USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1894-1897 > Part 19
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Name of Attending Physician,
W. O. Sleeper
Residence of Deceased-No.
M'ent Chelmsfordl
Street (or Corporation), Ward
Occupation
Housewife
Husband's Name,.
Charles S. "cartes
Place of Death-No
el, Thelmafinal
Street (or Corporation), Ward
Birthplace of Deceased,
Lavill ans
Father's Name.
Free, Pul Coburn Father's Birthplace,.
Swell Kurz
Mother's Name,
Mart C Coburn Mother's Birthplace,
Maine
Mother's Maiden Name,.
Pilartha O. Russell
Place of Interment,
Celou
Cemetery, Range
., Lots
, Grave,.
QB Courrier.
Signature of Undertaker or Informer,
Dated at Lowell, this
25ch
day of
auch
IS9
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.)
- Date of Death
mar 28'
Name and Sex of Deceased, In ferris
Cartão
Place of Death-No.
.....
(When the child is still-born, so specify.)
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
... male.
Street (or Corporation).
Rec
RETURN OF DEATH
OF
:
189
1
Rel
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 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 ehild born, were resident in any other eity or town in this Commonwealth at the timc. of said death or birtli; and shall transmit said certified copies to the elerk or registrar of the eity or town in which snell 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 sueli deceased person or parents so resided, whenever the same ean 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 effeet 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 Joun of Medfuld 1
(City or Town.)
during the month of March 1897
1. Date of Death, .
March 27, 1897
2. Name,
Hattie E. Hutchins
(Maiden Name), . . (Name of Husband),
Inigle, fernale.
4. Color,
48 Years,
Months, x Days.
Organic Brain Disease
Disease or Cause of Death,
Several years.
6. Duration of Siekness, By whom certified,. .
Edward French, M.D.
Chelmsford, Mais.
7. Residence,
Mine
8. Oceupation, .
Medfield Insane asylum.
9. Place of Death, .
10. Place of Birth,
11. Name of Father,
Matthias
12. Name of Mother, (Maiden Name.)
13. Birthplace of Father, .
14. Birthplace of Mother, . 15. Place of Interment, .
Carlisle, Mais.
I certify that the foregoing is a true copy.
Attest :
Stillman & Stream
.Clerk
(City or Town)
alire 2 1837
18%
P'late.
West-ford, Mass.
Emma g. (Ruga )
Carlisle Mass
Compton Canada.
3. Sex, and whether single, Married, or Widowed,
5. Age,
Ree
182
Commonlocalth 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),*
M
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age, 58 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, .
Valores
Chelmsford roland
Orven
Mary - Mc Quaid) Ireland 11
2 Themanon -
DATED at . Greenuford, on April 2 1897
* 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. Jan. 1895 - 5,000.
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263. ]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, 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; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that suel a child died after birth or was born dead. If a physician neg- leets or refuses to make a certificate as aforesaid, or makes a false statement therein, 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 sneh 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 a human body 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 eity or town elerk. 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 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 seetion 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 eannot 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 elerk, make suel 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 forth- with countersign and transmit the same to the elerk 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 deatlı, as the clerk or registrar may require. Any person violating any of the provisions of this seetion shall be punished by a fine not exceed- ing fifty dollars.
Let
183
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
1 So 7
Name,
Maiden Name
Sex.
.. male; Color,
While
Single, Married or Widowed,
Age, -years.
months, days.
Name of Attending Physician,
De Schiller
Residence of Deceased-No.
Chemesford
Street (or Corporation), Ward.
Occupation,
Husband's Name,
Place of Death-No.
Chementand
Birthplace of Deceased,
4
Father's Name.
Onesine Saymon
Father's Birthplace,
Canada
Mother's Name,
Clarins
4
Mother's Birthplace,
Mother's Maiden Name,
Cemetery, Range
Lot
......... , Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
day of
IS9 7
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death
april 5th
1897
00
Name and Sex of Deceased,
Still Born
male.
Place of Death-No.
Chemilford
Street (or Corporation).
Disease or Cause of Death,
Premature butto
duration of*
Complications,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Da, ELchiller
Residence, No.
570 ment
Street,
Dated at Lowell, this
5
.day of.
april
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 feniale, and when the deceased is colored please insert. ]
Street (or Corporation), Ward
Place of Interment,
' (When the child is still-born, so specify.)
RETURN OF DEATH
Gagnon
1897
Rel
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN To the Board of Health and the Clerk of the cityvet kowymhelmshad
Undertakers must make this return before the burial or removal of the deceased.
Date of Death,
April 13
Name, John & Butterfield
Maiden Name, ..
Sex.
.male ; Color,
SinNe, Married or Widowed,
Age, 59 years,
8
months,
17 days.
Name of Attending Physician,
In Martin
Residence of Deceased-No.
no. Chelmsford
Street (or Corporation), Ward
Occupation,
Machinuse
Husband's Name,
Place of Death -No.
No. Chelmsford
Street (or Corporationi), Ward
Birthplace of Deceased,
Tyngsboro mass
Father's Name,
James
Father's Birthplace,.
