USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1891-1893 > Part 3
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Ru No.
Commonwealth of Massachusetts.
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),*
3. Sex, and whether single, Married, or Widowed,
Married
White
4. Color, t ·
5. Age, . . .
66 Years,
Months,
.Days.
Rheumatism 3 years
N. B. Edwards M.D
7. Residence,
8. Occupation, . . .
9. Place of Death, . .
·
10. Place of Birth, .
11. Name of Father,
Edward ME Salle
Alice (Vinters) MENalle Ireland
Ireland
Lowell Mass
Signature of Undertaker or other person making the Return, .
Arthur & Sheldon
DATED at A Chelmsford, 01
Mar, 11th
1896
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. ¡ If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks. ] Plate. Ed. Nov. 1890 -5,000.
199
North Chelmsford lass. Laborer
North Chelmsford Mass Ireland
12. Name of Mother, . (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
May 10th 1891 Patrick Mc Nall
Male
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Sickness, . By whom certified,
[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. Seetion three of chapter thirty-two of the Publie Statutes, requiring attending physicians to furnish for registration certain faets 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 which he died, the duration of his last siekness, and the date of his deeease. 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 sueli eity or town, from the eity or town clerk. No such permit shall be issued until there has been delivered to sueh board, or agent or elerk, 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 seetion three of this chapter, or in lieu thereof a certificate as hereinafter 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 eity or town for the purpose shall, upon request of said board, agent or clerk, make such certifieate as is required of the attending physician; and in ease of death by violenee, the medical examiner shall, if requested, make the same. When sueli 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 eause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this seetion shall be punished by a fine not exceeding fifty dollars. [Approved May 4, 1888.
1.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
Carrie B Penneanzahl Theart
(Maiden Name) ,* · ... ..... ..
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t ·
23
Years,
7
Months,
16
Days.
5. Age,
Disease or Cause of Death,
6. Duration of Siekness, . By whom certified, ·
7. Residence, ·
8. Occupation, . ·
Hawel Black
9. Place of Death, . Jo, Chilin/ cad
10. Place of Birth, .
Lawell
Stewart
11. Name of Father, ·
12. Name of Mother, . ·
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment, ·
Signature of Undertaker or other person making the Return, .
Kamil & By
DATED at
.. , on
Tiky 16
1891
* If a Married Woman or Widow.
+ If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks. ] Plate. Ed. Feb. 1890-5,000.
99
.****
clara/
Deu Hamal
Maine
Leaux (
[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. Seetion three of chapter thirty-two of the Public Statutes, requiring attending physicians to furnish for registration certain facts relating to deeeased 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 which 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. Seetion 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 nntil 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 sueh board, or agent or elerk, as the case may be, a satisfactory written state- ment containing the faets required by this chapter to be returned and recorded, together with the certificate of the attending physieian, 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, orif the certificate of the attending physician cannot be obtained, for good and snffieient 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 violenee, the medical examiner shall, if requested, make the same. When sneh 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 seetion shall be punished by a fine not exceeding fifty dollars. [Approved May 4, 1888.
Rec
Commonwealth of Massachusetts.
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),*
3. Sex, and whether single, Married, or Widowed,
........ 1
4. Color, t .
5. Age,
Disease or Cause of Death, Carriesis
6. {Duration of Siekness, . By whom certified,
7. Residenee,
8. Oeeupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father, ·
12. Name of Mother,
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return, .
Daniel Bryan
DATED at
South Chelmsford, on May 18th
218 72.
* If a Married Woman or Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] Plite. Ed. Feb. 1890-5,000.
2 werkes.
South Chelmsford.
Seamstress.
South Chelmsford.
James Goblins
Elginaltobbins
Chelmsford.
Westworld. South Chelmsford
No ..
May 18, 1891 Elzinda E Goblins.
09 Years, 5 Months, Days.
[ACTS OF 1888, CHIAP. 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 threc of chapter 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 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 be pun- ished by a finc 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 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 casc 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 thercof 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, makc the same. When such satisfactory statement and certificate arc-de- livered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the samc 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. [Approved May 4, 1888.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred. = 1. Date of Death,
15/1
1
1
1
2. Name,
(Maiden Name),* · (Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age,
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Sickness, . By whom certified,
7. Residence,
8. Oecupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father, .
12. Name of Mother, . (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker or other person making the Return, . .
DATED at
D
18 7.1
* 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. Nov. 1890-5,000.
/ Years, 11 Months, 20 Days.
1
1
11
[ACTS OF 1888, CHAF, 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 chapter 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 uamc 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 be pun- islicd 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 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 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 threc of this chapter, or in licu 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 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 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. [Approved May 4, 1888.
1 2cc No.
Commonwealth of Massachusetts.
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),*
3. Sex, and whether single, Married, or Widowed,
1
1
4. Color, j
5. Age, . 73 Years,. 3 Months, /5 Days.
rastro Outside
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Sickness, . By whom certified,
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, .
.
( 1 ) 1
1
1 1.11
11
tail
1
11 1
/
DATED at 2. € , 011 18
* 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. Nov. 1890-5,000.
/4
1
1 2
1
[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. Scction three of chapter 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 which he dicd, the duration of his last sickness, and the date of his decease. If a physician neglects or refuses to make a certificatc, 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, scxtou or other person shall bury in a city or town or remove therefrom the body of a deccased 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 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 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 deatlı 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 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. [Approved May 4, 1888.
Commonwealth 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),*
3. Sex, and whether single, Married, or Widowed,
Male- Married
White
4. Color, t
5. Age, .
62 Years,
1
Months,
3
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Sickness, . By whom certified, ·
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 & Sheldon
DATED at
A Chelmsford, on
June 25th
1896
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
{ If other than White. (MI.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks. ] I'late. Ed. Nov. 1800~5,000.
Fatty
heart-
6 months
N. B Edwards M.D. North Chelmsford Mais. Gentleman
North Chelmsford Mass Concord Mars. John Flint
Roku (Putting) 7 link Concord Mass.
Westford Mass
Concord Mass
June 24th 1891 Charles W. Flink
[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 chapter 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 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 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 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 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 hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, carly 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 de- livcred 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. [Approved May 4, 1888.
No.
Commonwealth of Massachusetts.
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),*
3. Sex, and whether single, Married, or Widowed,
4. Color,t
5. Age, Years, Months, Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whom certified, .
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, .
******
.C ........
DATED at , on 18
* 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. Nov. 1890-5,000.
[ACTS OF 1888, CHAF. 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 chapter 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 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 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 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 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 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 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 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. [Approved May 4, 18SS.
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