USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1898-1899 > Part 3
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Adams Laura A. Ashworth James 86 Brown Hiram 1
Aquece Alice 2. Adams Sinwhy Adana Clara A. M. Ayar James H.
15 Wronwant Arthur
Nudestore Audrew 129 Brett Mary
137 Blood Samuel
164 Bray these
176 Butters George & 47
22X Bussell Emma 2 8/9 Brown Ronaldo
Butterfield Namah 7. 118 Bremser William 123 Bartlett Charles 8.8, 142 Boyuton James Brown Janet M 159
Boulay Charlesm. 186
- Blood Marcha 7, 208 Brown Mary 222
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Brown Frances £ 2x2
Page 8 21 31 34 44
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Gook Sarah On Corrigan Ann
Chandler) Villie 90
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book Williame Carlson Nellie 105
Erburu Betsey 125 Book May 213 Carlton Electrall, 215
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Dunn Vera Leslie Davis Here IT. Jam Melone O.
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24 Farley Julia M.
Durant Thomas 26 38
Duffy Thomas P.
Durant George &. Dwell Clifford
68 80
Downes tired
84
97 Dunne Ginevra J.
NECarterEt Ann, M 119
Watins Mande M. 126 Daley Daniel 136
Patrick 139
4 Foster Abigail W
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Detron Edwin 6. 231
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Giannell Amalia 77 gervais Francois f 88 Jorge Daniel M. 102 Diilson Alva 100
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16 Kelley Chedrew 17 Reisen James 69 Kelley Elizabeth Amet Clarissa P. 72 Ridder Shallow F. Hodgson Samuel Hoyt Lucy L.
Huntoon Mores 6. Hart William &
Harrington 107 Hall Elizabeth B. 121 14.5 Hazen James A. Hanson Onos X. 148
Fiale Oliver A. 149 Hall Ornest W. 163 Hutchins Matthias 173 Hardy James il 182
78 Randrick Dalia 92 Kelley Violet O. 94 Ruawalton Rate Of. 96 innball Namalo 2 Keinen Thomas Kearney Ellen
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Page
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2 Malvin Alonzo 2 12 Meaday Ada J. 23 32 22H Glinchey Been 33 MerVally Alice 37 42 43
2 40 Heads Leonard 52 Mc Quade Mary B.
55 Morning Machen 50
Magnaut Adele 62 Mc Naughtuse Natten P. 6X Mooney Ann- Mc Emaney Mary 70
Marcel Harry L. >/ L
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M Lichfield Paul F. 198 He Garvey Thomas !!! 101 Loucroft Bridget 20/ 95 N O Lambert Marie Rose 228 Magnus Simon 104 Le Duke David 234 Mooney Frank A. 106 'P Larkin Margaret 239, Mulno Odich L, 112 Q Lawrence Alma Grazie 241. Mc Glym James 128
UN Nulty Patie 100
R Marshall Werch & May 131 S 11ª Nalles I Johns 135 Nichols John H.
1/ Manomin Janic 132 U No Giri Cassia 166 V Mcnulty Mary A. 172 W Ile Nulty Rose 177 Y Nicholson James 6 179 7 145
Page
Larsine Winnifred Lamplere Frank de Lains Aswath 6, Lancome Harriet O.
Panphere Albion Lambert Semana WC Lewis Lucy Af.
81
Lafram Nathan J 72
Parkinn Anna 100
Vemay George W Lambert Joseph P.G 146
Lowney
M . Murphy, Veronica 181
Mc Blusky Mildred 184 HoBlusky Mabel 184 Michel Graziella 20
218
Moore Charlotte S.
Macdougall Willie T. 219 McGramer 221
Morally James X. 232 Moore Olla f. 238 Mallen James 249
O'Keefe 0
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Parkhurst dwie R. 27
Revere JimmieVi
REardon 46 Perkau Samuel Q. 61
Proctor George W 39 Parhan Albert & 51 Randlast James 58 Johnson Frank WV. 60 Perham Lizana N. 6% Russell E. Lincoln 76 Patches James W 79 Richardson Edward 2. 147 Roddy 165
Define S. Thomas 82
Perry Marie 89
Plante Rose 116
Parker Newell 133
Randall tammie V. 188
Ripley Julia S, 212
Pullau Harriet 154 Reed William H. 230
Parler Alfred E, Parker Arteinas
156
168 S' 109 Sheldon Julia 2 6
Stevens Walter Gr.
