USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1894-1897 > Part 1
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Ed. Sept., 1SS9. 5 M.
[ACTS OF 1889, CHAP. 208.] AN ACT
Plate.
IN RELATION TO THE RETURNS OF BIRTHS AND DEATHS.
Be it enacted, etc., as follows :
SECTION 1. The elerk or registrar of each eity and town shall on the first day of each month make a certified copy of the record of all deaths and births recorded in the books of said eity or town during the previous month, whenever the deceased person or the parents of the child born, were resident in any other eity or town in this Commonwealth at the time of said death or birth; and shall transmit said certified copies to the elerk or registrar of the eity or town in which such deceased person or parents were resident at the time of said death or birth, stating in addition the name of the street and number of the house, if any, where such deceased person or parents so resided, whenever the same ean be aseertained ; and the elerk or registrar so receiving such certified copies shall record the same in the books kept for recording deaths or births. Such certified eopies shall be made upon blanks to be furnished for that purpose by the secretary of the Common- wealth.
SECTION 2. This aet shall take effect upon its passage. [Approved April 5, 1889.
Blank to be used in compliance with the foregoing.
Copy of the Record of a DEATH 4
recorded in the books of the City of
(City or Town. )
during the month of.
January
1894.
1. Date of Death, .
Emulany 20. 1894
2. Name,
( Bartholomeus O'neil
(Maiden Name), . (Name of Husband),
3. Sex, and whether single, Married, or Widowed,
Male
Widowed
4. Color,
5. Age,
70 Years,
Months, Days. Incumonia
Disease or Cause of Death,
6. Duration of Siekness, By whom certified,.
I. E. Simpson M. D
7. Residence,
8. Occupation,
City Hospital
9. Place of Death, .
10. Place of Birth,
Ireland
11. Name of Father,
12. Name of Mother,
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
I certify that the foregoing is a true copy. (
Attest :
Jam, 30
City Clerk.
(City or down.)
South" Chelmsford 1
Farmer
Catholic Limeters Locale Ma2
- 1
20
PLEASE FILL OUT WITH INK.
UNDERTAKER'S
RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must make this return before the burial or removal of the deceased.
Date of Death, January 19
1898 Name Sarah Blood
Maiden Name,
Cunningham Sex, female; Color, 20
Age, 70 years,.
months,
days.
Single, Married or Widowed,
Name of Attending Physician, Dr Howard
Residence of Deceased ---
East Chelmsford
Street (or Corporation), Ward
Occupation, At Home
Husband's Name,
Samuel Blood
Place of Death - Last Chelinsforce Street (or Corporation), Ward
Birthplace of Deceased, Washington, me
Father's Name,
Timothy Cunning hamser's Birthplace, unknown
Mother's Name,
Mary
Mother's Birthplace, Washington
"1
Mother's Maiden Name, ..
Roust
Place of Interment,
Edson
Cemetery Roswellot Thank
Signature of Undertaker or Informer, ABCunier
Daled at Lowell, this
1 1th
day Of
January
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.
Date of Death Jan 10 IS9 3
Name and Sex of Deceased Sarah Blood
TOmale,
Place of Death -No. East Chelmsford
Street (or Corporation).
Disease or Cause of Death
duration of *
Complications,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title, Scharale return)
Residence, No.
Street
Dated at Lowell, this day of
189
* Reckoned to the time of death. [ Be very particular to fill the blanks, and strike out words that are not correct, such as street or corporation, single, married or widowed, and insert "fe" before male when the deceased is a female, and when the deceased is colored, please insert. ]
RETURN OF DEATH - OF -
18g
--
No.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Jan. 12th x44
2. Name,
BetsenA Dear born
(Maiden Name),* (Name of Husband),*
Haren Dearborn
Fernale
3. Sex, and whether single, Married, or Widowed, 4. Color, t
Widow
White
5. Age,
81
Years,
5 Months,
28 Days.
Disease or Cause of Death, (Primary and Secondary), # 6. {Duration of Sickness, .
By whom certified,, 7. Residen forth ilNA
8. Occupation, .
9. Place of Death, .
North Chelmsford Mass
10. Place of Birth, .
Northfield N.H.
11. Name of Father,
12. Name of Mother, (Maiden Name),
Northfield , V.H.
13. Birthplace of Father, .
14. Birthplace of Mother, .
Northfield 1 " Tilton
15. Place of Interment, ·
Signature of Undertaker or other person making the Return, .
Arthur & Sheldon
DATED at A Chelmsford, on Dan 12th 1894
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks. ] Plate. Ed. September, 1892 .- 5,000.
[Public Statutes, Chapter 32, as amended by Acts of 1333, Chapter 305 ; Acts of 1939, Chapter 224.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his deccase. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he cau state the same. If a physician refuses or neglects to make such certificate he shall forfcit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceeding fifty clollars.
