USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1894-1897 > Part 8
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24
1
81
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To theBe potterand the Clerk of the Congoof Lower elmayor
Undertakers must make this return before the burial or removal of the deceased.
Date of Death, April 25th
189 5 Name,
Maria Atwood
Maiden Name,
Sex, female ; Color,.
Singe, Married or Widowed,
Age, 6.6 years,
3
months,
2.
days.
Name of Attending Physician,
Dr Martin
Residence of Deceased-No.
& Chelmsford
Street,(or Corporation), Ward
Occupation, ..
At home
Husband's Name,
bra Atwood
Place of Death-No.
E. Chelmsford ..
Street (or Corporation) Ward
E. Chelmsford
Birthplace of Deceased,
Father's Name,
Jonathan Prece father's Birthplace,
Mother's Name,
Hannah ..
Mother's Birthplace,
Mother's Maiden Name, Harrington
Place of Interment,
Echton
Cemetery Range
powered
Grave,
Signature of Undertaker or Informer , ..
Dated at Lowell, this
20
day of
1896
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.) *
Date of Death
Chr 25#
18.5
Name and Sex of Deceased,
Maria Atwood
.. Ze. male.
Place of Death-No.
E. Chelmsford
Street (or Corporation) .
Disease or Cause of Death,
Carcinoma
duration of*
several years.
-year .
Complications,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
Formex Martin MD
Residence, No.
17 Krik x. (office)Street,
Dated at Lowell, this
206
day of
18905
& Bouncer
the:
RETURN OF DEATH
OF
18g
Rce
No.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
May 6th 1895
2. Name, Esperanza I Burns
(Maiden Name),* (Name of Husband),*
Emma I Hutchinson
Judson Ct. Burns
3. Sex, and whether single, Married, or Widowed, Married
4. Color, t
5. Age,
25 Years, 9 .Months, .. 18 Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whom certified,
7. Residence,
Chelmsford
8. Occupation, Housekeeping
9. Place of Death, .
Chelmsford
10. Place of Birth,
Westhow
11. Name of Father,
Arancio Hutchinson
12. Name of Mother, (Maiden Name),
Sarah S, Temple
13. Birthplace of Father, .
Heston
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return, .
S. R. Howard
DATED at.
Chelmsford, on May
6 ths 189.5.
* 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.
82
Hertford
[Public Statutes, Chapter 32, as amended by Acts of 1333, Chapter 305 ; Acts of 1339, 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 aforcsaid, he shall be punished by a finc not exceeding fifty dollars. In case the deceased was a soldicr 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.
t
83
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, 721 auf 13 189 5 Name, arech
Maiden Name,
Sex, ........... male ; Color,
Single, Married or Widowed,
Age, years,
months, 3- days.
Name of Attending Physician, D. Buzzsette
Residence of Deceased-No. Chchnsford Center
Street (or Corporation), Ward
Occupation, Husband's Name,
Place of Death-Not Chelmsford Center Street (or Corporation) Ward
Birthplace of Deceased,
Chinaferd hats 1 Father's Birthplace,.
Father's Name
Mother's Name Cavolider Mother's Birthplace,
Mother's Maiden Name,
Place of Interment
Cemetery Range
Signature of Undertaker or Informer,
Dated at Lowell, this
day of
189.25.
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death 15 hr
189€ 7
Name and Sex of Deceased, .....
..... .male.
Place of Death-No. 6.7.22-2 ×12 C. 11 Lez Corporation).
Disease or Cause of Death, 11.2. 222
duration of*
Complications, ..........
I certify that the above is a trite return to the best of my recollection and belief.
Name and Professional Title,
1 Residence, No. Office
Dated at Loweff, this
15 th
Theorelililly Street THE car day of 1895-
Ree
1
RETURN OF DEATH
OF
18g
1
Commonbocalth 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
4. Color, t
5. Age,
82 Years, 9 Months,. 21 Days.
Disease or Cause of Death, (I'simary and Secondary), ;
6. Duration of Sickness, . By whom certified,
7. Residence,
Chelmsford
8. Occupation,
9. Place of Death, .
Sharon Mass
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, (Maiden Name),
Benjamin Hadges Hannah Talbot Sharon Mass
13. Birthplace of Father, .
14. Birthplace of Mother, .
Sharon, Inass
15. Place of Interment, .
Chelmsford
Signature of Undertaker or other person making the Return, .
S. R. Howard
DATED at , on .
18
* If a Married Woman or Widow. 1 lf 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.
84
June 16th 1895 Benjamin J Hodges
Farmer Chelmsford
[Public Statutes, Chapter 32, as amended by Acts of 1838, 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 deceasc. If a physician neglects or refuses to make a certificate, as aforcsaid, he shall be punished by a fine not exceeding fifty dollars. In case the deccased 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 hercinafter 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 siid 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.
85
Commontocalth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
June 22nd 1895 Nythe Josselyn
2. Name,
11 Chandler
(Maiden Name),* (Name of Husband),*
Edwin Josselyn Female
3. Sex, and whether single, Married, or Widowed,
Widow
4. Color, t
5. Age,
White
79
Years, .....
9
Montlis,
22
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, .