",
Mother's Name,
Rachael
Mother's Birthplace, .
Parham
Mother's Maiden Name,
Place of Interment,
No. Chelmsford
Cemetery, Range
, tot-
Grave,
,
DAGunier
Signature of Undertaker or Informer,
Dated at Lowell, this
14 th
day of
Abril
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death,
April 13
IS92.
Name and Sex of Deceased,
John H Butterfield
male.
Place of Death-No.
harth Chelmsford Mass
Street (or Corporation).
(When the child is still-born, so specify.)
Disease or Cause of Death,
Accident
duration of*
10 days
Complications,
Hypostatic) pneumonia.
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Forrest Martini MO
Residence, No.
7.0
4th
Street,
Dated at Lowell, this
day of ...
184
*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 he deceased is a female and when the de exced is cale ela einschl
RETURN OF DEATH
OF
189
1835
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
april 14th
189.).
Name, 40
John 26 Dans
Maiden Name
Sex,
male ; Color,
Single, Married or Widowed, ..
Age,.
42 years.
months,
days.
Name of Attending Physician,
Ds Welch
Residence of Deceased-No.
East Chelmsford Street (or Corporation), Ward.
Occupation,
East Chelmsford
Husband's Name,
Place of Death-No.
Street (or Corporation), Ward
Birthplace of Deceased,
Billerica
Father's Birthplace,
Ireland
Mother's Name,
Budget- Oneill
Mother's Birthplace,
. .
Mother's Maiden Name,.
StPatricks Lenne nefery,
, Range
, Lot
, Grave, ..
Signature of Undertaker or Informer, ..
Jahn
OF Gamers
Dated at Lowell, this
12,001
clay of
abril
1897
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death
alm 14th
189
7
Name and Sex of Deceased,
John H. Sauce
male.
Place of Death-No.
Last Chelmsford
Street (or Corporation).
Disease or Cause of Death,
Phthisis
(When the child is still-born, so specify.)
duration of*
Complications,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Edward J. Welch M.S.
Residence, No.
4919annuel
Street,
Dated at Lowell, this
14等
day of
apr
*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,
Rec
Father's Name
Martin Leave
Place of Interment,.
RETURN OF DEATH John "A Laml) Are 15-1897
186
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN Town of thelong ford
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,
Afric 16
189>
.Name, ..
Sarah M. Putney
utney
Maiden Name,.
Lawyer
Sex.
male; Color, and
Single, Married or Widowed,
Age, 71 years, 4
months,
.....
days.
Name of Attending Physician,
Dattoward Chelmsford
Residence of Deceased-
Chelmsford muss
Street (or Corporation), Ward
Occupation,
Hansuite
Husband's Name,
Samuel Putney
Place of Death-No.
Chelmsford
Street (or Corporation), Ward
Birthplace of Deceased,
Buxton maine
Father's Name,
Barnabas Lawyer
Father's Birthplace,
Unknown
Mother's Name,.
4
Mother's Birthplace, .... "
/
Mother's Maiden Name& Richardson
Place of Interment
Lowell Anass
Cemetery, Range.
.. , Lot
, Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
day of
189
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death,
April 16X
IS9 7
Name and Sex of Deceased, Parahon Putney
male.
Place of Death-A.
Chelons fund mas
Street (or Corporation).
Disease or Cause of Death,
Paralysis
(When the child is still-born, so specify.)
" several months.
Complications,
old age -
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Amara Itoward m. D.
Residence,
Chelmsford
-Street,
duration of *
Dated at Lowell, this
day of .
afmil
*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 DEA'
OF
189
...
185
Lee
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
may
8
may gan
1 597 Game,
Daily
Maiden Name
Sex
male ; Color,
Single, Married or Widowed,.
Name of Attending Physician,
Peter
Age, .:
" ..... years.
months,
17 days.
Residence of Deceased-No.
Street (or Corporation), Ward
Occupation, .......
Husband's Name,
Place of Death-No.
Street (or Corporation), Ward
Birthplace of Deceased,
Chelmsford Mass
Father's Name
Thomas Daily
Father's Birthplace,
not There.
Mother's Name,
Treaser
Mother's Birthplace,
Scotland
Mother's Maiden Name,
lars
Place of Interment.
Cattolica"
Cemetery, Range
, Lot.
., Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this.
destur day of
189.22.
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death Julen 8
Name and Sex of Deceased,
Bail
male.
Place of Death-No.
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.
Residence, No.
23, Salad
Street,
Dated at Lowell, this
clay of
189.
7
*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 ff fe " male when the deceased is a female, and when the deceased is colored please insert.]
(-(When the child is still born, so specify.)
Name and Professional Title, tose E a true return to the
RETURN OF DEATH
OF
.......
:
189
......
.... .
Ree No.
Commonlocalthy of Massachusetts.
188
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
May 25-1897
2. Namc,
(Maiden Name),* (Name of Husband),*
3. Sex, and whether single, Marricd, or Widowed,
S
4. Color, t
5. Age, Ycars, &_Months, Days.
Acute Stomatite
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, .
