USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1908-1909 > Part 1
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OFFICE OF THE
CHI
R
D
LET THE CHILDREN
WHAT THE
SIRES
GUARD
HAVE WON.
SLI
1655 CHUS
TOWN CLERK
CHELMSFORD, MASS.,
190
7
Berry
43 DE
Adama Umve B.
MAS
Coleman William . Clarke Havet a. Controunto Panteles Chamberlain Ges. M. Gorz She alth Craig John G. Chamberlain arenath M. Callahan annova a
Cowon Melvin . 127
Gailairan arthur
Coburn Daniel M. Clarke Carroll Charles Cheney Laroy Clausen Elene
Christianson
Comtois Marie y 215
Connere Charles 217
Draper William 2 9 18 Doherty Edward 47 Griecoll abbie ). 54 Downs Horatio B. 58 Danson - 75 ١
Davis Henry Prescott
91 Douglase ilfred 2. 112 Donahue Charles it.
Zarley Hannah 150 Downs Other Q.
186 191 199 202 212 214
11 16 64 78 81 90 113 119 138 163 168 184 187 203 1 206 224 Dunn James Str. 226
Lavie Verin Dodge Orlando It Dollard William F. Dinsmore Clarence Dutton Samuel L. Donnelly Helen8.
Durant Blanch E. 237
dame Elizabeth H. 7
7 arvidson Carl a.
adama amor. B. 30
aldrich Emily 43
adams Grace P. 159
ackroyd Ruth S.
164 (Barkman Charles
H
Brennan Patrick J.
Bury abbie &
Blackdell Andrew M.
993
110 JK Bridgeford arthurm. 1 Byand Lucy O . 130 + L
By am Hannah M. 141.
Bjorge Margaux S. 144 4
Ball William 7V. 1 6.9 7 MC
Bell Chester 2. 173
Brown martha&
182
Byam George Q
238
Brennan James 246
Burline on Mary. 249
Byam Mary P. 251
A B C D
8 17 49
E F G 51;
N 0 P Q R S T
U V W
Y 7
Burndrett Joseph
Buttery Lucy a. Blodgett
Brake Elisha Q. 50
Brake Halter E.
63 7671 77 2,
M
Eriksen Olaf ? Elliott Jasper
46 Finnick Charles
253
Farrow Joseph ? 34
Felch Sertinde G. 38
Jian William 44
Frisette Edouard 55
Fection Sammel P.
Fletcher Lucinda V. 59
62
Slavill- F
69.
tiles Everett P. 132.
Howle William P.
-145
Freel alice 146
Fortin Lucien 157
Ferrin Eugene T. 160
finch mary 197
Front Edward
2.30
greenwood- Gray Edith M. Your Rydial. Godfrey darren, 4. Sandette Sarah
3 Hogan Evilin 25 House Duthun 7 40 Heureux Joseph & E? 42 Hanvar are with H. 48 Herron Margaret Q. 80 Holmes John C. 175 Hue
Gilmore Luther
Griffin Hillis F.
220 Holland alice
Gray margaret E. Gilbert Oscar & 216
San dette Clifford 2. V. . 233
Green alonga G.
242
158+L Harvard adelard 161 178 4
M Hoyt Ervilla .
Hennesey Francis 2. 196 7 MC Holt Sarah m. C. 201
N
Heureux Prepelle 2. 265 0
Hubbard Charles 219 Hardy Mary 6. 222
240
Howard Emilie B. 254
P Q R S T
U V W
Y
7
14
26 E 3/ F 32
G 66 72 H 85 71 98 2 J
Hall Thomas 1583
Heureux Marie E.L.
139 , K Hough Charlotte R.
Ingham Gilliam a.
185
Jordan Rebecca Jordan Gertrude M. Johnson Jeter M. 103 Johnson Johanna &
83
Jones Warren J. 116
Johnam Sarah 8. 134
Knowles Isaac King Charles Elson
4 Lambert Hector 8. 5 84 Lemay Olive 41
LEgrandee Edward 52
Lane Hiram P. 79 Leakey Hammaking 93
La grandeur annie
109
Lord Fielen .
Larkin Frederick 122 J
Larkin Edward 123
Luce Frank S.
