USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1900-1901 > Part 17
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Name, ....
Maria a Perham
Sex,
H
Color, Co.
Date of Death,
Sett 28
190/; Age, 67 Years,
11 Months
9 Days.
Maiden Name, { If married, widowed )
or divorced.
Maria a Byany
Husband's Name,
David C. Pertant
-Single, Married, Widowed or Divoreed,
Occupation,
Housewife
*Residence, { If out of town, )
¿ also state fully.
Chelmsford
Place of Birth,
*Place of Death,
"
Name and Birthplace of Father,
Solomon E, Bram Westford
Maiden Name and Birthplace of Mother, Hannah M. adams
Place of Interment, (Give name of Cemetery), ....
Forfatter Center
Dated at
Halten Perhang
on
Sefa 280
190€,
Signature and
place of business
of Undertaker.
Chelmsford
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
died at.
Chelingfra
JEfl. 25
190 /.
Primary, Disease or Cause of Death, ¿
Secondary,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Quer Pinti
M. D.
253 Central
Date of Certificate,
190/.
* Give also street and number, if any. | Give sex of infant not named. If still-born, so state.
{ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Maria a Pechan Age, 68%. /1 . D.
Duration,
5 days
Signature and Residence S of Certifying Physician.
No.
RETURN OF THE DEATH
OF
at
Date,
190
Filed,
190_
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
' SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued ritten statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When sul Latement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit th same to the clerk of the city or town for registration.
SECTION 5. Penalty for violation not exceeding fifty dollars.
Rec
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Julia In. + aubry
Sex,
Color,
Date of Death,
100/ Age, 84 Years,
Months,
Days.
Maiden Name, { { If married, widowed !
or divorced.
Husband's Name, ....... Single, Married, Widowed or Divorced, Occupation, at home
*Residence, { also state fully. S
( If out of town, }
West Cholinfond.
Place of Birtlı, Girland
* Place of Death,
Name of Father,
Birthplace of Father,
Maiden Name of Mother, not, inque Insland
Birthplace of Mother, ...
Place of Interment (Give name of Cemetery),
Dated at
Signature and place of business of · Undertaker. 1
IF Dowall
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Julia I Farley 61
Age,
M.
D.
Place and Date of Deatlı,
Disease or Cause of Death,#
Dieever of Heart-
Duration of Sickness,
I certify that the above is true to the best of my knowledge and belief.
JE Vaney
Signature and Residence of
City Physician. Oct. 14.
north Chelisten
M. D.
Date of Certificate 1901
* Give also street and number, if any.
t Give sex of infant not named. If still-born, so state. If child died immediately after birth, so state.
# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
5
THAOES HADA COUNCIL
died at Test Chelmsford Sept. 30- I
901
on.
247
No.
RETURN OF THE DEATH
OF
at
Date,
I
Filed,
I
Acts of 1897, Chapter 444. [EXTRACTS FROM SECTIONS 6, 7, 8, 10, II AND 12.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
1
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION IO. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION II. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars. SECTION 12. Any When'ient of a human body shall obtain the physician required by caf m. t.
ro, and rett. t, together with the facts n in which the death occurred.
248
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Ellen IRcarney
Sex, ........... Color,
Date of Death
Oct 1
190% ; Age, 10
.Years, ..
. Months, ....
... Days.
Maiden Name,
( If married, widowed }
or divorced
Husband's Name,
.......
Single, Married, Widowed or Divorced,
Occupation,
at Home
*Residence
{ If out of town }
Dreland
Place of Birth,
* Place of Death,
Chelmsford Center
Name of Father,
Francis Kearney
Birthplace of Father,
..............
Ireland
Maiden name of Mother,
.........
Rose An Morrison
Birthplace of Mother,
Place of Interment, (give name of cemetery)
Dr Patrick Cemetery
Dated at .. Jewell Mass
Signature and
James 4 1 Somcell
place of business
. of Undertaker
1324 Market Ir
PHYSICIAN'S CERTIFICATE.
Ellen Nharney
Age, TO Y-M -D.
Place and Date of Death,
died at
Chilmator, Drives, let,
19011.
Disease or Cause of Death, #
Phchiaro Pulmonalis -
Duration of Sickness.
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
Arthur Di Scobona
M. D.
of
City Physician
Chilmotor, man.
Date of Certificate
2
1901.
Agent Board of Health.
* Give also street and number, if any.
+ Give scx of infant not named. If still-born, so state. If child died immediately after birth, so state.
# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Canse.
TRAGES MAIN COUNCIL
Ireland
Name and Age of Deceased t
Chelmsford Center .
