USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1963 > Part 40
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19
DATE OF BURIAL
Arthur S. Porcella
ADDRESS
876
Winthrop Ave., Revere
Received and filed
Jetobe 8
(Registrar)
1/2125
DISEASE
Due To (c)
OTHER
CARCINOMA OF RECTUM
SIGNIFICANT
CONDITIONS
2YRS.
Was autopsy performed ?
NO
What test confirmed diagnosis ?
CLINICAL
5 Was disease or injury in any way related to occupation of deceasedO If so, specify
PARENTS
M. 1).
(Signed)
MICRON
MI KINGM.D.
(PRINT OR TYPE SIGNATURE)
(Address) 222PLEASANT ST Date ... 10 /8 63
(City or Town)
7 NAME OF
FUNERAL DIRECTOR
9-925686
CENSE PITIT
(a) Residence. No.
(Usual place of abode)
28years.
PHYSICIAN - IMPORTANT [(Was deceased a U. S. War Veteran, [if so specify WAR)
W W # 1
3 DATE OF
October 7,1963
Due To ARTERIOSCLEROTIC HEART (b)
AGE
Years
Months
16
MARRIED
WIDOWED Widowed
or DIVORCED
1963
R-301A 1
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE 5/17/17
DATE OF DISCHARGE 5/19/19 RANK, RATING
ORGANIZATION AND OUTFIT U.S. Coast Guard
SERVICE NUMBER
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 un- related to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, 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 occupa - tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Chil- dren 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. 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.
RECEIVED
TOY
OF
-
OFFICE
71 12 1
MINI
3
-
6
CLERK
HROR
OCT =81963 PM
RM R-301
burial permit d of Health Agent. CTIONS R ERTIFICATE
R TYPE CAUSES ATH : enter an one or each ) and (c)
not mean of dying, art failure, c. It means or compli- ich caused
s, if any, ve rise to use (a), he under- use last.
ons contrib- ath but not the terminal dition given C
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS TEM STANDARD CERTIFICATE OF DEATH DERT
(City or Town making this return)
Registered No. 201
((If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME.
Obediah Countaway.
(If deceased is a harried, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
(if so specify WAR).
no
(a)
Residence. No ....... 5.1 .... Somerset ..... Avenue.
(Usual place of abode)
St (If nonresident, give city or town and State)
Length of stay: In place of death ......... years .......... months ....... .. days. In place of residence.5 ... years .......... months .......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
October
9
1963
(Month)
(Day)
(Year)
4 IHEREBY CERTIFY , That I attended deceased from
may 19,
948,
to Click. 9
I last saw h.ikhalive on
Oct. 8
, death is said to
11 If married, widowed, or divorced HUSBAND of Winifred Barbara Matthews
(or) WIFE of.
(Husband's name in full)
12
AG 91 Years 6 Months 1
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
house painter
(Kind of work done during most working life)
14 Industry
contractor-self employed
15 Social Security No ..... 0.13-28-9245
16 BIRTHPLACE (City) ... .. Lunenburg
(State or country)
Nova Scotia
17 NAME OF
FATHER
Joseph Countaway
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Lunenburg
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Catherine Tanner
20 BIRTHPLACE OF
MOTHER (City)
Lunenburg
(State or country)
Nova Scotia
Mrs.
Bradford Rafuse
21 Informant
I HEREBY CERTIFY that a satisfactory standard certificate of death Masas filed with me BEFORE the burial or transit permit was issued: Ralphle Verranno (3) (Signature of Agent of Board of Health or other) Healthofficin CliTobie 11,1960
(Official Designation)
(Date of Issue of Permit)
T
V.B. V
A TRUE COPY ATTEST:
(Registrar ) ||
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR
W
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
(write the word)
widowed
Fine. w
- (Give maiden name of wife in full)
-
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
INTERVAL BETWEEN ONSET AND DEATH
(b)
arteriosclerosis gea
Due To (c)
Cholangitis-cholecyst
OTHER
SIGNIFICANT
CONDIT
itus -chole lithiasis
Was autopsy performed?
ivo
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased 00 If so, specify
(Signature)
M. D.
Joseph GREGORIE
(Print or Type Name)
(Address 94 literhington WIE
Date.
10/9
63
Winthrop Cemetery
Winthrop, Mass
6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
October 11 ,1963
19.
( Address)
87 Milton St. Arlington
7 NAME OF
FUNERAL DIRECTOR
alfred B. Marsle
ADDRESS174 Winthrop St. winthrop,
Received and filed
OCT 1 1 1963
19
-932382
1
No .... Winthrop Community Hospital Robert
have occurred on the date stated above, at
8:40Am.
(a)
Myjecard at Heart Disease
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE
RECEIVED
RANK, RATING
TOW.
ORGANIZATION AND OUTFIT
SERVICE NUMBER.
RULES OF PRACTICE HROP.
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 gare during blast inness from disease un- related to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths froin disease resulting from injury or infection related to occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Chil- dren 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. 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.