140 K
Zarkin
154 L
Lowering Mary S. 177
M
Litchfield Sarah C. 1814
Lovaly Felix 189 7 MC
Lafontan Louis 192
N
recourt alphonse 198
0
Leith Ernesto 2 21
P
Levis William F. 235
Lundgren anna D. 243
Q
Lowney Catherine 250
R
S
T
U
V W
Y 7
Mulligan John muller Wüllen Mary &. Marshall Lucy ? Maguire Pasanna
Manseau Leon L.
Merrill martha .
Macnutt Phenby F.
Martin maryt.
marks
Mungoran
Miner alfred a. 167
Murphy Catherine a. 174
Montgomery Sarah E. 188
Miner Elizabeth 207
Moore Mabel R.
208
Morse Janet N. 211
melvin Jerome B.
231
19 M En any alice & 10
27 Mahon Pathline 12
29 Mr Jeanque Michael 33
37 M Donough Mary 7/ 67 MEnamen Thomas . 87
92 Mcgrath Joseph H. 120
95 Mnicholl Charles 121
.97 mcQuade 166
129 Inc Clure Florence B. 176
143 McLarney Elizabeth 200
15.5 Mc Farlin Susannalv
218
tilson Nichols Charles 102
23
Calmioto 21
Perrill mabil . 45 73
Barkhush Elizabeth R.
Newman 172
Nichols agnes D.
213
Jakson Eloner M. 232
Jakon august
239
Pickard
142 .. 14.8
Parker Josse H.
Parler Bessie &. 165 171
Perkins Laura O.
Gagnon Stéphanie
Parker Willard S.
Jefin ann In.
M
rescott Hearing S
Chinkett Ellen
Odell James Dh
53
Thlon Helen&
61
Brien Denniel 65
Osgood many G. 190
Deterlund Ellen 225
Osterlund Ellen S. 227
1
MC N 0 P
195
204 236. 244 247
R S T U
W Y
7
Pihl martinG. 131 136
Paarche B. a.
Singly James
234 Grodrigue albina 36
Roberge Olive 88
Reed Emily G. 104
Ready Katherine B. 133
Robert J . R. a. 137
Redmond William H. 193
Scoloria Ennice Sleeper Sophia 2.
2 6
Thompson mildred E. 22
Thompson Bernice 8. 24 15 Thompson anastasia B. 70
56 Tisdale anna S. 125
Scoloria arthur
Swain ara M.
60
- antamons Lillian
82
Sheehan annie.
89
Shea Dennis 94
Saverne Carl &. 100
Searles John F . 101
Senior Wilfred Leroy 107
Searle Martha F. J
114
Spaulding George as 115
Smay Henry
124
Station Nancy S.
149
Stearns Carola M.
170
Stuart Sarah P.
179
Shanley Stephen
180
Sweater Lorenza
183
Senior Harold Nelson
194
S
Spalding Emma a Smith Fand
209
2.28
Silk
245
Sweeter Herbst a.
24.8
1
T U V
W
Y
Z
Smith Frank Elmer 4 Savoie mary A.
57 Tremblay Rogus 229
Q R
Vernon agnes 128 Viale with 151
Shinning Elizabeth 20
Aright arthur Draad illary 39
35
good Ettale.
68
Harley Sarah 74
Height nathan 96
Hitch John
105
Wright Frederick 2.
106
Harch Leo /18
Wright Jefferson Hard
126
135
Stillis Rosco 2, 147
Wheeler John 152
Halch William 153
Hinship Many M. 156
Hilson ann 162
Whitemore Frac M.
241
Whitney Adres Fr.
252
U V
W Y 7
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME Rebecca
Indan
Registered No. 1
Place of }
Death *
5
West, Chelmsford mas Date of
Death
San
1
1908
Residence
West Chelmsford
Age.
67
.. years.
months.
...... .... .days
STATISTICAL DETAILS
SEX Shemale
COLOR
white
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Wider
MAIDEN NAME + Rebecca
Spinney
HUSBAND'S NAME + Charles Jordan
BIRTHPLACE # England
NAME OF
FATHER
Benjiman Spinney
BIRTHPLACE
OF FATHER#
England
MAIDEN NAME OF MOTHER Mary
BIRTHPLACE
OF MOTHER +
England
OCCUPATION at home
INFORMANT §
PLACE OF BURIAL OR REMOVAL II DATE OF BURIAL West Chelmsford Jan 5 190 90.8
4 ADDRESS
UNDERTAKER L. M. Honing 33 Prescott )
PHYSICIAN'S CERTIFICATE
| HEREBY CERTIFY that I attended deceased during last illness, from July 1905 to Jamy1 1908
... , that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows:
Primary :
Organic decease I heard
.DURATION
.. DAY8
Contributory :
.( DURATION). .. DAY8
(Signed)
N
M.D.