No. RETURN OF THE DEATH
OF
at
Date,
I
I
Filed,
Acts of 1897, Chapter 444. [EXTRACTS FROM SECTIONS 6, 7, 8, 10, 11 AND 12.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to tlie board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel sliall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which the vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION. 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION II. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the seco. r immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, tell dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance ch section Io, and return it, together with the facts required by section t, to the board of health or to the clerk of the city or town in which the death occurred.
Rec
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK.
ALL NAMES TO BE IN FULL.)
Name,
James Mellen
Sex,
male
Color,
. White
Date of Death,
Oct 3.1
190 / ; Age,
6%
Years,
3
Months,
14 Days.
{ If married, widowed
Maiden Name,
or divorced.
Husband's Name,
Single, Married, Widowed or Divorced,
MarriedOccupation,
Shoe maker
*Residence, { also state fully. § { If out of town, } Chelmsford mago
Place of Birth, Vermont
* Place of Death,
Chelmsford Mas
Name of Father,
Ebenezer Mellen
Birthplace of Father,
Vermont
Maiden Name of Mother,
Pulinda Muncon
Birthplace of Mother,
Vermont
Place of Interment, (Give name of Cemetery), Edson Cemetery
Dated at
Lowell
Signature and
B. M. young bles
33 Prescott St
place of business
O11
Oct 4 . 901
of Undertaker. 1
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased+ James Mellen Age, 67 %. 3 M 19 D.
Place and Date of Deatlı,
died at
Chelmsford act 3.1901
Disease or Cause of Death,#
Ahthisis -
Duration of Sickness,
Several years.
I certify that the above is true to the best of my knowledge and belief.
Umasa Howard.
M. D.
Signature and Residence 5. of City Physician. Chelmsford, Mark
Date of Certificate
Oct. 4 0
1901
* Give also street and number, if any.
+ Give sex of infant not named. If still-born, so state. If child died immediately after birth, so state.
# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
5
KIRAGESTORA COUNCIL
249
--
No. RETURN OF THE DEATH
OF
at
.. I
Date,
I
Filed
Acts of 1897, Chapter 444. [EXTRACTS FROM SECTIONS 6, 7, 8, 10, II AND 12.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. SECTION IO. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION II. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a liumai shall obtain the physician's certificate made in accordance with section Io, and return it, together with the required by section I, to the board of health or to the clerk of ti ty or town in which the death occurred.
Rec
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Raymond T Vinal
Sex,
Male. Color, white
Date of Death,
6 Oct 5
190 / ; Age, ..
~ Years,
7
Months,
20
Days.
Maiden Name, or divoreed.
{ If married, widowed į
Husband's Name,
Single, Married, Widowed or Divorced, desigle Occupation,
{ If out of town, {
*Residence, {also state fully. )
north Chelmsford
Place of Birthi,
north Chelmsford
* Place of Death,
Name of Father, Intim We Vina2
Birthplace of Father,
Tyngsboro Mass
Maiden Name of Mother,
Maris E Budoufra
Birthplace of Mother
England
north
Chelmsford
Place of Interment, (Give name of Cemetery),
Dated at
Signature and
place of business
of Undertaker. 1
33 Prescott Lf
O11
Oct 5
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Raymond I Tual
Age, - v 7 M 20
D.
Place and Date of Death,
died at
north Chelmsford Oct-5ª
1901
Pulmonary + Meningeal tuberculosis
Disease or Cause of Death, #
Duration of Sickness,
two weeks
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
City Physician.
Mont Chalinafer
Date of Certificate
Cel.54
1901
* Give also street and number, if any.
+ Give sex of infant not named. If still-born, so state. If child died immediately after birth, so state.
# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
5
250
JE Vaney
M. D.
No.
RETURN OF THE DEATH
OF
at
Date,
I
Filed,
I
Acts of 1897, Chapter 444. [EXTRACTS FROM SECTIONS 6, 7, 8, 10, II AND 12.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. . Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. SECTION IO. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts. SECTION II. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state tlie same. Penalty for refusal or neglect, ten Fars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section Io, and return it, together with the facts required by section I, to the board of healthi or to the clerk of the city or town in which the death occurred.
1
Page B
1
Abrahamson Victor 4 Anderson tua 46 Adams Charlas W.S. 4] Alderton Alice A, 8% Allard Josephat. 12. adams Laughton Mellen 177 adams Olis 179
adamson Martha
-
201
Bales Olive Boisvert Anna 12 Boudreau 38 Byany Arsulla Grace 40 Boisvert Frederick W. 45 Bileault Florida 56
Battles John Quincy 78 Bartlett Harriet w, 106 Bell Arthur 119 142
Brown Oliza Brown- 204 20%
Buntle Chester a.
Brown James 212 Boardman Hannah- 216 220
Bell
Barn Hilmot a. 232 Bellerose Olivine 237
C ...
