USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 33
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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, sucb recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwith counter-ign it and tranantit It to the clerk of the town for registration. The person to whom the permit la so given and the physician certifying the cause of death shall thereafter furnish for registration any other nueces sary Information which can be obtained as to the deceased, or as to the mater of callse of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 46. G. L., (Tercentenary Edition ).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to Issue such permita, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have tbe care of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died by vinleuce. If a medical examiner has notice that there is within hils county the body of such a person, he shall forthwith go to the place where the body lles and take charge of the same; ... - General Laws, Cbap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1) Attending phyalcians will certify to sucb deatba only as those of persona to whom they have given bedside care during a last Illness from disease unrelated to any form of Injury.
(2) Board of Health phyalolans will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbyel- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will investigate and certify to all ilcatba aup- possibly due to Injury. These Include not only deaths cancer directly or In- directly by traumatism (Including resulting septicemia), and by the action of chemical (drugs or poisons), therinal, or electrical agents, and deaths following abortion, but also deaths from diacasa resulting from Injury or Infection ralated to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death meana the disease, or complication which causes death. not the mode of ilying. e. g., heart fallure, asphyxia, astbenla, etc. As principal cause name tbe disease caualng death. As related causes, name earlier morbid conditions, If any, related to the principal cause and any Important compliestion of the principal cause.
Statemant of Occupation .- Precise statement of occupation la very Im- portant, so that the relative bealthfulness 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 usual occupation prior to Illness. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at borne. For a woman wbose only occupatiou was that of honre bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, an bousekeeper-private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) No. 421 ... Pleasant
The Commontoralth 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, St. ¿ give Its NAME Instead of street aud number) PHYSICIAN - IMPORTANT
2 FULL NAME.
Cora D. Reed
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
421 Pleasant
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In nosoltal or Institution
(Refnre death)
(Specify whether)
years
months
days.
In this community
1 yrs. 9
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEJ
.Thite
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEDICarried
Sa If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife In full)
(or) WIFE of
alter
1. Need
( Husband's name in full)
6 Age of husband or wife if alive 39
years
IF STILLBORN. enter that fact here.
AGE35 9 Months
Years 0 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Housewife
Industry 10 or Business :
11 Social Security No.
None
*2 BIRTHPLACE (City)
( State or country)
Lebanon Springs,
<
13 NAME OF
FATHER
John F. Foley
14 BIRTHPLACE OF
FATHER (City)
Berlin,.
(State or country)
15 MAIDEN NAME
OF MOTHER
Cora Blich
16 BIRTHPLACE OF
MOTHER (City)
Stephentown,
(State or country)
N.Y.
17 Walter R. Reed
-Relation, If any Husband
Informant.
(Address) 421 Pleasant at
nthron
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the Burial of transit permit was Issued : Mm D. Cherdreng
(Signature of Agent of Board of health be other). Healthe Office 3/12/44
(Official Designation) ) (Date of Issue of Permit) /
18 DATE OF
DEATH
12 1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That 1 attended deosased from
19 ..
., Ło
19
I last saw h ...
allve on
death Is said to
have occurred on the date stated above, at 2.30/1 .m.
Immediate cause of death ................
Duration IMPORTANT
....
Due to
Due to (metistra -
Other conditions.
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings:
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to ocoupation of deceased ?
If so, specify ........
(Signed)(
(Address)
M. D.
21
Pittsfield Cemetery
iftsfield ...
l'lace of Burial, Cremation or Removal.
(City or Town)
Lass .
19.
DATE OF BURIAL
May 15, 1914
22 NAME OF
J.S."laterman & Sons
FUNERAL DIRECTOR
ADDRESS
Boston, Mas.
Received and fled. MAY 15 1944 19
( Registrar)
....