Pickard Carleton M. 17% Back John Nesmith 306 Shaw Elisha 7. Pickard William It, 216 Store Wiecard 2. Perhan Maria, 246 Shields Margaret
29 +/P 59-0 63
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57 Stevens Edel .
92 103
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Spaulding Jacob 113 Staples William H. 122 Safford Harry 8. 124 Sheamus Almina
Y Z
144 Stavila Benjamin /SV
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Page 3
Richardson Elizabeth 183 Ryan William of 185
Pattern Soth N. " 153
Purcell Jamie
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
Mario 19
189 8
Name,
alanza IL Afelvis
Maiden Name
Sex,
male; Color,
White
Brasil
Age, 58 years,
5
months,
14 days.
Single, Married or Widowed,
Name of Attending Physician,
Residence of Deceased-No.
Street (or Corporation), Ward
Occupation,
Husband's Name,
Place of Death-No.
Peterband ra
Street (or Corporation), Ward
Birthplace of Deceased,
Father's Birthplace,
Lawell muss
Mother's Name,
Mary L
Mother's Birthplace,
Exeter NH
Mother's Maiden Name,
L Leighton
Place of Interment, .
dawell
Cemetery, Range
,
Lot ..
Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
day of
189 8
Physician's Certificate of the Cause of Death. (SEE EXTRACTS FROM ACTS OF LEGISLATURE BELOW.)
Date of Death
april 14
1898
Name and Sex of Deceased,
alamad
2
Kelvin
male.
Place of Death-No.
Chemwarf
re
مصـ
Street (or Corporation).
Disease or Cause of Death,
Heart disease
(When the child is still-born, so specify.)
duration of*
Complications,
gropay
I certify that the above is a true retirarto the best of my recollection and belief.
Name and Professional Titled Quar Porter m.V.
Residence, No.
20-3
Central
Street,
Dated at Lowell, this
day of
april
189
Father's Name,.
Quean Milion
-
-
₹
CETUGN OF
OF
189
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 20#
189 8 ...
Name,
George febsier.
Maiden Name
Sex,
male; Color,
Single, Married or Widowed,
Viarrud
Age,
48 years,
7
months,
days.
Name of Attending Physician,
Dr. Howard
Residence of Deceased-No.
Chelmsford
Street (or Corporation), Ward
Occupation,
lecarpenter.
Husband's Name,
Place of Death-No.
6. le helmsford
Street (or Corporation), Ward
Birthplace of Deceased,
Father's Name,
Cliphalet Webster
Father's Birthplace,
Unknown
Mother's Name,
Harriet Webster
Mother's Birthplace,
Mother's Maiden Name,
Place of Interment,
Edson
Cemetery, Range
.. , Lot
, Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this
2/57
day of
1890
L
Physician's Certificate of the Cause of Death.
(SEE EXTRACTS FROM ACTS OF LEGISLATURE BELOW.)
Date of Death
A pril 20
189.
Name and Sex of Deceased,
, George Helster.
male.
Place of Death-No.
6. Chelmsford
Street (or Corporation):
Disease or Cause of Death,
Typhoid
Fever
duration of*
seven weeks.
Complications, .
I certify that the ghope is a true return, topthe best of my recollection and belief.
Name and Professional Title,
Umasastoward
M. D.
Residence, No.
Chelmsford
aster.
Street,
Dated at Lowell, this
219
day of
april
189 %.
(When the child is still-born, so specify.)
ELLEATH
OF
189
Rer
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 21 RA
.189 &.
Name,
Jennie W.
Revue.
Maiden Name
Jennie Ir Houdgedon
Sex,
Female; Color,
white
Single, Married or Widowed,
manved
Age,
62 years, 1.
months, / 7
days.