RM R-301
burial permit of Health Agent. CTIONS R ERTIFICATE
R TYPE CAUSES ATH enter an one or each ) and (c)
not mean of dying, art failure, c. It means or compli- ich caused
, if any, e rise to use (a), e under- use last.
ons contrib- ath but not he terminal dition given
PLACE OF DEATH
SUFFOLK
(County) WINTHROP
(City or Town)
WINTHROP COMMUNITY HOSPITAL
No ..
ETTA BUDDELOF (MORRIS )
(If deceased is a married, widowed or divorced woman, give also maiden name.)
8 FORREST STREET
St
WINTHROP
(If nonresident, give city or town and State)
Length of stay: In place of death .......... years .......... months.
5
.days. In place of residence ...
.years months-days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
9 COLOR
8 SEX
Female White
10 SINGLE
(write the, word)
MARRIED
WIDOWED
-DIVORCED
UNKNOWN
2 clowes
11 If married, widowed, or divorced
HUSBAND of
"Give maiden name of wife in ful)
Varhan Haddelet
(or) WIFE of ..
(Husband's name in full)
12
70
.. Years
.Months.
Days
If under 24 hours
.Hours ........ Minutes
13 Usual
Occupation :
(Kind of work done during most working life)
14 Industry
or Business:
15 Social Security No .. ...
16 BIRTHPLACE (City)
(State or country )
17 NAME OF
FATHER
(((BZ) Morris
18 BIRTHPLACE OF
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
6.332
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mari Aprince.
21 Informant
( Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with me BEFORE the burial or transit permit was issued: Kaiph & Dercanna (B) (Signature of Agent of Board of Health or other) Health, Offrir Det 11,1963
(Official Designation)
(Date of Issue of Permit)
1
X
A TRUE COPY ATTEST:
M. D. PARENTS
(Signature) ILL PLEASANT ST WINTHROP MYRON N. KINGAND 10/10 10 63
()
Place of Burial or Cremationl.
(City or Town)
DATE OF BURIAL
Oct 13 1963
19
7 NAME OF
FUNERAL DIRECTOR
TORF final Service
15, Washmatin Que Chelsea
ADDRESS
Received and filed
OCT 11 1963
19
(Registrar )
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No. 202
S (If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
(if so specify WAR)
(a) Residence. No ...
(Usual place of abode)
10
1963
(Day)
(Year)
4 I HEREBY CERTIFY , That 1 attended deceased, from
JAN
19:59
to ..
OCT 10
1963
I last saw h.s. olive on
Octio
6
death is said to
have occurred on the date stated above, at
.. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) CEREBRAL VASCULAR ACCIDENT
Due To
(b)
ARTERIO SCLEROTIC HEART
DISEASE
Due To
(c)
+ HYPERTENSIVE HEART DIS
OTHER
SIGNIFICANT
CONDITIONS
NONE
Was autopsy performed?
No.
What test confirmed diagnosis ?
CLINICAL
5 Was disease or injury in any way related to occupation of deceased If so, specify
Myronh Ring
5YRS
INTERVAL
BETWEEN
ONSET AND
DEATH
6 DAYS
AGE
50
(City or Town making this return)
I
·932382
2 FULL NAME
3 DATE OF
DEATH
OCT
(Month)
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
62
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 telsuch deaths Only af those of persons to whom they have given bedside care during a-last Hiness from disease un- related to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths froin disease resulting from injury or infection related to occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Chil- dren 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. 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.
Y
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
LISERTAY
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or Town making this return)
Registered No.
203
[(If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Anna M. Rawston
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
(if so specify WAR)
no
(a) Residence. No ..
459 Winthrop St.
(Usual place of abode)
St
(If nonresident, give city or town and State)
..... years .......... months .......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
OCTOBER
11,
1963
(Year)
(Month)
(Das)
4 I HEREBY CERTIFY, That I attended deceased from
... ,
to.
OCT 11,
19 ...
63
OCT 10, 1963
I last saw
HERalive on
Oct. 10,
1963., death is said to
have occurred on the date stated above, at 1/A
.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
ACUTE CARDIAC FAILURE
(a)
Due
(b)
RHEUMATIC HEART DISEASE
8 YEARS
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
VIRAL BRONCHITIS
3 DAYS
Was autopsy performed?
NO
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify
NO
(Signature)
En Caplan
M. D.
A. N. CAPLAN MD
(Print or Type Name) 1868RISCETOUST EAST BOSTON Date 10-11. 19 .. 67 ....
6
Winthrop
Winthrop
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
October 14
19
63
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS
Winthrop Mass
OCT 14 1963
Received and filed
19
( Registrar)|
A TRUE COPY ATTEST:
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED Married
WIDOWED!
DIVORCED
UNKNOWN
11 If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
RobertF .Rawston
(Husband's name in full)
12
AGE+1
.. Years.
Months.