100M-€ - 2-42-8855
. extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physicians to insert a recital to that effect. PARENTS
(Was deceased
U. S. War Veteran,
if so speolfy WAR)
No
MEDICAL CERTIFICATE OF DEATH
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physioien or registered hospital medical officer shall forthwith, after the death of a person whoin he has attemled during his last illness, at the request of an undertaker or other authorized person or of ans meniber of the family of the deceased, furnish for registration a atandard certificate of desth, 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 re- quired by section one. wlirre same was contracted. the duration of his last Ilinesa, when last seen alive by the physician or officer and the date of his death ... Cen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served In the army, navy or marine corps of the I'nited States in any war in which it has been engaged, insert in the certificate s recital to that effect, speci- fying the war, and shall aiso certify in such certificate both the primary and the secondary or immediate ceuse of death as nearly as he can state the saine. For neglect to comply with any provision of this section, sucb physician or officer shall forfeit ten dollars. For the purposes of thie aec- tion and of sections forty-five, forty-six and forty seven of said chapter one humired and fourteen, the word "war" shall inchinle the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety- eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chiap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been buried, until he haa received a permit from the board of health, or ita 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 otber person ahall exhume a buman body and remove it from a town, from one cenietery to suother, or from one grave or tomb other than the receiving tomb to another In the same cemetery, until he haa received a permit from the board of health or ita agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until tbere aball have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statenient 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, aa required by law, o1 in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, hia certificate cannot be obtained early enough for the purpose, or is insufficient, a physl- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application niake the certificate re- quired of the attending physician. if death is caused by violence. tbe medl- cal examiner chall make such certificate. If such a permit for the removal of a human boity, not previously interred, from one town to another within the commonwealth cennot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession ot tbe undertaker desiring to make such removal shall constitute a permit for such removal; 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 hody has been sooner obtalued hereunder. If the death certificate containa a recital, aa required
by section ten of chapter forty-six, that the deceased aerved in the army, navy or marine corps of the United States In any war In which It has been engaged. such recital shall appear upon the permit. The board of healtb. 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 nece+ sary information which can be obtained as to the deceased, or as to the manter or cause of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought luto the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issue such permita, or if there is no such hosrd, from the clerk of the town where the boily is to be buried or the funeral is to he held, or from a person appointed to have tbe care of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died by violence. if a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body liea aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calle for the observance of the following rulea of practice :
(1) Attending physicians will certify to sucb deatba only as those of persona to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deaths only as those of persons who, though disshled by recognized disease unrelated to any form of injury. have died without recent medical attemlance or whose pbyaf- cian ia absent from home when the certificate of death le needed.
(3) Medioal Examiners will investigate and certify to all deatha sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism (Including resulting septicemia), and by the action of chemical (drugs or poisons), therinal, or electrical agents, aml deatbs following abortion, but also deatha from disease resulting from injury or Infection related to ocoupetlon, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causea death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name tbe disease caualng death, As related causea, name earlier morbid conditions, if any, related to the principal cause and any Important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation Is very im- portant, 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 ou account of the disease causing death, report the usual occupation prior to Illness. if the deceased bad retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may be returned aa at school or at huine. For a woman wbose only occupatiou waa that of honie bousework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, as housekeeper-private family, cook-hotel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop Mass ... (City or Town)
The Commontoralth 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. 101
Registered No.
§ ( If death occurred in a hospital or institution, ¿ give Ita NAME Instead of street aud nuniber)
2 FULL NAME
Female Forte
(If deceased Is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deocased a
U. S. War Veteran,
if so spoolfy WAR) NO.
(a) Residence. No.
(Usual place of abode)
(If nonresident, give clty or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
hospitaln- months - days.
In this community - yrs. -
mos.
-
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE|
White
5 SINGLE
( write the word)
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 Age of husband or wife if alive years
IF STILLBORN. enter that fact here. Stillborn
8
AGE
Years
Months
-
Days
-
If less than 1 day
Hours. .Minutes
Usual
9 Occupation :
None
Industry
10 or Business:
None
11 Social Security No.
None
'2 BIRTHPLACE (City)
(Siate or country)
Winthrop, Mass.