Name of Attending Physician,
Dr. Howard
Residence of Deceased-No.
Chemsford Center
Street (or Corporation), Ward
Occupation,
Husband's Name,
nathan & Revere
Place of Death-No.
Chemsford Centro
Street (or Corporation), Ward
Birthplace of Deceased,
South Berwick Maine
Father's Name,
John
Mother's Name,
Unknown
Father's Birthplace,
Mother's Birthplace,
york
Mother's Maiden Name,
Place of Interment,
Leder
Cemetery, Range
, Lot
Grave,
Signature of Undertaker or Informer,
Dated at Lowell, this.
Qwerty Just
day of ....
apul
189
Physician's Certificate of the Cause of Death.
(SEE EXTRACTS FROM ACTS OF LEGISLATURE BELOW.)
Date of Death
april 21 RA
189 ....
8
Name and Sex of Deceased,
Jennie L. Revere
Place of Death-No.
Chemsford center
Street (or Corporation).
Disease or Cause of Death,
Consumption
(When the child is still-born, so specify.)
duration of*
8 months
Complications,
Blood poisoning following removal of tumor.
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title,
amarastoward M. G.
...
Residence, No.
Chelmsford
Street,
day of
a/n.
1898
Dated at Lowell, this
2,0%
-
3
JE male.
..
... ..
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, .
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 Siekness, . By whom certified,
7. Residenee,
8. Oeeupation, .
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 A Sheldon
DATED at. N. Chelmsford
April 25th 98
* If a Married Woman or Widow. # If a Soldier who served in the War of the Rebellion.
j 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.
April 25th 1898 Thomas P. Duffy
Male
Single
White
2 Years, 3 Months, 13 Days.
Sixme
m.g. Brown Ph. D.
North Chelmsford Mais
North Chelmsford Mass. North Chelmsford Mass, Thomas P. Duffy
Margaret (1" Nalle) Duffy Ireland Ireland Lowell Mass
[Public Statutes, Chapter 32, as amended by Acts of 1888, 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 aforcsaid, 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.
Commontocatthy of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
april 26 Vera Perlie Driver
(Maiden Name),*
(Name of Husband),*
Female
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age,
.Years,
10
Months,
2) Days.
Disease or Cause of Death, (Primary and Secondary), #
6. (Duration of Sickness, . By whom certified,
of P. Yenithe MID Chehansford
7. Residence,
8. Occupation, .
Chelansford
Chelans ford
10. Place of Birth, .
11. Name of Father,
Ser Anche Mackenzie
12. Name of Mother, (Maiden Name),
Great-Pound Ite &
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Chelensford
Signature of Undertaker or other person making the Return, .
Allbert- P. Perhan
DATED at
Chelons laich, on ...
Oltre 27
1898
* If a Married Woman or Widow. 4 If a Soldier who served in the War of the Rebellion.
t If other than White. (31.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.] l'late. Ed. Jan. 1895 .- 5,000.
11
9. Place of Death, .
[ 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- 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 such certificatc 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 certifieate 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 eity 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 certifieatc arc 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 finc not exceed- ing fifty dollars.
6
Commontucatth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death, .
2. Name,
(Maiden Name),* (Name of Husband),*
George T. Sheldon 4 Ripley
Female
Married White
69 Years, 10 Months, 28 Days.
Myocarditis Six Weeks
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
Lunenb Mais
Lewis Ripley
12. Name of Mother, (Maiden Name),
Sophia (Gardner) Ripley Walpole N.N.
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return, .
Arthur H Sheldon
DATED at,
N. Chelmsford, on May 3rd
189.8
* 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. Dec., 1596 .- 5,000.
1
Rel
May 2nd 1898 Julia L. Shaldon
3. Sex, and whether single, Married, or Widowed,
4. Color,t
5. Age, Disease or Cause of Death, (Primary and Secondary), #
Melvin A. Brown M. D. North Chelmsford. Housekeeper
North Chehurford
11. Name of Father,
Temple NA.