.Days
If under 24 hours
.Hours ........ Minutes
13 Usual
Occupation :
Clerk
(Kind of work done during most working life)
14 Industry
or Business:
Post exchange
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
John W. Gay
PARENTS
18 BIRTHPLACE OF
FATHER (City)
East Boston
(State or country )
Mass
19 MAIDEN NAME
OF MOTHER
Theresa Tierney
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21 Informant
Robert F. Rawston
( Address)
459 Winthrop St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Parph É Viruanna (3) N(Signature of Agent of Board of Health or other) Health Officer October 14 6 3
(Official Designation)
(Date of Issue of Permit)
T V.B.V
burial permit of Health Agent. TIONS
RTIFICATE
TYPE CAUSES ATH enter an one r each and (c)
not mean of dying, urt failure, . It means or compli- ch caused
, if any, e rise to ase (a), e under- se last.
ns contrib- th but not he terminal ition given
932382
M R-301
1
No 459 Winthrop St.
Length of stay: In place of death .......... years .......... months .......
.days. In place of residence.8
INTERVAL
BETWEEN
ONSET AND
DEATH
Minutes
East ..... Boston
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE
RECEIVED
OF TOWA
77 12 3
OFF
10.
V
Aj
CLERK
V
'IN
THROR MA
OCT 1 41963 AM
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 un- related to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths froin disease resulting from injury or infection related to occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, 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 occupa - tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Chil- dren 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. 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.
×
PLACE OF DEATH
SUFFOLK (County)
WINTHROP
(City or Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
(City or Town making this return) ....
Registered No.
204
[(If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
No.
Winthrop Community Hospital
2 FULL NAME MARY V. G. SCHIVERCE
(First Name)
(Middle Nau .)
(Last Name)
U. S. War Veteran,
if so specify WAR)
NO
(If deceased is a married, widowed or divorced woman, give also maiden name.)
71 Birch Road, Winthrop
(a) Residence. No.
(Usual place of abode)
Length of stay : In place of death .............. years .............. months ..
7 days. In place of residence.
40 years months
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October
11,
1963
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.)
Fracture .... of .... elbow ........... Hypertensive .... cardio .. vascular disease Uremia
5 Accident, suicide, or homicide (specify)
Accident.
Date and hour of injury
September 21,
19
63
IF ACCIDENTAL, was injury causally related to the death?
Yes.
Injury occur ?
Where did
Winthrop Massachusetts
(City or town and State)
Did injury occur
n or about home, on farm, in industrial place, or Nu
public place ?
Home.
(Specify type of place)
Manner of Injury .....
Fall down cellar stairs.
(How did injury occur ?)
While at work ?
Was autopsy performed
NO,
6 Was diecase of injury in any way related moc unavion of depcased ?
Michael A. Luongo, M.D. ......
(Address) Boston ( Print or "Type Rame)
10/11 63
7 WINTHROP
Place of Burial or Cremation. (City or Town)
DATE OF BURIAL OCT 15 19.63
8 NAME OF MAURICE K. KIRBY FUNERAL DIRECTOR
ADDRESS WINTHROP
Received and filed
OCT 14 1963
19
A TRUE COPY ATTEST:
(Registrar)
9 SEX
10 COLOR WHITE
11 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
SINGLE
12 If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
13 83 ears
Months ..... .... Days
If under 24 hours Hours .......... Minutes
14 Usual
Occupatien :
RETIRED )
(Kind of work done during most of working life)
15 Industry off Bus ness :
RESTAURANT
624-09-3566 ....
K Social Security \No.
17 BIRTHPLACE (City) (tate of country )
GLOUCESTER MASS
18 NAME OF FATHER ALFRED SCHIERLE
19 BIRTHPLACE OF
FATHER (City)
(State or country)
PIE.I
20 MAIDEN NAME
OF MOTHER
JUDITH PETERS
21 BIRTHPLACE OF MOTHER (City) (State or country) PEIL
22 Informant (Address)
LOUIS A ROE
41 BIRCH RD WINTHROP
I HEREBY CERTIFY that a satisfactory standard certificate of death was, filed with me BEFORE the burial or transit permit was issued: Raspolo É devanna (2)
(Signature of Agent of Board of Health or other)
Health fin
(Official Designation)
(Det 17. 19634
(Date of Issue of Permit) V.B. V
-
-303
burial permit of Health Agent.
DEATH in plain terms, so that it may be properly classified under the International Classification of Causes Nature of Injury of Death, See reverse side for additional information. See also Chap. 38, §§ 6, 20; Chap. 46, §§ 9, 10; Chap. 114, If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
§§ 44-48.
100M . 3.62-932695
Date WINTHROP
19
PARENTS
M. D.
HU
. MEDICAL EXAMINER'S CERTIFICATE OF DEATH
PHYSICIAN - IMPORTANT
[(Was deceased a
(write the word)
FEMALE
St (If nonresident, give city or town and State)
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
6
RANK, RATING 4000
ORGANIZATION AND OUTFIT
OCT 1 41983 PM
SERVICE NUMBER
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 unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poison) , thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a collision of railroad train and automobile." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic for (enter name of operation and disease or condition requiring surgery) ." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
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