USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1939 > Part 62
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or DIVORCED
Married
(write the word)
(Give maiden name of wife in full)
If less than 1 day
Hours
Minutes
Electrician
9 Industry or business In which
work was done, as silk
.Boston Elevated
saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
spentin this
this occupation (month and
4
7
1 & ation
(State or country)
Massachusetts
13 NAME OF
FATHER
Edmund A. Spence
FATHER (City)
Cannot Be Learned
Margaret A. MacKeon
Cannot Be Learned
(State or country)
Scotland
( Wife
Winthrop Mass
(Registrar of city or town where death occurred)
19.
39
.....
St.,
Ward
give its NAME instead of street and number)
PERSONAL AND STATISTICAL PARTICULARS
T ??
...
CF
AUG-81933 AM
D
R-302
Essex
PLACE OF DEATH
Daffver's
CanMoms State Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Bessie Wingersky
(If deceased is a married, widowed or divorced woman, give also maiden name.)
206 Washington Ave.
St.,.
Ward,
Winthrop
(a) Residence. No.
(Usual place of abode)
2
Length of residence in city or lown where death occurred
yrs.
6
mos.
i days.
How long in U. S., if of foreign birth?
утв.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OFJuly 10, 1939.
DEATH
(Month)
(Day)
(Year)
19
HEREBY CERTIFY, That ! attended deceased from
39
C
I last saw h ...
er
alive on
1.19.39
death is said
to have occurred on the date stated above, & .... ] ?.. .. m.
The principal cause of death and related causes of importance in order of
HoTelithiasis
5 yrs
Date ofonset Chr: Cholecystitis
Perforation or rati bladder I
Chir. nyocardi 13 10 yrs.
Contributory causes of importance not related to principal cause:
Name of operation
What test confirmed diagnosis? autopsy
Was there an autopyo.s
Date of
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
Melvin Goodman
(Address)
DSH
. M. D.
70 4/39 19
21
Harmony Grove Salen
Place of Burial. Cremation or Removal.
(City or Town)
DATE OF BURIAL/ 13/39
19
22 NAME OF
UNDERTAKER
Duhvery
H. Crosby
ADDRESS
Received and filed 19
(Registrar of City or Town where deceased resided)
important.
50m-11-'36. No. 9080-g
1
No.
2 FULL NAME
3 SEX
4 COLOR OR RACE
MARRIED
WIDOWED
or DIVORCED
white
female
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
80
AGE
Years
Months
Days
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
9 Industry or business In which
work was done, as silk mill,
saw mill, bank, etc
this occupation (month and
year)
Dutch Guinea
12 BIRTHPLACE (City)
13 NAME OF
Alfred Sarqui
FATHER
15 MAIDEN NAME
OF MOTHER
PARENTS
OCCUPATION
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17
1 .. McPhillips
Informant
DSH
(Address)
A TRUE COPY.
tion 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
(State or country)
So. America
5 SINGLE
(write the word)
widowed
5a If married, widowed, or divorced
HUSBAND of
Abraham(Giveimaidennameof wife in full)
If less than 1 day
Hours
Minutes
Housewife
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
14 BIRTHPLACE OF
Dutch Guinea
FATHER (City)
So. America
(State or country)
Rachael Lesquito
Dutch Guinea,
So.America
Relation, if any (
-
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
7/17/39
19
St.,
Ward
1
(L U. S.
War Veleran,
specify WAR)
(If nonresident, give city or town and state)
19
to
July
10,
19
AUG1 -21.30 AM
R-302
PLACE OF DEATH
(County)
(City or Town) Lass General Hos?
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
nsT'
(City or town making return)
Registered No.
6326
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
105 Cottage Avo
St., ............
Ward,
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX M
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
Eugenia Feuro
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7.72 AGE.
Years. Months Days
If less than 1 day Hours Minutes
OCCUPATION
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc ....
cook
9 Industry or business In which
work was done, as silk mill,
saw mill, bank, etc ..
Hotel
10 Date deceased last worked at
this occupation (month and
year)
1935
11 Total time (years)
spent in this O
occupation.
12 BIRTHPLACE (City)
(State or country)
Italy
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Italy
(State or country)
15 MAIDEN NAME
OF MOTHER
Rosa ---
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Informant (Address)
Relation, if any (
A TRUE COPY.
10
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jul 11/ 39
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
7/5/39
,19 ........ , to.
7/11/39
19
I last saw fra
alive on
7/11/39
19
death Is said
to have occurred on the date stated above, 35
.m.
The principal cause of death and related causes of Importance in order of onset were as follows:
Dateofonset
br pneumonia rt base
Contributory causes of importance not related to principal cause: art .. solerosismcoronary ....... toute.
Name of operation
Date of
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)
OF Houser
(Address)'oss Con Loen
M. D.
02/11/39
19
21
Place of Burial, Rmationpor Removal Op
(City or Town)
DATE OF BURIAL
19
7/18/29
22 NAME OF
UNDERTAKER
J .... Cincotti &Sons
ADDRESS.
Boston
Received and filed
7/14/39
19
(Registrar of City or Town where deceased resided)
50m-11-'36. No. 9080-g
tion 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.