1900 ... (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
.. years
months. .................... days
Where was disease contracted, If not at place of death ?.
Filed San 4 19of Edward & Kobling
Clerk
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special information," If In a Hospital or Institution, give Its NAME Instead of street and number,
t In case of married or divorced woman, or widow. # State or country; also city, town or county, If known.
§ Name and address of person giving statistical details. Il Name of cemetery.
MARGIN RESERVED FOR BINDING
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
2 7
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME
Place of Death * + fourth
Date of Death
Age
6?
.years.
6
months
4
days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť
HUSBAND'S NAME +
1
1
1
BIRTHPLACE #
NAME OF FATHER
James, 13, Gilmore.
BIRTHPLACE OF FATHER+
1
MAIDEN NAME OF MOTHER
BIRTHPLACE OF MOTHER #
OCCUPATION
INFORMANT §
.
PLACE OF BURIAL OR REMOVAL II South Chelmsford, Mas.
DATE OF BURIAL Jan. 6, 1908
UNDERTAKER ADDRESS D Bleuver & Co Nouvelle, mais.
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from 190 ..... to 190 .. , that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary : Influenza and Chronic
(DURATION).
15 Uhrs.
Contributory :
.(OURATION). ..... DAYS
-
(Signed)
M.D.
Han 4
190.7 ... (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Translents, or Recent Residents.
Former or Usual Residence
How long at Place of Death ? .. Days
Where was disease contracted, If not at place of death ?..
Filed Acm 4
190€ Quand la Ffin
Down Clerk
* Clty or town, street and number, if any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
§ Name and address of person giving statistical details. !/ Name of cemetery.
MARGIN RESERVED FOR BINDING FILL OUT WITH INK. - THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
1,19
Registered No.
£
COMMONWEALTH OF MASSACHUSETTS
3
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
Still
Born
Place of l
Death *
5
East Chelmsford mass
Date of
4
190
Residence
East Chelmsford
Age
years
-
-
months.
days .
STATISTICAL DETAILS
SEX male
COLOR
white
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME +
HUSBAND'S NAME +
BIRTHPLACE # Chelmsford Iaso
NAME OF FATHER William S. Greenwood
BIRTHPLACE
OF FATHER#
England
MAIDEN NAME
OF MOTHER
Sarah In. Haufeni
BIRTHPLACE
OF MOTHER +
England
OCCUPATION
INFORMANT § father
PLACE OF BURIAL OR REMOVAL II Edson Cemetery
DATE OF BURIAL
Jan 6
190.8 ..
UNDERTAKER le Mr. Elanna
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. 190 % ... to - 7
190 that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary :
(DURATION)
. DAY8
Contributory :
(DURATION). DAY8
(Signed)
S. a. Mahon
M.D.
190% .. (Address) Lowell mass
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at Place of Death ? years. ... .. . ... ..
. months. ................ days
Where was disease contracted, If not at place of death ?.
Filed Jan. 6
190.
8 Edwant ). Restring
Clerk
Com
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
ADDRESS
3312
§ Name and address of person giving statistical detalls. Il Name of cemetery.
MARGIN RESERVED FOR BINDING FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
.Registered No.
3
Death
S
COMMONWEALTH OF MASSACHUSETTS
4
Lowell
(CITY OR TOWN.)
FULL NAME
Jaar Knowles
Place of )
Death *
5
Chelmsford, Mas
Death
8
1905
Residence
Chelmsford Mars
Age
74 years
11 months.
9 days
STATISTICAL DETAILS
SEX
m
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť
HUSBAND'S NAME +
BIRTHPLACE# Wellington, me
NAME OF
FATHER
John Knowles
BIRTHPLACE OF FATHER# Unknown
MAIDEN NAME OF MOTHER Rebecca Goodwin
BIRTHPLACE
OF MOTHER #
Unknown
OCCUPATION
Farmer
INFORMANT § Melissa Chadlow
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL
Edson Cemetery lan
10, 1908.