11 Robert Stickwnie Maggie Sawney Ireland Face River
Lowell 1
Robert Shinkwin ......
DATED at
, on1
May 26
* 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. Jan. 1895 .- 5,000.
8 Bheemford
8- 8 hereford
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263. ]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, 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; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, 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 a human body 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 forth- with 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 exceed- ing fifty dollars.
Rec
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
2/1/1/4
I 89. 7
Name,
Ellen Device
Maiden Name
Sex.
male ; Color,
Single, Married or Widowed,
Age, 14
.years ...
months,
days.
Name of Attending Physician,
Residence of Deceased-No.
Merdans
Street (or Corporation), Ward
Occupation,
Husband's Name,
Place of Death-No.
Carlisle Easteheh . spor treet (or Corporation), Ward
Birthplace of Deceased,
Eastebel ford
Father's Name.
Ellenc Devine Mother's Birthplace,
Mother's Maiden Name,
Place of Interment
Catholic Lowce
Cemetery, Range
Lot
Grave,
Signature of Undertaker or Informer,
A Mille Dejinett
Dated at Lowell, this. day of IS9 .......
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.)
Date of Death
4
189.
نبه
Name and Sex of Deceased,
Ellen
... male.
Place of Death-No.
Carlisle 88, 8, Chelisty
Street (or Corporation) .
(When the child is still born, so specify.)
Disease or Cause of Death,
Far
af 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.
295 (Suite
Street,
Dated at Lowell, this.
day of
189
* edtonel in the time of death.
189
Father's Birthplace,
Jeland
Mother's Name,
Ellenc Quinua
RETURN OF DEATH Ellen" Devine
a
190
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 June 239
1897
Name,
Almerco H Laverae
Maiden Name
Age, .
803 years,
S.months,
days.
Single, Married of Widowed,
Name of Attending Physician,
Dr Neuneys
Residence of Deceased- North Chleuspore Street (or Corporation), Ward
Occupation,
at Home
Husband's Name, James Janete
Place of Death-No Waith (Utens hora or Corporation), Ward francistown
Birthplace of Deceased,
Father's Name,.
William Hyde
Father's Birthplace, ..
Avon Com
Mother's Name,.
Mother's Birthplace,
Billerical Man
Mother's Maiden Name,
Marshall
Place of Interment,
North Phlesuspen Cemet & Menge
Lot
, Grave,
Signature of Undertaker or Informer, ..
Dated at Lowell, this
day of
IS9
Physician's Certificate of the Cause of Death. (SEE EXTRACTS FROM ACTS OF LEGISLATURE BELOW.)
Date of Death
June 23
1897
Name and Sex of Deceased,
Almera Il
Lovell
e male.
Place of Death-No. Thorth Chelmsford
Street (or Corporation).
Whey the child is still-born, so specify.)
Disease or Cause of Death,
Sulestru al Obslu chiên
... duration of*
one week.
Complications,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Da Varney
Residence, North Cheliefer.
Street,
day of fame.
189 )
Dated at Lowell, this
Sex, Le male; Color,
RETURN OF DEATH
OF
Almera N. Lovell. france 23 1897 ... ....
191
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
June 26
1897
Name,
Dora B Pike
Maiden Name
Sex. Le male; Color, a.
Single, Married or Widowed,
Age,
68 years.
11
months,
20
days.
Name of Attending Physician,
De Holbrook
Residence of Deceased-No.
E. Chelmsford
Street (or Corporation), Ward,
Occupation
At home
Husband's Name,
Place of Death-No.
& Chelmsford
Birthplace of Deceased,
Street (or Corporation), Ward
Lelago Me
Father's Name
Oliver In Pike
Father's Birthplace,
Cornich the
Mother's Name,
Sally P
4
Mother's Birthplace,.
Epping /h.H
Mother's Maiden Name,
Page
Place of Interment,
Edson
Cemetery, Range
., Lot
Grave,
Signature of Undertaker or Informer, AMeunier
Dated at Lowell, this
day of
189
Physician's Certificate of the Cause of Death. (See extracts from Acts of Legislature below.)
Date of Death
June 26
1892
Name and Sex of Deceased,
Dora B Pike
Je.male.
Place of Death-No.
East Chelmsford
Street (or Corporation).
Disease or Cause of Death,
Heart Disease
(When the child is still-born, so specify.)
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.
275-
Street,.
Dated at Lowell, this
27 rt
day of
1897
the time of death.
hof Corporation single married it widowed and insert " fe "
Rec
RETURN OF DEALT
OF
189.
192
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowett,
Town of Chelmsford
Undertakers must make this return before the burial or removal of the deceased.
Date of Death
June 28th
Name,
Philip D Edmands
Maiden Name
Sex,
male ; Color,
Single, Married or Widowed,
Age, 80
vears.
4
months,
8
days.
Name of Attending Physician,
Dr Warner
Residence of Deceased-No.
East Chelmsford
Street (or Corporation), Ward.
Occupation,
Acermer
Husband's Name,
Place of Death-No.
E, Chelmsford
Birthplace of Deceased, .....
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