USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1894-1897 > Part 10
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Ree
/ No.
Commontocalth of Massachusetts.
100
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
4. Color, t
5. Age,
46 Years, 3 Months, 25 Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whom certified,
7. Residence, Chelmsford
8. Occupation, Grain Merchant
9. Place of Deathı, .
10. Place of Birth, .
11. Name of Father,
Elbridge Dutton
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, .
S. R. Howard
DATED at
May 12.
1896.
* 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.
Chelmsford
Chelmsford
Laura Mr. Wright-
Chelmsford
Westford
letechnsford
May 12, 1895. Relais Mr. Dutton
[Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 306 ; Acts of 1539, 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 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.
-
10/
Plate.
Ed. Jan. 23, 1894. 5,000.
[ACTS OF 1889, CHAP. 208.] AN ACT
IN RELATION TO THE RETURNS OF BIRTHS AND DEATHS.
Be it enacted, etc., as follows :
SECTION 1. The clerk or registrar of cach city 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 city or town during the previous month, whenever the deccased person or the parents of the child born, were resident in any other city or town in this Commonwealth at the timc. of said death or birth; and shall transmit said certified copies to the clerk or registrar of the city or town in which such deccased 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 can be ascertained ; and the clerk or registrar so receiving such certified copies shall record the same in the books kept for recording deaths or births. Such certified copics shall be made upon blanks to be furnished for that purpose by the secretary of the Common- wealth.
SECTION 2. This act 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
recorded in the books of the City of Lowell
(City or Town. ) during the month of. September 18 q5.
1. Date of Death, . September 14, 1895
2. Name,
Samuel D Whittier
(Maiden Name), . (Name of Husband),
3. Sex, and whether single, Married, or Widowed,
Male
Married
4. Color, .
5. Age, 40 Years,
Months, Days.
Disease or Cause of Death,
Injury of both legs
6. {Duration of Siekness, By whom certified,.
I. Harrol M. D
7. Residence,
So Chelmsford
8. Occupation, .
Railroad Employee
9. Place of Death, .
St Johno Hospital
10. Place of Birth,
Lawsiner Mars
11. Name of Father,
Jeremiah
12. Name of Mother, (Maiden Name.)
-
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment. .
I certify that the foregoing is a true copy.
Attest :
Kara 3
Clerk.
(City or Towh.)
Edson Ginster Lowell Maro,
18
102
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,. October 16
IS J Name,.
Bridget htc orally
Maiden Name,
Sex,
male ; Color, ...
Single, Married or Widowed,
Age, 2 8 years,
months,
days.
Name of Attending Physician,
Residence of Deceased-No. Worth Thelin ford Street (or Corporation), Ward
Occupation,
Cotton mill
Husband's Name,
Place of Death-No. Uro Chiliwofford
Street (or Corporation), Ward
Birthplace of Deceased,
Ireland
Father's Name,
Patrick
Father's Birthplace,
Mother's Name,
Sarah
Mother's Birthplace,
Maleape
Mother's Maiden Name,
Place of Interment
Cemetery Range
, Lot
, Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
16.
day of
October
1895
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death,
Oct 16h
18905
Name and Sex of Deceased.
Bridget Ms Mally
.. male.
Place of Death-No. north Chelmsford
Street (or Corporation).
Disease or Cause of Death,
Consumption
duration of * dont Know as
Iwas only consultial na professionally Complications,
I certify that the above ista true' return to the best of my recollection and belief.
Name and Professional Title,
Residence, No North Chelmsford
Street,
Dated at Lowell, this 1700
day of
October
* Reckoned to the time of death.
ID new sserestar to fill the lan's and strike out words that are not correct such as afreefor corporation singles married or widget
and Roses "h" before
Re
RETURN OF DEATH
OF
189 ... .
103
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,
Oct 22
189
5
Name,
Still born
Higgins
Maiden Name,
Sex, Emale; Color, white
Single, Married-or Widowed,
Age,
years, - months, - days.
Name of Attending Physician,
Howard
Residence of Deceased-No.
Chelmsford Centerstreet (or Corporation,) Ward.
Occupation,
Husband's Name,
Place of Death-No. Chelmsford Center
Street (or Corporation), Ward
Birthplace of Deceased,
Chelunsford Center
Father's Name,
David Higque Father's Birthplace,
Chelmsford Center
Mother's Name,
Delia
Mother's Birthplace,
Ireland
Mother's Maiden Name,
Naughton
Place of Interment,
Catholic
Cemetery, Bange.
, Lot
, Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
22 Bu.
day of
De/-
IS9 5
Physician's Certificate of the Cause of Death.
