83
OCCUPATION
PARENTS
Informant
tion should be carefully supplied. Age should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH
yeer)
(If U. S.
War Veteran
specify WAR)
(Usual place of abode)
13
Relation, if any
sister)
DATE OF BURIAL
July 9
1939
120
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 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 cugaged 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, 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 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 nepbritis
1921
Cerebral hemorrhage
July 5. 1927
Contributory causes of importance not related to principal cause :
In a group of causcs 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 therefroin 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 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 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 licu 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 hody has been sooner obtained hereunder. If the death certificate contains a recital. as required by section ton 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 peintits, 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. (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.
301
PLACE OF DEATH
Sulfock
0 0 (County)
Wenthuske
(City or Town)
Events
watifere 8/9/39 The Commonwealth of Alassachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
146
ยง (If death occurred in a hospital or institution,
.Ward \ give its NAME instead of street and number)
2 FULL NAME
Ellen.L.Carr ..
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No. 46 Autumn St
Everett
St.,
Ward,
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
days.
How long in U.S., if of foreign birth?
years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widow
5a If married, widowed, or divorced
HUSBAND of
(Giye maiden name of wifetn full)
(or) WIFE of ....
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE ..
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc .......
at Home
9 Industry or business In which work was done, as silk mill, saw mill, bank, etc.
10 Date deceased last worked at
this occupation (month and
year)
Wokewed
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Jamie Holey
14 BIRTHPLACE OF FATHER (City) ..
Ireland
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Manning
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Pretend
17 Varsh If. Howard (Dawali) Relation, if any
Informant
(Address)
46 auturin St Cruett
I HEREBY CERTIFY that a satisfactory standard, certificate of death was filed with me BEFORE the buDay or transit permit was issued:
1
(Signature of Ageny of Board of Health or ot) .
Healthe officer 7/10/39
/ (Official Designation)
(Date of Issue of Permit)
18 DATE OF
DEATH
July 8 1939
(Month)
(Day)
(Year)
19( I HEREBY CERTIFY, That i attended deceased from
20, 30 1998 , to .. gala 80 193.7, death is sal
8
1:39
I last saw h .. . ... allve on
to have occurred on the date stated above, at 11.30A.m. The principal cause of death and related causes of Importance in order of onset were as follows: Cerebral Dale of Oaset
Cerebral
Joe 31939
Contributory causes of Importance not related to principal cause: Anpulluma
en .1938
D
Diabetes Mellitus
1938
Name of operation ...
What test confirmed diagnosis? Canal
.Date of.
.Was there an autopsy ?.
20 Was disease or Injury in any way related to occupationrof deceased?
(Signed)
(Address) 596Broadway
21 ....... Place of Burial, Cranation or Removal .- Town)
DATE OF BURIAL. July 11, 1939 19 ..
22 NAME OF
045 Hirnisstill
UNDERTAKER
ADDRESS
Received and filed ... 19
A TRUE COPY ATTEST
(Registrar)
100m-12-'35. No. 6156E
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 OCCUPATION
1
46 autoren No.
104 Tafts Que
St.,
(City or town making return)
(If U. S.
War Veteran
specify WAR)
MEDICAL CERTIFICATE OF DEATH
7 71 .Years. Months .Days
If less than 1 day
Hours.
.......... Minutes
Y ...
11 Total time (years)
spent in this
occupation ...
PARENTS'
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 section for every person aged 10 years or over. II 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, ctc. 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 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.
GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- 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.
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 casc may be, 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.
.... 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 cemetery or burial ground in which the interment is made. . . .- CHAP. 114, SEC. 46, G. L. (TERCENTENARY EDITION.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ob- servance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septi- cemia), and by the action of chemical (drugs or poisons), thermal. or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
R-301A
PLACE OF DEATH
Suffolk County)
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.
( If death occurred in a hospital or institution, St.,
.Ward give its NAME instead of street and number)
2 FULL NAME
Charles Payson Floyd
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St.,.
Ward,
(If nonresident, give city or town and state)
months
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
12
1939
0
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
10
1939, to que 12
1939
last saw h ....
.
... allve on.
Juli
1939
death is said
to have occurred on the date stated above, at ........ A ..... m.
The principal cause of death and related causes of Importance to order of onset
were as follows:
Date of Ogget IMPORTANT
Chumi
May 24 14 39
hear 1419
P
Name of operation
Date of.
What test confirmed diagnosis? Austin
Was there an autopsy? No
20 Was disease or Injury in any way related to occupation of deceased? No
If so, specify ...
(Signed)
M. D.
(Address) Writing
Date June 12 1939
Hinchrop Cemetery Munterob Mass
21
Relation, if any/
Place of Burial Creination or Removal.
(City of Town)
DATE OF BURIAL
July 14
1939
22 NAME OF
UNDERTAKER
I. Waterwant Tous Ine
ADDRESS
Boston Mass. F. B.a.
Recelvad and filed. JUL 20-1939 19 ......
(Registrar)
100m 11-'36. No. 9080-F
important.
1
(City or Town)
38 Locust
No.
(a) Residence.
No.
38 Lower St
(Usual place of abode)
Length of residence in city or town where death occurred
years
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
4 COLOR, OR RACE
Utrite
5 SINGLE
HARRIED
WIDOWED
OF DIVORCED
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
74
AGE ..
. Years ..
If less than 1 day
.Hours
7
.Months
0 Days
8 Trade, profession, or particular
kind of work done, as spinnes,
sawyer, bookkeeper, etc.
9 Industry or business in which
work was done, as silk mill,
Taylor
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