Arthur H. Sheldon
Signature of Undertaker or other person making the Return, .
Amasa Howard M.D. North Chelmsford
North Chelmsford Merrimack N.N. Daniel Chandler Sarah (Danforth) Chandler Andover Mars
Merrimack N.H.
North Chelmsford
DATED ate at N. Chelmsford, On June 24th 1895
* 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.] l'late. Ed. September, 1892. - 5,000.
[ Public Statutes, Chapter 32, as amended by Acts of 1838, Chapter 305 ; Acts of ISS9, 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 ean 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 sueh board, or agent or clerk, as the case may be, a satisfactory written statement containing the faets 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 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 certifieate 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 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 death, as the elerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceeding fifty dollars.
86
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the dayone Inquel she lowshare
Undertakers must make this return before the burial or removal of the deceased.
Date of Death,
July 4
1895 Name, Christina
Jacolson
Maiden Name,
Sex, Le male ; Color, La
SinNe, Married or Widowed,
Age, 24 years,
2
months,
19 days.
Name of Attending Physician,
d. Es Jaren
Residence of Deceased-No. west Chelmsford
Street' (or- Corporation), Ward
Occupation,
At home
Husband's Name,
Emil Jacobson
Place of Death-No.
Passt Chelinsford
Street (or Corporation) Ward
Laeden
Birthplace of Deceased,
Father's Name,
Olavs Anderson
Father's Birthplace, ..
Mother's Name,
Brita
Mother's Birthplace,
Unknown
Mother's Maiden Name,
Place of Interment,
Edson Cemetery Cemetery
Lowell omactive,
Signature of Undertaker or Informer, ABCunico
Dated at Lowell, this
day of
189 .56 ..
Physician's Certificate of the Cause of Death.
(See extracts from Acts of Legislature below.)
Date of Death
July 4.
1895-
Name and Sex of Deceased, Christina Jacolson
Place of Death-No. volt 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
1
July
.
Al. male.
-
.
RETURN OF DEATH
OF
189
1
1
:
1
Tel
Commonbocalth of Massachusetts.
87
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
July 214 1895 Frankins
2. Name,
(Maiden Name),* (Name of Husband),*
Male- Single
3. Sex, and whether single, Married, or Widowed,
4. Color,t
5. Age,
2:5 Years Months, Days. Accidental Drowning
Disease or Cause of Death, (Primary and Secondary), # 6. {Duration of Sickness, . By whom certified,
J.G. Frish Medical Examiner
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, .
Laborer A. Chelmsford Mass
Glasgow Scotland
Scotland
frotlande
North Chelmsford
Arthur Ht Sheldon
DATED at July 22ma On July 2234 1895
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. f 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.
10.
[Public Statutes, Chapter 32, as amended by Acts of 1833, Chapter 305 ; Acts of 1339, 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 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.
Rec No.
Commontocalth of Massachusetts.
88
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
July 212 1895 Nathan le Beau
2. Name, (Maiden Name),* (Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
Nidonner
4. Color, t
5. Age,
7 6 Years ... 8 Months, 3 Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . -
By whom certified,
7. Residence, Chelmsford
8. Occupation, .
Harmin
9. Place of Death, .
10. Place of Birthi, Gloves NA
Samuel Bean
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 Q. T Howard
DATED at Chelmsford on July 21 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.
[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 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.
89
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,
July 28
1895-
Name,
Rachel E. Syer
ter
Maiden Name,
Sex, F Female ; Color,
Single, Married or Widowed,
Age,
....... years, .
2 months,
- days.
Name of Attending Physician, Or Varney
Residence of Deceased-No ...
Chelmsford
Street (or Corporation), Ward
Occupation,
.Husband's Name,
Place of Death-No.
Chelmsford
Street (or Corporation) Ward
Birthplace of Deceased,
George F.Dyer
Father's Birthplace, ...
Chelmsford
Mother's Name,
adelante
..
Mother's Birthplace,
new york
Mother's Maiden Name,
Fletcher
Place of Interment,
Edson
Cemetery Range
.... , Lot
Grave,
Signature of Undertaker or Informer
day of
1895-
Physician's Certificate of the Cause of Death.
Date of Death
July
280
(See extracts from Acts of Legislature below. )
Name and Sex of/ Deceased,
Rachel E. Dyer
female.
Place of Death-No.
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
* Reckoned to the time of death
189
Father's Name,
Dated at Lowell, this
2.8
RETURN OF DEATH
OF
189
-
- -
-- -
90
PLEASE FILL OUT WITH INK.
UNDERTAKER'S RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers mist make this return before the burial or removal of the deceased. Date of Death, July 29 189:3. Name, .. mon rad Gallagher
Maiden Name,
Sex, ..... male ; Color, .......
Age, Leo
years,
months,
........ days.
Single, Married or Widowed,
Van
Name of Attending Physician, Residence of Deceased-No: North Becerfre
Street , (or Corporation), Ward
Occupation,
Labora
Husband's Name,
Place of Death-No
North Chili for
Street (or Corporation) Ward
Birthplace of Deceased,
Учение
Father's Name,
not Know
Father's Birthplace,
Mother's Name,
many
Mother's Birthplace,
Mother's Maiden Namey Teagur
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.