North Chelmsford
[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 regi -- 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- 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 eause 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 sueh 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 lien 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, inake 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 certifieate 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 elerk 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.
- ki
Undertakers must must make this return before the burial or removal of the deceased.
Date of Death,
muy
189
8
Name,
Maiden Name,
Sex,
male : Color,
Single, Married or Widowed, Brown
Age, 19 years,
months,
days.
Name of Attending Physician,
Residence of Deceased- No. With Chilmagad
Street, (or Corporation), Ward
Occupation,
Operativo
Husband's Name,
Place of Death - No. Moral
-No. rood Guenford
Street, (or Corporation), Ward
Birthplace of Deceased."
granturile
Father's Birthplace,
Priland
Father's Name
Game
Mother's Maiden Name,
Cemetery, Kange
Lọt
.
, Grave,
Signature of Undertaker or Informer,
May
8
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,
manH
1898
Name and Sex of Deceased, Miniford. Larkin
male.
Place of Death - No.
North Chelmsford
Street, (or Corporation).
Disease or Cause of Death,
Consumption.
duration of
Complications, I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title, Melvin Brown MOD.
Residence, No. North Schelmsford
Street,
Dated at Lowell, this Fifth
clay of
may
1898
Mother's Name
many
Mother's Birthplace,
double Mason OF O Normal
When the child is still-born, so specify.)
OF
189
Rue
PLEASE FILL OUT WITH INK.
UNDERTAKER'S
RETURN
To the Board of Health and the Clerk of the City of Lowell.
Undertakers must must make this return before the burial or removal of the deceased.
Date of Death,
may 4
189
. Name, arthur Brennan
Maiden Name,
Sex,
male ; Color, ..
10
Age,
.years, .
3
. months,
days.
Single, Married or Widowed,
Name of Attending Physician.
J. Shelunsford
Residence of Deceased - No.
Street, (or Corporation), Ward
Husband's Name,
Occupation, ...
1. Shelunsford
Place of Death - No.
Street, (or Corporation), Ward ...
Birthplace of Deceased
Pita !
Father's Name,
Father's Birthplace,
Mother's Name,
maly S
Mother's Birthplace,
Mother's Maiden
Auscall
Voury Catholic
Place of Interment,
.
Lot
, Grave, ...
Signature of Undertaker or Informer,
Dated at Lowell, this
But: James . ODnel
day of
189
Physician's Certificate of the Cause of Death. (SEE EXTRACTS FROM ACTS OF LEGISLATURE BELOW.)
Date of Death,
may 4
1898
Name and Sex of Deceased,
Arthur Brennan
male.
Place of Death - No.
North Chelinsford
Street, (or Corporation).
Disease or Cause of Death.
Accident
duration of *
Two hours
Complications,
Shock,
I certify that the above is a true return to the best of my recollection and belief.
Name and Professional Title.
Melvin q. Brown M.D.
Residence, No.
North Chelmsford Street,
Dated at Lowell, this
fawith
day of
may
1898
Chelmsford
anderen
When the child is still-born, so specify.)
8
1
DET OF DEATH
IILIVIII
OF
189
Rec No.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
alpint 24 1898
2. Name,
Chercheur Kelley
(Maiden Name),*
(Name of Husband),*
Male
3. Sex, and whether single, Married, or Widowed,
16, 2%
4. Color, t
5. Age,
76
Years,
11
Months,
24
.Days.
ParceQue ir contraclecture
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Siekness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
*
Billerica
10. Plaee of Birth, .
11. Name of Father,
Andhuur Fellen
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, .
DATED at
Chelansford
, On
Apr 25.
1888
* 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 flll all Blanks.] l'late Ed. Jan. 1895,-5,000.
the Work of the Rebellion
E. H. ChangestanieM. D. Chiclana Smol
Frequser
Chelons lord
Billhired
Western
Lowell
[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 statiug, to the best of his knowledge and belief, the name of the deccased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease; aud 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 furnisli for registration a certificate, stating to the best of his knowledge aud belief the fact that such a child dicd 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 ease 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.
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