12
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must make this, return before the burial or remgyal of the deceased.
Date of Death,
IS9 4 Name Le amelia H Dabbing
Maiden Name,
Sex,
male ; Color,
Single, Married or Widowed,
marcel
-
Age, 45 years, 10
months,
days.
Name of Attending Physician, Dr. Pablobuy
Residence of Deceased --- No.
Street (or Corporation), Ward
Richard Noterer
Occupation,
Husband's Name, {/
Place of Death -No.
Street (or Corporation), Ward
Birthplace of Deceased,
Father's Name, Jäschlichstitu
Father's Birthplace,
Mother's Name, Elizabethi
Mother's Birthplace, .
Mother's Maiden Name,
Place of Interment,
Lowell
Cemetery Range. , Lot. , Grave .
Signature of Undertaker or Informer,
Daled at. Lowell, this
12 21
day of.
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.
Date of Death
Name and Sex of Deceased Camelia Ht
male,
Place of Death - No.
thelmforte
Street (or Corporation) .
Disease or Cause of Death De and viseuse
duration of *
Complications,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Street ..
Kinh
Residence, No.
F
day of
Jamy
Dated at Lowell, this ...
22
* Reckoned to the time of death.
[ Be very particular to fill the blanks, and strike out words that are not correct, such as street or corporation, single, married or widowed, and insert "fe" before male
Inthe
4
RETURN OF DEATH -OF-
...
18g
1
Commonlocalth of Massachusetts.
L
No. RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. 'Date of Death, .
Jam 24, 1894,
2. Name,
(Maiden Name),* (Name of Husband),*
Male
3. Sex, and whether single, Married, or Widowed, 4. Color, t
marcial.
While,
5. Age,
68 Years,
Months,
12 Days.
1 Disease or Cause of Death, (Primary and Secondary), # 6. {Duration of Sickness, . By whom certified,
1 muk. Dr. lecher Westford
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth,
11. Name of Father,
12. Name of Mother, (Marlen Name),
13. Birthplace of Father, .
England.
11. Birthplace of Mother, . 1 .1 wer Chelmsford
15. Place of Interment,
Signature of Undertaker or other person making the Return,
1 Geot now
5 For Brand of Health
NATED at
, on Jan, 24, 1894,
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.] Plate. Ed. May, 1SJ1. -- 5,000.
west Chelmsford. Tanner
pour Chelmsford. Leeds. England. Banj morton may morton
[ACTS OF 1888, CHAP. 306.] AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted, etc., as follows :
SECTION 1. Section three of eliapter thirty-two of the Public Statutes, requiring attending physicians to furnish for registration certain facts relating to deceased persons, is amended so as to read as follows : - Section 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of whiel he died, the duration of his last sickness, and the date of his decease. If a physician negleets or refuses to make a certificate, as aforesaid, he shall be pun- ished by a fine not exceeding fifty dollars.
SECTION 2. Section five of said chapter, prohibiting the burial or removal of a human body until a proper certificate is fur- nished, is amended so as to read as follows :- Section 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such eity or town, from the city or town elerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the ease may be, a satisfactory written state- ment containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hercinafter provided. If there is no attending physician, orif the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or elerk, make such certificate as is required of the attending physician; and in ease of death by violence, the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are de- livered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the elerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a finc not exceeding fifty dollars. [ Approved Muy 4, 1888.
Commontoralth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),* (Name of Husband),*
Male
3. Sex, and whether single, Married, or Widowed,
Single
White
4. Color, t
5. Age, .
23 Years, 10 Months
Days.
Pericarditis -
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Siekness, . By whom certified,
Amara Sizivard M. D.
7. Residence,
8. Occupation,
9. Place of Death, .
10. Place of Birth,
11. Name of Father,
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker or other person making the Return, . .
Arthur H. Sheldon
DATED at N. Chelmsford, 011.
Jan, 31st 1894
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] l'late. Ed. September, 1892 .- 5,000.
North Chelansford Mas Moulder
North Grelosford Mas. Ireland
Patrick Finnegan
Bridget beachan
Freland
Ireland
Lowell Mass
Man. 314- 1894 Bernard Finnegan
[ Public Statutes, Chapter 32, as amended by Acts of 18SS, Chapter 306 ; Acts of 1839, Chapter 224.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his dlecease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceeding fifty dollars.
Commonbentth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
ver, 2-94
1. Date of Death, .
2. Name,
Agnes Morris
(Maiden Name),*
/
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
×
4. Color, t
5. Age,
.Years,
3
Months
14 Days.
Bronchitis
Disease or Cause of Death, (Primary and Secondary), # 6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
11
10. Place of Birth, .
11. Namc of Father,
11 Thos. 6 Noone
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Many ( Shields) Ireland
Signature of Undertaker or other person making the Return, .
