USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1939 > Part 59
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information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate.
PLACE OF DEATH
1
(City or Towni)
No. 267 Bowden st. Winthrop St.,
Ward
(If U. S.
War Veteran,
1939
AGE
11 Total time (years)
Informant (Address) 267 Bowdian ST Winthrop Mass
Revised United States Standard Certificate of Death
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- cver 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," ctc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store," "factory, " '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 engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the 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: Arteriosclerosis
Date of onset
1915
Chronic interstitial nephritis
1021
Cerebral hemorrhage
July 5, 1927
Contributory causes of importance not related to principal causc:
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.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- 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 deceased, 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 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 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 medical examiner shall make such certificate. 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 appcar upon the permit. The board of health, or its agent, upon receipt of such state- ment 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., as amended.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have dicd by violence .... Gen. Laws, Chap. 38, Sec. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attend- ance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from 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
'lo be filed for burial permit with Board of Health or its Agent.
Registered No. 150
(If death occurred in a hospital or institution,
St.,
Ward give its NAME instead of street and number) -
2 FULL NAME
Clifford Telford
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
108-4 Quincy Ave., Winthrop
Length of residence in city or town wbere death occurred
25 years
months
days.
How long in U.S., if of foreign birth? 35 years
months
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July
19
19.39
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That [ attended deceased from
3
(19 2, to
1mg3
19
- last saw h.L.A.
.allve on.
fue 18
....
death is said
to have occurred on the date stated above, at ..
4,30€,m.
The principal cause of death and related causes of Importance in order of onset
were as follows:
Dele of Daset IMPORTANT
Carcinoma
Contributory causes of Importance not related to principal cause:
Exploration
Name of operation ...
What test confirmed diagnosis?
.Date of
Was there an autopsy ?...
20 Was disease or Injury in any way related to occupation of deceased?
If so, specify
(Signed)
M. D.
(Address)
200mamy el Date 7/20 19 39
21.
Woodlawn
Everett, Mass.
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
July 21 1939
19
22 NAME OF
Guichard 16 White
FUNERAL DIRECTOR
ADDRESS 147 Winthrop St., Winthrop
Received and filed
!!!! 2 6 1939
19
(Registrar)
100m-9.'37. No. 1859.i.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the bujial or transit permit was issued: Juldress &
(Signature of Avent of Board of Health of other)
Health Atlich
7/21/39
/ (Official Designation)
(Date of Issue of Permat)
(write the word)
Married
6a If married, widowed, or firgreed Klagge Telford
HUSBAND of
(Give maiden name of wife in full)
If less than 1 day Hours. .. Minutes
Interbor Decorator
11 Total time (years)
1936
spent in this40
occupation.
not known
May Klagge Telford
Relation, if any Wife
17 Mr Informant ..... . 38- (Address) Quincy Ave. Winthrop
(If U. S. War Veteran
specify WAR)
St.,
Ward,
(If nonresident, give city or town and statc)
No. 108-A Quincy Ave ..
1
Winthrop
(City or Town)
(Usual place of abode)
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
53
AGE
Years
Months.
.Days
8 Trade, profession, or particular
kind of work done, as spinner.
sawyer, bookkeeper, elc .......
9 Industry or business In which
work was done, as silk mill.
10 Date deceased last worked at
this occupation (month and
OCCUPATION
year)
12 BIRTHPLACE (City).
(State or country)
England®
13 NAME OF
FATHER
William Telford
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Eng land
15 MAIDEN NAME
OF MOTHER
not known
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
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 ..
Contract
e
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 HOUSE WORK 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. L'nder 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.
CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, after the death of a person whoin 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 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 nave been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement con- taining the facts required by law to he returned and 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 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 reinoval 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 l'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 far 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 .... He shali : . GEN. LAWS, CHAP. 38, SEC. 6.
by violence.
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) Winthrop (City or Town)
8/9/39 BOSTON NOTIFIED 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.
51
No. Winthrop Community Hopital .St.,
[ (If death occurred in a hospital or institution, Ward ( give its NAME instead of street and number)
2 FULL NAME
Catherine Ryan
(If U. S. War Veteran
specify WAR)
(a) Residence.
No.
56 At andrew Road
St.
(l'sual 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? YO years months days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
Widowed
(or) WIFE of
Thomas
Olyan
(Husband's name in full)
6 IF STILLBORN, entar that fact here.
If less than 1 day
AGE .Years Months Days
Hours.
.Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ......
at Home
10 Date deceased last worked at
11 Total tima (years)
this occupation (month and July 1939
spent in this
occupation ...
39
12 BIRTHPLACE (City)
· (State or country)
Ireland
13 NAME OF
FATHER
Bernard Leddy
14 BIRTHPLACE OF
FATHER (City)
Ireland
15 MAIDEN NAME
OF MOTHER
Ellen Smith
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Thomas Ayan
Relation, if any
Informant
(Address) 56 St andrew Rd Crosta
I HEREBY CERTIFY that a satisfactory standard certificata of daath was filad with ma BEFORE tha burial or transit permit was issuad: Wm. Achildrens
(Signature of Agents Board of Health or other)
July 22/34.
(Official Designation) Date of Issue of Permit ......
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
July
20. 1939
(Month)
(Day)
(Year)
19 HEREBY
Fully/
190%
...
., to ....
CERTIFY That I attended deceased from
20 1929
Ylast saw b ....... Y ... alive on.
qui
1
00
19 ........ , death is said
88.
to have occurred on the date stated above, af The principal cause of death and rdfated causes of importance in order of onset were as follows: Date of Onset IMPORTANT Nypostific Precumonia am
Cture Heart disease
Contributory causes of Importanca not related to principal cause: Carcinoma of breast with
7/1/36
Mutaslacto
Name of operation
What test confirmed diagnosis?
Une
Date of.
Wasthere an autopsy? ....
20 Was disease or injury in any way relatad to occupation of deceased? If so, specify ( Top. It. Schwartz (Signed)
(Address) 19 Panela Sr 913
Date
7/2/
1939
21 Holy Cross
Malden
Place of Burial, Creigationfor Removal.
(City or Town)
DATE OF BURIAL
July 24
1939
22 NAME OF
UNDERTAKER
ADDRES
17 Bennington At Breton
Received filed .. 04 26 1599 19.
(Registrar)
100m 11.36. No. 9080.F
1 8 SEX female 7 63 OCCUPATION PARENTS tion should be carefully supplied. Age should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH year)
4 COLOR OR RACE White 5a If married, widowed, er divorced HUSBAND of (State of country) 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 9 Industry or business in which work was done, as ailk mill, saw mill, bank, etc ..
Ho ,
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Ward,
Each Boston
(If nonresident, give city or town and state)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(Give maiden name of wife in full)
7/10/39
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 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.
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