No.
St.,
Ward
Hector Brugnani
(If U. S.
War Veteran,
specify WAR)
D
Winthrop
(a) Residence. No.
(Usual place of abode)
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
13 NAME OF
FATHER
Giovanni Brugnani
0
AUG1 41:30 MM
R-302
tion 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 PARENTS
important.
50m-11-'36. No. 9080-g
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
19.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jul 17/39
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
6/6/39
19
.. , to ...
19.
I last saw @t.
alive on
7/17/39
19
death Is said
to have occurred on the date stated abdva, cet.
m.
The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
cong.hemolytic anomia-hepato megaly -entoricglandular hyper- trophy cardiac hypertrophy
Contributory causes of importance not related to principal cause:
Name of operation splonectomy.
Date of
What test confirmed diagnosis? ..
Was there an autopsybs.
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed) .D ...... Pdsor
(Addres500.Longwood Avo
M. D.
Date: 17./59.19
21
David Vicur ... Cholin
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
7 /17/30
19
22 NAME OF
UNDERTAKER
B F Solonon
ADDRESS
Brool-line
1/19/39
Received and filed
19
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATH
SUFFOLK BOSTON
(City or Town) The Childrens Hosp
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
6465
(If death occurred in a hospital or institution,
Ward
give its NAME instead of street and number)
Frances Meltzer
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
80 Saramore
Ave
.St., ..
.. Ward,
Winthrop
(If nonresident, give city or town and state)
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or divorced 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
AGE
2
15
If less than 1 day Hours. Minutes
OCCUPATION
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
9 Industry or business In which
work was done, as silk mill,
saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
(State or country)
Boston
13 NAME OF
FATHER
Jacob Meltzer
14 BIRTHPLACE OF
FATHER (City)
New York NY
(State or country)
15 MAIDEN NAME
OF MOTHER
Shirley Litchnan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Tow York NY
17 Informant ( Address)
Relation, if any
father
(
₹
(L U. S.
War Veteran,
specify WAR)
(a)
Residence.
No ..
(Usual place of abode)
Length of residence in city or town where death occurred
YTS.
days. How long in U. S., if of foreign birth?
yTs.
mos.
.St.,
No.
Years
Months
Days
this occupation (month and
year)
:
2
5
0
AUG1 41632 AM
tion 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.
A TRUE COPY.
ATTEST:
James Q.Bush
(Registrar of city or town where death occurred)
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jul .... 18/39
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
7/1/39
19
.... , to.
7/18/39
19.
I last saw hor
.. alive on
7/18/59
19
death is said
to have occurred on the date stated above, 350
m.
The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
metestatio ... cancer ... of ... brain
?
Contributory causes of importance not related to principal cause: concor of left breast
2
Name of operation craniotomy
Dite 01/39
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)
A L Sorel
(Address)
350 Crestline Av
Dator.30./509
21
inthron Everett
Place of Burial, Cremation of Removal.
(City or Town)
DATE OF BURIAL
7/8/39
19
22 NAME OF
UNDERTAKER
M Stanetaky
ADDRESS
Boston
Received and filed
7/20/39
19
(Registrar of City or Town where deceased resided)
50m-11-'36. No. 9080-g
1
PLACE OF DEATH
(County) BOSTON
(City or Town Loth Israel Hosp
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making:+@n)
Registered No. .............
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Matilda Rudginsky (Tillie)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
29 Ocean Ave
(a)
Residence.
No.
(Usual place of abode)
St., ............... Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCEDarriod
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of Harry
(Husbarld's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE 52 Years .Months Days
If less than 1 day
.. Hours
.Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ......
lousowife
9 Industry or business In which
work was done, as silk mill,
saw mill, bank, etc ..
at hone
10 Date deceased last worked at
this occupation (month and
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
David Vigorda
PARENTS
(State or country)
15 MAIDEN NAME OF MOTHER ---
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Informant (Address)
Relationsifdany (
No.
St.,
....
Ward
(Lf U. S.
War Veteran,
specify WAR).
Winthrop
2 FULL NAME
R-302
year)
14 BIRTHPLACE OF
FATHER (City)
M. D.
Tr
-
5
AUG1 41030 AN :.
Suffolk
PLACE OF DEATH
Chelsey
sadTers' Home
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Chelsea
(City or town making return) 519
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
(Lf U. S.
World Var
War Veteran,
winthr
(a) Residence. No ...
(Usual place of abode)
Length of residence in city or town where death occurred
St., ............
Ward,
(If nonresident, give city or town and state)
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX M
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
AFeedBerry
5a If married, widowed, HUSBAND of
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
50 10
16
7 AGE Years Months Days
If less than 1 day .. Hours Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ...
Photo Engraver
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)
11 Total time (years) spent in this occupation ...
12 BIRTHPLACE (City)
Revere, Mass.