Date of Death,
act. 22 ml
(See extracts from Acts of Legislature below.)
Name and Sex of .Deceased,
Emale.
Place of Death-No.
Street (or Corporation).
Disease or Cause of Death,
still born
duration of *
Complications.
I certify that the above tsy a true return to the best of my recollection and belief.
Name and Professional Title,. Umasa lavare MIL.
Residence, No -.
Chilmaford
Street.
Chilometri,
Dated at Lowell, this
Or4. 122
day of
October
*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 mole when the deserved is a female and when the decercet is colored please in art
O.Sowell
Rec
RETURN OF DEATH
OF
.... 189
No.
Commontocalth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Oct 24 6895
2. Name,
Jonathan Larcour
(Maiden Name),* (Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
Married
4. Color, t
5. Age,
/ Years, 2 Months,
21 Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . By whom certified,
7. Residence,
Chemsword
8. Occupation, .
Contractor,
9. Place of Death, . the cus ford Beverly
10. Place of Birth, .
11. Name of Father,
Bezcancer , arcom.
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, .
Y
7 Howard
DATED at
Chelaw ford, on
Oct 26, 1895-
* 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.
.......
2
Bever tu
Cherino
1201
........
[ Public Statutes, Chapter 32, as amended by Acts of 1838, 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 decease. If a physician negleets 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 lie 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 stid 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.
1000
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, ... Oct 24
189.
Name,
Willie & Boughton
Maiden Name,
Sex,
male ; Color,
(UKfreTi
Single, Married or Widowed,
Age, 12
years, 10
months, 20 days.
Name of Attending Physician,
Dr Howard
Residence of Deceased-No.
Chelong Lord Center Street (or Corporation), Ward
Occupation,
Husband's Name,
Place of Death-No.
Chelineford- Center Street (or Corporation) Ward
Birthplace of Deceased,
Father's Name,
William Oboughto Father's Birthplace
Mother's Name
Mother's Birthplace,
Mother's Maiden Name
Place of Interment,
Edm
Cemetery Range ... , Lot .. , Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
24
day of
189.5?
Physician's Certificate of the Cause of Death.
Date of Death
Oct. 23.
(Seg extracts from Acts of Legislature below.)
Name and Sex of Deceased, ..
Millie 8. Boughton
1800
male.
Place of Death-No ..
Chilmatos
Street (or Corporation) .
Disease or Cause of Death,
aberration stomach
. duration of*
Complications, ..
aronie Cystitis
I certify that the above is a true return 16 the best of my recollection and belief.
Name and Professional, Title, ..
amaratoward 1,8:
Residence, No.
Street,
Dated at Lowell, this
24mm
day of
Oct.
1890-
* 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 malo when the deceased is a female in when the
RETURN OF DEATH
OF
18g
106
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowell.
Date of Death, h 30th
Undertakers must make this return before the burial or removal of the deceased,
Joseph 9. Guessy : Sex male ; Color,
Maiden Name,
-Single, Married or Widowed,.
Age, 5) years, - months,
Name of Attending Physician, De Harlow Tyngelow
Residence of Deceased-No.
Wheat chelmsford
Street (or Corporation,) Ward
Occupation,
Carpenter
Husband's Name,
Place of Death-No. Test Chelmsford
Street (or Corporation), Ward
Birthplace of Deceased Canada
Father's Name, ... John Pressy
Father's Birthplace, .
Canada
Mother's Name,
may
Mother's Maiden Name,
Mother's Birthplace, ugh known
Place of Interment,
Cemetery, Range'
, Lot
Grave,
Signature of Undertaker or Informer,
June 4. Donnel
Dated at Lowell, this
day of
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death,
Belobien
80 !!
Name and Sex of Deceased,
Joseph lo Quesoy
male.
Place of Death- Werd chelmsford
...
Street (or Corporation).
Disease or Cause of Death, Pulmonary Phthisis duration of * 18 mounting
Complications.
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
D. P. Harlow 1. 20
Residence, No.
Tyngsboro
Freet.
Dated at Lowell, this Theity first
day of
October
189 %*
2 days.
RETURN OF DEATH
OF
...
189
107
DY Howard
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, November 3, 1895.
Name, Iven Ohlson
Maiden Name,
Sex,
... male ; Color, La
Single, Married or Widowed,
Age, 10 years, ~ months, 30 days.
Name of Attending Physician,
Dr Howard
Residence of Deceased-No.
East Chelmsford
Street (or Corporation), Ward
Occupation,
Farmer
Husband's Name,
Place of Death-No.