ADDRESS
UNDERTAKER c. Heinbeck 80 Middy, SA
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. 190 7 to Jemy 8 1908 that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary : Typhoid fever
(DURATION)
21
DAY8
Contributory :
.(DURATION). ......... . DAYS
(Signed).
JE Varney
M.D.
190.2 ... (Address).
H1 Chilenafino.
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
. years.
months
. days
Where was disease contracted,
If not at place of death ?.
Filed
Jan 10,
8 Edward J. Pathing
Clerk
* City or town, street and number. If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Speclal Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow.
# State or country ; also city, town or county, if known.
§ Name and address of person giving statistical detalls. Il Name of cemetery.
MARGIN RESERVED FOR BINDING FILL OUT WITH INK. - THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
RETURN OF A DEATH
Registered No.
301
Date of ¿
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
..
(CITY OR TOWN.)
FULL NAME
Hector E. Lambert
Registered No ..
Place of l Chelmsford Mars
Death * ...
1
Death S
11
months.
.days
STATISTICAL DETAILS
SEX
Male
COLOR
white
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť
HUSBAND'S NAME +
BIRTHPLACE# Lowall Mass.
NAME OF
FATHER
Edmond Lambert
BIRTHPLACE OF FATHER# Canada
MAIDEN NAME OF MOTHER Pase Anna Reeves
BIRTHPLACE OF MOTHER #
Rhode Island
OCCUPATION at home
INFORMANT §
Edmond Lambert
PLACE OF BURIAL OR REMOVAL II
DATE OF BURIAL Joseph @ Chelmagan. 2008
UNDERTAKER Joseph albert
ADDRESS 5)Cheever
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from Jan. 14
. 1908 .... to .. aw//,1908 that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
(DURATION) DAYS
Contributory :
(Signed)
H. L. Yagy
M.D.
Jan. 18.
1900 (Address)
28. There fore, Mas.
SPECIAL INFORMATION only for Hospitais, Institutions, Transients, or Recent Residents.
How long at Place of Death ? . years.
months .................... days
Where was disease contracted, If not at place of death ?
Filed Jan. 18 198 Edward J. Kabling
Clerk
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, if known.
§ Name and address of person giving statistical details. Il Name of cemetery.
MARGIN RESERVED FOR BINDING FILL OUT WITH INK .- THIS IS A PERMANENT RECORD
ALL NAMES TO BE IN FULL
Date of ¿ Jan. 17th 1908
Residence
Age
15 .years.
5
(DURATION) DAYS
Der Lage
130.38
MARGIN RESERVED FOR BINDING FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
STATISTICAL DETAILS
SEX
COLOR
Female White
WIDOWED, OR DIVORCED
MAIDEN NAME + Sophia Douglas
HUSBAND'S NAME t
Daniel W. Sleeper
BIRTHPLACE # new Brunswick
NAME OF
FATHER
Edward Douglas
BIRTHPLACE
OF FATHER$
Scotland
MAIDEN NAME
OF MOTHER
Francis Erb
BIRTHPLACE
OF MOTHER #
new Brunswick
OCCUPATION
House Keeper
INFORMANT §
Hannah H. Sleeper
PHYSICIAN'S CERTIFICATE
| HEREBY CERTIFY that I attended deceased during last
illness, from
nor 22
taux 20
.190 ..... to 1908, that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
Trombosis of cord.
7028
(DURATION).
.. DAY8
Contributory :
Rheumatem
2 minutos
.. DURATION).
........ DAY8
(Signed) JE Varney
M.D.
Dary 20 1908 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
. . years.
... months.
.. days
Where was disease contracted, If not at place of death ?.
Filed
Jan 22
1908 Edward J. Rolling
Tom Clerk
PLACE OF BURIAL OR REMOVAL I!
Riverside
UNDERTAKER
DATE OF BURIAL
Jan 22, 198
ADDRESS
I.B. Currier Co 58 Prescott
(CITY OR TOWN.)
FULL NAME
Place of l
Death * S
Residence
RETURN OF A DEATH Sophia Douglas Sleeper north Chelmsford mass Death
Registered No. 6 2- 3
Date of ¿ January 201908
"59
Age
.. years ..
.months.
8 .days
COMMONWEALTH OF MASSACHUSETTS
6
* City or town, street and number, If any, If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If in a Hospital or Institution, give Its NAME Instead of street and number. t In case of married or divorced woman, or widow. + State or country; also city, town or county, If known. Name and address of person giving statistical detalls, Name of cemetery.