(State or country)
13 NAME OF Vim. A.Walton
FATHER
14 BIRTHPLACE OF
FATHER (City)
Nova Scotia
(State or country)
15 MAIDEN NAMAMY OF MOTHER
Fredericks
16 BIRTHPLACE OF MOTHER (City) (State or country)
Nova Scotia
17 Hospital Records
Informant ( Address)
)
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED Sept. 5,1939 19
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
Aug. 24,1939
(Month) (Day)
(Year)
19 1 H EREBY Jan. 1 CERTIFY, That Iattended deceased from Aug.24
1 last saw h
.alive on
Aug. 24
39
19.
death Is said
to have occurred on the date stated above, 7 10 p.m.
Dateofonset The principal cause of death and related causes of importance in order of onset were as follows: Cerebral accident
Hypertension
?
Hypertensive heart disease Chronic .. nophritis
Contributory causes of importance not related to principal cause:
Name of operation
none
Date of.
What test confirmed diagnosis? clinica.1 .. Was there an autopsyno
20 Was disease or injury in any way related to occupation of deceased? no.
If so, specify
M. D.
(Signed) .Lewis ..... Glazer
(Address)
Soldiers' ... Home
DatAug .. 249 ....... 39
21 Winthrop Cemetery, Winthrop Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIALAug. 26 1939
22 NAME OF
R.H.White
UNDERTAKER
ADDRESS
147 Winthrop St. Winthrop
Received and filed .19
(Registrar of City or Town where deceased resided)
50m-11-'36. No. 9080-8
OCCUPATION tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE important. OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very PARENTS
1
No.
St.,
Ward
Frank E.Walton
2 FULL NAME
wurgrieg Fidowed or divorced woman, give also maiden name.)
days. How long in U. S., if of foreign birth?
19
, to.
19
(Give maiden name of wife in full)
1m
Relation. if any (
R-302
TOWI
OF
OFFIC
C
SEP-91839 AM
R-301A
SUFFOLK
(County)
Card
9/3/20
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.
(If death occurred in a hospital or institution,
No .... StaHosp Ft Banks
AS.S.
St., ....................
.Ward
give its NAME instead of street and number)
2 FULL NAME
JOSEPH R. BOILY
(If deceased is a married, widowed or divorced woman, give also maiden name.)
53 Ash St
.St.,
.. Ward,.
Manchester, NH
(If nonresident, give city or town and state)
Length of residence in city er town where death occurred
yTs.
mos.
days.
How long in U. S., if of foreign birth?
yTs.
MOS.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
August 1 1939
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That i affeaded deceased from
July 31.
19.39 . August 1,
19.39
I last saw h. i.m ..... allve on .. Aug ... 1, 19.39
19
death is said
to have occurred on the date stated above, at 12:50FM The principal cause of death and related causes of importance in order of enset were as follows:
Peritonitis, acute ,general severe att.
Dale of Onsel
IMPORTANT
Unkn.
8 Trade, profession, or particular kind of work done, as spinner. sawyer, bookkeeper, etc .... CCC
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc. CCC
10 Date deceased last worked at
11 Total time (years)
this occupation (monte and 939
spent in this
occupation ...
...
12 BIRTHPLACE (City).
Manchetes n.H.
(State or country)
13 NAME OF
FATHER
De cledine Brily
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
15 MAIDEN NAME
OF MOTHER
Rebecca Boule
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
Relation, if any
17 InformantResgitrar., Sta .. Hesp ... Et ... Banks , Mass ... (Address)
.)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health on other)
Realties Offices 8/2/39 (Oficial Designation) (Date of Issue of Permit)
20 Was disease or injury in any way related to occupation of deceased?
N
If so, specify
(Signed)
, M. D.
(Address)
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Met. Calvary- Manchester
(City or town) 1-H. DATE OF BURIAL Pleeg. < >Cemetery)
1939
A
22 NAME OF
UNDERTAKER
OR Bennem
ADDRESS
winthe Dans
Received and filed ..
..... .19 ...
AUG : 1939
(Registrar)
100m-12-'34. No. 2938-f
1 3 SEX Mala (or) WIFE of 7 AGE. 39 OCCUPATION PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state year). 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 certificato.
4 COLOR CR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
Rose Lussier
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full) [ useer
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
Years.
3
Months
.Days
1
If less than 1 day ... Hours ...... .Minutes
Contributory causes of importance nol related to principal cause:
Ulcer, perforated, ileum.
Unknown
Para ... lytic ilous
Unkmm
Name of operation
None
What test confirmed diagnosis?
Autopsy
Dale of.
Was there an autopsy?
Yes
.....
Fart MC US Army"
Date.
(If U. S. War Veteran,
specify WAR)
WW
(a) Residence.
No ..
(Usual place of abode)
(write the word)
PLACE OF DEATHI
WINTHROP (City or Town)
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- ever 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 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:
Date of onset
Arteriosclerosis e
1015
Chronic interstitial nephritis
192!
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.
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 perinit 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 cnough 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 such a permit for the removal of a human body. not previously interred, from one town to another within the common- wealth cannot be obtained early enough for the purpose. the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the ocath certificate contains a recital, as re- quired by section ten of chapter forty-six. that the deccased served in the army, navy or inarine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter ¡ furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, - which the clerk or registrar may require. - Chop. 114, Sec. 45, G. L., (Tercentenary Edition.)
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