East Chelmsford
Street (or Corporation) Ward
Sweden
Birthplace of Deceased,
Father's Name,
Oloff Ohlson
Father's Birthplace,
Mother's Name,
Christine
11
Mother's Birthplace,
..........
......
Mother's Maiden Name,
......
Unknown
Place of Interment,
Edson
Cemetery Range
... ... ?
Lot
,
Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
day of
November 180)
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death
how 3
189.3.
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,
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. ]
11
Name and Sex of Deceased,
Sven
Ohlson
male.
Rec
RETURN OF DEATH
OF
189 .
108
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,
clor 23 v1.
189 5.
Name, ...
Mary & Butter
Maiden Name, Chapman
Sex, ..
.. male; Color,
Single, Married or Widowed,
Age, 63 years, 8 months, days-
Name of Attending Physician,
Sareteir
Residence of Deceased-No.
Le hehmbard
Street (or Corporation, ) Ward
Occupation,
Husband's Name,
V
Place of Death-No.
Street (or Corporation), Ward
Birthplace of Deceased,
Father's Name,
Vital Chapman Father's Birthplace,
Mother's Name,
Betrag
Mother's Birthplace,
Mother's Maiden Name,
Damon
Place of Interment,
well Macemetery, Range
Lot , Grave,
Signature of Undertaker or Informer,
John of Hunbech
Dated at Lowell, this
day of
IS9 5,
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death,
afvi 29-201
Name and Sex of Deceased,
Mary & Butter
male.
Place of Death-No.
Street (or Corporation).
Disease or Cause of Death,
lancer
duration of * About 4 025 years.
Complications.
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
that ISSmeeten m.Il.
Residence, No. 276 Westford SSt.
treet.
Lamell Onass
Dated at Lowell, this.
24
day of Oran
1895-
*Reckoned to the time of death.
RETURN OF DEATH
OF
189
ł
1
109
Commonlocalthy 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,
Single
4. Color, j
5. Age, 81 Years, 4 Months, 6 Days.
Disease br Cause of Death, (Primary and Secondary), ;
Pneumonia 4
two weeks
7. Residence,
Chelmsford
8. Occupation, .
Housekeeper
9. Placc of Death, .
Chelmsford
10. Placc of Birth, .
Peter Marshall
Mary Marshall
12. Name of Mother, . (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
Chelmsford
15. Place of Interment,
Signature of Undertaker or other person making the Return, .
of . Howard
DATED at
Chelmsford, ou.
1895-
* 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.
Nov. 13 , 1896 . Mara Marshall
6. {Duration of Sickness, . By whom certified,
Chehansford.
11. Name of Father,
[.Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 305 ; 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 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 perinit 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, carly cnough 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 suid 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.
Ed. Jan. 23, 1894. 5,000.
[ACTS OF 1889, CHAP. 208.] AN ACT
I'late. 110
IN RELATION TO THE RETURNS OF BIRTHS AND DEATHS.
Be it enacted, etc., as follows :
SECTION 1. The clerk or registrar of each city 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 city or town during the previous month, whenever the deceased person or the parents of the child born, were resident in any other city or town in this Commonwealth at the time of said death or birth; and shall transmit said certified copies to the clerk or registrar of the city 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 can be ascertained ; and the clerk or registrar so receiving such certified copies shall record the same in the books kept for recording deaths or births. Such certified copies shall be made upon blanks to be furnished for that purpose by the secretary of the Common- wealth.
SECTION 2. This act 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
recorded in the books of the. „of (City or Town.) during the month of. November 1885
1. Date of Death, .
Now 7. 1895
2. Name,
Oda - Isacson
(Maiden Name), . (Name of Husband),
Charles
female
3. Sex, and whether single, Married, or Widowed,
4. Color,
32 Years,
Months; 10 Days.
Pulmonary Tuberculosis
(Disease or Cause of Death, 6. Duration of Sickness, By whom certified,. .
2+2 years
7. Residenee,
No Chelmsford Mass
8. Oeeupation, .
Grove Hall Consumption Home
10. Place of Birth,
11. Name of Father,
Andren
12. Name of Mother, (Maiden Name.)
Christina Achusar
13. Birthplace of Father, .
Sweden
14. Birthplace of Mother, .
15. Place of Interment, £
. I certify that the foregoing is a true copy.
Attest : James O. taller
l' aux betyr
18
(rm Town.)
Anderson
5. Age,
9. Place of Death, .
Rec No.
Commonfocalth 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),*
-
Male
Widener
White
4. Color, t
›. Age,
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