Lowell Mass
٦٠
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME Elizabeth, Ho adams
Place of Death * North Chelmsford
Date of Death. January 23 1908.
Age
85 ve
months
days
STATISTICAL DETAIL
SEX
COLOR
SINGLE, MARRIED? WIDOWED, OR DIVORCED
MAIDEN NAME Ť
Elizabeth 21: Filchnet
HUSBAND'S NAME + abiel & adams
BIRTHPLACE # andover, Mass
NAME OF FATHER
amos Gilchrist
BIRTHPLACE OF FATHER
Dracut Maso
MAIDEN NAME OF MOTHER Unknown
BIRTHPLACE OF MOTHER # andover, Mass
OCCUPATION
INFORMANT §
PLACE OF BURIAL OR REMOVAL |1 Riverside Cemetery
DATE OF BURIAL Jan 25,8
UNDERTAKER
ADDRESS CA. Yreinbeck 80 Middle, St.
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last.
illness, from ..
Many 19 1908 to Jour 23
that to the best of my knowledge and belief death occurred on the
date stated above, and that the CAUSE OF DEATHI was of follows :
Primary :
Prev month.
6
.. (DURATION)
. DAYS
Contributory
... (DURATION). ... DAYS
(Signed)
JEVaren
M. D.
facey 23
190.8 .. (Address).
I. Chilucia
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
Former or Usual Residence . Place of Death ?. . Days
How long at
Where was disease contracted, if not at place of death ?.
Filed Jan. 24 08: Edward). Rolling
Com Clerk.
"City or Town, street and number, if any. If death occurs away from USUAL RESIDENCE, give facts called for under " Special Information.' If in a
Hospital or Institution, give its NAME instead of street and number.
+ In case of married or divorced woman, or widow.
# State or Country ; also city, town or county, if known.
§ Name and address of person giving statistical details.
Il Name of cemetry.
ALL NAMES TO BE IN FULL.
MARGIN RESERVED FOR BINDING FILL OUT WITH INK .- THIS IS A PERMANENT RECORD
CITY OF LOWELL
7
301
Registered No.
٢
٨
COMMONWEALTH OF MASSACHUSETTS
8
CITY OF LOWELL
RETURN OF A DEATH
(CITY OR TOWN.)
28
FULL NAME
Place of l
Death * S
Residence
Chelmsford, mars.
Age
63
.. years
.months.
.days
STATISTICAL DETAILS
SEX
COLOR
It.
SINGLE, MARRIED,
WIDOWED, OR
DIVORCED
m,
MAIDEN NAME + HUSBAND'S NAME +
BIRTHPLACE + England,
NAME OF
FATHER
Luis Bun Chrett
Lunes
BIRTHPLACE
OF FATHER$
England
MAIDEN NAME
OF MOTHER
BIRTHPLACE
OF MOTHER +
England
OCCUPATION
Engraver
INFORMANT § Hidow
PLACE OF BURIAL OR REMOVAL II
Edson Gian. Lowell,
DATE OF BURIAL
Jan. 9 1908
UNDERTAKER
G. m. 400mg
ADDRESS
3 Prescott RA
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from 190 . to
.190 ..... that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
(DURATION)
. DAY8
Contributory :
(Signed)
Charles L. Hoods
.. 4 (DURATION) .. DAYS
M.D.
6
.190 ...... (Address)
10 John 21.
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
.. years.
months.
.... days
Where was disease contracted, If not at place of death ?
Filed
1908
leite
Clerk
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If in a Hospital or Institution, give its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
§ Name and address of person giving statistical details, Il Name of cemetery.
MARGIN RESERVED FOR BINDING
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
gareth Burndrett
Registered, No.
Date of l
6
.190
8
Death
Diz Central Qt
٠٠
COMMONWEALTH OF MASSACHUSETTS
CITY OF LOWELL
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
William I Coleman
68
Place of )
Lowell Gend Nospt
Death * S
Residence
Chelmsford mars
1
Age
.. years.
9
.months.
days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED,
WIDOWED, OR
DIVORCED
MAIDEN NAME Ť HUSBAND'S NAME t
BIRTHPLACE #
Lowell mars
NAME OF
FATHER
Thomas Coleman
BIRTHPLACE
OF FATHER$
Freland,
MAIDEN NAME
OF MOTHER
annie Mahan
BIRTHPLACE
OF MOTHER +
Freland
OCCUPATION
INFORMANT § Father
PLACE OF BURIAL OR REMOVAL !!