13 NAME OF
FATHER
Arthur Forte
14 BIRTHPLACE OF
FATHER (City)
Hartford
(State or country)
Conn.
15 MAIDEN NAME
OF MOTHER
Filomena Longo
16 BIRTHPLACE OF
MOTHER (City)
Roxbury
(State or country)
Mass.
(Address) 19 Byl 5 Date Met 1944
21
St
Michaels Cemetery
.Boston
l'lace of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIALMay17
. 1944
22 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby
ADDRESS 17 Bennington St., E. B.
(Signature of Agent of Board of Health or other)
Health Ofheart 3/17/44
(Official Designation) ( Date of Issue of Permit)
18 DATE OF
DEATH
may 13, 1944
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
19
19
to
......
1 last saw h ......
......
.. allve on
19.
.... , death Is said to
have occurred on the date stated above,
1.29 P
m.
Immedlate cause of death
Duration
IMPORTANT
.............
Due
dench in Uters
torica
Other conditions
( Include pregnancy within 3 months of death)
Major findings : Of operations
Date of.
Of autopsy
What test confirmed diagnosis?
IMPORTANT Physician Underline the cause to which death should be charged sta. tistically.
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, specify.
Samo Esduarte M. D.
(Signed) ...
17
Informant Mrs B. Longo.
Relation, If any Grandmother
(Address) 88 Putnam St. E. B.
I HEREBY CERTIFY that a satisfactory standard certificats of death was filed with me BEFORE the burial or transit permit was Issued :
Received and Aled MAY 2 8 1844
19
(Registrar)
100M-6 -2-42-8855
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46. Section 10, requires physiolans to insert a reoital to that effeot. PARENTS
No. Winthrop CommunityHospital
St.
88 Putnam St ...
St.
Fast .... Boston
......
Due to ... Stille
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith. after the death of a person whoin he has attended during his last illness, at the request of an undertaker or other anthorized person or of ans member of the family of the deceased, furnish for registration a atandard 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 re- quired by section one. where same was contracted. the duration of his last illnesa, when last seen alive by the physician or officer aud the date of his death ... Gen. Laws, Chap. 16, Sec. 9.
A physician or officer furnishing a certificate of death as required hy .the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, aerved In the army. navy or marine corps of the I'nited States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or iinmediate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sections forty-five, forty-six and forty-seven of said chapter one humired and fourteen, the word "war" shall inchide the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chiap. 16, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not been buried, until he has received a permit from the board of health, or its agent appointed to lasue 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 froin a town, from one cenietery to another, or from one grave or tomb other than the receiving toush 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 ahall have been delivered to such hoard, agent or clerk, as the case tnay he, a aatisfactory written atatement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original Internieut, by a satisfactory certificate of the attending physician, if auy, aa required by law. o1 in lieu thereof a certificate as liereinafter 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 physl- cian who is a member of the board of health, or employed by it or hy the aelectmien for the purpose, shall upon application niake the certificate re- quired of the attending physician. If death ia caused by violence. the medl- cal examiner shall make such certificate. If auch a permit for the removal of a human body, not previously interred, froin one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession ot the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unlesa 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 ten of chapter forty-six, that the deceased aerved in the army, navy or marine corps of the United States in any war In which It has heen 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 nece+ sary information which can be obtained as to the deceased, or as to the manner or cultse of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashea thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the hoard of heaith or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which ibe interment is made. ... Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within hils county the hody of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the ohaervance of the following rules of practice :
(1) Attending physicians will certify to such deatha only as those of persons to whom they have given hedside care during a last illuesa from disease unrelated to any form of injury.
(2) Board of Health physiolans will certify to such deaths only as those of persons who, though disshled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose phyaf- cian ia ahseut from home when the certificate of death ia needed.
(3) Medloal Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and hy the action of chemical ( drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deatha from diseasa resulting from Injury or Infeotlon related to oooupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death meana the disease, or complication which causea death, not the mode of dying. e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualug death. As related causes, name earlier morbid conditiona, if any, related to the principal cause and any Important complication of the principal cause.
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