DATED at
le hecuruford, on
tiene
189.4
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks. ] l'late. Ed. September, 1892 .- 5,000.
E. Chelmsford
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall he punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until therc has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceeding fifty collars.
26
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must make this return before the burial or removal of the deceased.
Date of Death,
IS9 4
Name
Ruth U. Son the
Maiden Name, Ware
Sex, . . male ; Color,
Single, Married or Widowed,
Age, 76 years, ~ months, - days.
Name of Attending Physician,
Residence of Deceased --- No. Chelmsford Center Street (or Corporation), Ward
Occupation, Husband's Name,
Place of Death -No.
Birthplace of Deceased,
Father's Name,
Jaseph Hare
Father's Birthplace,
Mother's Birthplace,
Mother's Nande 5 Mother's Maiden Name, Heston
Place of Interment,
Ednavi
Cemetery Range , Lot , Grave
1
Signature of Undertaker or Informer,
day of February
1
IS9 2€
Daled at Lowell, this
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.
Date of Death
OFelo 2 ªs
Name and Sex of Deceased Ruth IN 1 89 4 Smith
male,
Place of Death - No. Chelinford center
Street (or Corporation) .
Disease or Cause of Death Pneumonia
duration of *
20% day2
Complications, I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title, ....
, S.18 Chanhului Zu, it.
Residence, No.
Street
February
IS9 L.
Dated at Łowell, this
day of
...
* Reckoned to the time of death.
[ Be very particular to fill the blanks, and strike out words that are not correct, such as street or corporation, single, married or widowed, and insert "fe" before male when the deceased is a female, and when the deceased is colored, please insert. ]
:
RETURN +7
F
189
Ree
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must make this return before the burial or removal of the deceased.
Date of Death, Fiby @
189
Name
Many mahoney
Maiden Name,
Sex ._ male ; Color,
Single, Married or Widowed,
Age, 6 3 years,
months,
.days.
Name of Attending Physician,
Chandbulan
Residence of Deceased --- No.
thelunsford
Street (or Corporation), Ward
Occupation,
Husband's Name,
Place of Death -No.
Street (or Corporation), Ward
Birthplace of Deceased,
Trelabel
Father's Name,
Ihn Aturley
Father's Birthplace,
Ireland
Mother's Name,
many 2 In
Mother's Birthplace,
Mother's Maiden Name
Place of Interment
Milford Not Cemetery Range
x
Signature of Undertaker Or Informer,
Daled at Lowell, this
day of
Heby
1894
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.
Date of Death 189
Name and Sex of Deceased male, Street (or Corporation).
Place of Death - No.
Disease or Cause of Death
duration of
Complications, I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Street
Residence, No.
day of
189
Dated at Lowell, this
* Reckoned to the time of death. [Be very particular to fill the blanks, and strike out words that are not correct, such as street or corporation, single, married or widowed, and insert "fe" before male when the deceased is a female, and when the deceased is colored, please insert. ]
Approved.
1
.. , Lot
, Grave
RETURN OF DEATH
18g
25
PLEASE FILL OUT WITH INK.
UNDERTAKER'S
ETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must make this return before the burial or removal of the, deceased.
Date of Death, Man 31
189 4 Name Macharia Checkar
Maiden Name,
Sex, .... ... male ; Color,
Single, Married or-Widowed,
Age, 94 years, - months- days.
Name of Attending Physician,
Residence of Deceased --- No.
Chelsfacce
Street (or Corporation), Ward.
Occupation,
at Home
Husband's Name,
Place of Death -No.
Chel, scores access
Street (or Corporation), Ward
Birthplace of Deceased,
Mulauch
Father's Name.
Charles Daily
Father's Birthplace,
Mother's Name,
fechana
Mother's Birthplace,
Mother's Maiden Name,
Place of Interment,
Catholic
Cemetery Range
, Lot
.,
Grave
Signature of Undertaker or Informer,
Deineatt
Daled at Lowell, this
day of
IS9
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.
200
RETURN OF DE -- OF -
1
-
1
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must make this return before the burial or removal of the deceased.
Date of Death, March 4 th
IS9 4 Name George R. A. Holt
Maiden Name,
Sex, .
male ; Color, White
Single, Married or Widlowed,
Age, 19 years, 1
months, - days.
Name of Attending Physician,
Residence of Deceased --- No.
North Chelmsfordcet ( Corporation), Ward
Occupation,
Clock
Husband's Name,
Place of Death -No. North Chelmsford
Street (or Corporation), Ward
Birthplace of Deceased, .
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