De- Patrick Cem Lowell Jaw 12
DATE OF BURIAL
.. 190 8
UNDERTAKER
Peter H. Savage
ADDRESS
169 Harthere Ot
PHYSICIAN'S CERTIFICATE
I HEREBY/ CERTIFY that I attended deceased during last illness, from. Och. 14 1907 to Jan. 11 190 that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
Inanition
-
. (DURATION).
. DAY8
Contributory :
(Signed)
Charles At Robertson
... (DURATION)
DAY8
.M.D.
Jan /1 1908
Lowell Hand Hackt,
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
.. years.
. months.
days
Where was disease contracted, If not at place of death ?
Filed / Jan 13 1908
bity
Clerk
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If in a Hospital or Institution, give Its NAME instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
§ Name and address of person giving statistical detalls. Il Name of cemetery.
MARGIN RESERVED FOR BINDING
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
.Registered No.
Date of l Jan 11
8
190
Death 5
9
-
COMMONWEALTH OF MASSACHUSETTS
10
North thelusfond ness (CITY OR TOWN.)
10
FULL NAME
.. Registered No.
Place of l
mx 51-Month thelestore
Date of l Jan 27 190
Death +
Residence
Age
40 C .. years ...
-
... months ..
.days
STATISTICAL DETAILS
SEX
COLOR
White
SINGLE, MARRIED, WIDOWED, OR DIVOROED
MAIDEN NAME +
HUSBAND'S NAME + Som Dr. MSO nancy.
BIRTHPLACE#
NAME OF FATHER Derini M. Groth
BIRTHPLACE
OF FATHER+
Eland
MAIDEN NAME OF MOTHER Mini Mi Casa
BIRTHPLACE OF MOTHER#
OCCUPATION
INFORMANT § Nom r . M .: Enoney Ausbruch
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from, May 21 190 J to Pay 27 1908 that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary : Taenia -
(DURATION). 7
DAY8
Contributory :
Orfacere deces ) Kidney.
unknown. .(DURATION). . DAY8
(Signed)
M.D.
Pac 28
1905
.(Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at Place of Death ? . years ..
months. ...................... days
Where was disease contracted, If not at place of death ?
Filed
Jan. 29
Edward & Jobbing
Clerk
PLACE OF BURIAL OR REMOVAL I StParts forral Mac
DATE OF BURIAL
8
190.0
ADDRESS
UNDERTAKER Normal Tons
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Speclal Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
§ Name and address of person giving statistical detalls. Il Name of cemetery.
MARGIN RESERVED FOR BINDING
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
RETURN OF A DEATH
Death *
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
Lowell
(CITY OR TOWN.)
FULL NAME
William Lestir Draper
.. Registered No ..
Place of l
Death * S
North Chelmsford Mano
Death
1
190f.
Residence
North
Chelmsford
Maso Age
71 years.
8 months.
/
.days
STATISTICAL DETAILS
SEX m
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME +
HUSBAND'S NAME +
BIRTHPLACE# Loughborough Iny.
NAME OF FATHER
John Draper
BIRTHPLACE OF FATHER# England
MAIDEN NAME
OF MOTHER
Sarah Lester
BIRTHPLACE
OF MOTHER #
England
OCCUPATION
Carriage mg
INFORMANT S
Elizabeth Draker
PLACE OF BURIAL OR REMOVAL II
Edson Cometera
DATE OF BURIAL
Jeb. 4.
1900
UNDERTAKER
ADDRESS
to Maddy St
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last
illness, from
190
to
190 ...... , that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
aregina
Pectoris
DAY8
Contributory :
(Signed)
I Elaney
M.D.
Foly 2
2. Chelumino
190 8 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at ........... Place of Death ? ... years .. ........ ....... months. ...... days
Where was disease contracted, If not at place of death ?
Filed
FIEb.
3
1909 Edward . Robbing
Clerk Japan
* City or town, street and number, if any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
§ Name and address of person giving statistical detalls. Il Name of cemetery.
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
I
MARGIN RESERVED FOR BINDING
Go, 11
Date of ¿
Feb. 1
(DURATION)
2
(DURATION) ..... . DAY8
COMMONWEALTH OF MASSACHUSETTS
12
RETURN OF A DEATH
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