Coolidge Ruch & 23 Garron Aderire Louis Doté 42 Callahan John 471 Callahan Nail basey Daniel W. 62 Burtin Siorias P. 88 Gumminão Hillard B. 96 bote Many 113 6ochran Deborah 116 Chaney Draw, 123 Gross Mary Anne 128 Clarke Alfred A. 143. Chapin arthur B. 185 Callahan Nellie 187 Callahan ann. 191
Cheeley Harrison Starren 231 bollich albert D. 243
Duffy Margaret Dutton HenriettaMl Duncan
6 14
DECarteret Reginald A 168 Eaton Henry E. ickey George R. 73 86
awson -
ay ( juorg) 97 /13
-122220
uffy Patrick 115.
Evine John 134. onovan Frank 9. 148
near .. . 152
Ou cette Mary Ellen 162 Lawson Elizabeth 194
Davis Riley 200
Donahoe Thomas L 206
Donahoe Michael L 22St
Falkhond Maria
239
1
Emerson Sarah P. 82 Emerson Henry 71. 214 Eaton Mary 218 219
A B
C D
1.
1
IT
١
١٠
٣
Glidden Nathaniel A. Gallagher ..
E F G H
Greenwood Anie 13 25 20 1 Gay Zuba 33 35 Gray Garter Thomas J. arlaced Samuel J. Gauthier Marie Gale Sylvia &1 Lookin Mary . 58 54 100 127 170 240 221
Jagnondonis H 18 Howard Mary H. 15
29 Hall George OS. 32 Hyde Charles 36 89 7/ Nagan Mary 124
92 Formlow 130 tollausby) Rose 104 Harrington /33 Harr Raymond GG 159 Hutchins Wealth Oma J, 140 Fiske Mary Fiske Oliver
183 Hoet Dron S. 149 190 Hodson Henry R. 151 Humphrey Sarah A. 160
Hills Lizzie R. 161
Holt Marcha 169
Holland margaret 180
Hartwill Lora M. 202 Haggerty John 205 Hulbert 233
lovey)
Finnick Thomas 1 Fanning William Fletcher SarahM Fletcher Robert fallon tefredag
71
Hall Lonisa S. 240
Page
i
Kelley Catherine 1
9 Kilbourne Margaret Kinch
61 70 Kennedy HarrietMl. 109 Reisen Hugh / 71
Faceland William @dams 211
I
Orich Emma nunca 163
1
Jaffray John f.
Josselyn Carrie A. 90 147
1 Leyden Sarah A
Jahuay Ralph & 26
Joker Harinah 3/ Lambert Mary Alice 32 Levering Odward N. 67
Lambert Lucie 51 Lovrien Almira S. 85 Larkin Ollacc 11 Lee 114 Numbers Jete Dar 2 121 Lafortuna Deluca 145 Larkin Ellen 174 Longley Eliza 181
1
Loucroft, Many Helen 195 Lambert Mirlael 217
Lussier Mathilda 236
J
K L
Manseau Laura Meldrum Robert Merrill Henry A. Moore Mancare Henry Miller Viola March Ann Mungovan Mullen Margaret Murray Patrick- morrill albert
21 MC Mahon Catherine 28 K Larney Anastasia V, 1) 60 ME mais 99 WEnancy Peter J.
27 149
10 rue Phillips HElau 74 80 83 91 110 1200 141 M2 199
120 M Gonnael Maxander 126 M Omnis Edward 175 He Garver faires 234 Me Clure William 242 1 Mullan Rose R, Me Cabe Terence
Mc Enaney Terrence mnalley Sarah.
Mcginnis Hannah 203
McEnaney Patrick 222 In Carthy Helen 226
Mc Larney Rose
238
.
Nault Henry 3 Needham Maria L. 188
C Odell Mary Jane O'Hara: Catherine Q
M Mc
75 N 196 0
Manseau Laura Meldrum Robert Merrill Henry A. Moore Mancard Hemen Miller Viola March Anno Mungovan Mullen Margaret murray Patrick Morrill albert
21 MC Mahone Catherine 28 11 Larney Anastasia V, 11 60 ME mais
99 Me Onany Peter J. the Phillips
120 Me Gomad Maxander 126 M Omis Edward 175 He Garver Jaimes 234 Me Clure William 242 1 Mullan Rose A. 120 141 192 1.99 Me Cabe Terence Mc Enamen Terrence Mnalley Sarah. mcginnis Hannah 203
Mª Enaney Patrick 222 In Carthy Helen 226 238
Mc Larney Roce
2 7 149 74 80 83 91 110 1
Nault Henry Needham Maria 2. 188
3
1
C Odell Mary Jane O'Hara, Catherine a
M M
75 N 196 0
P
Page
Proction Army B. Parler Manyto Paige Sarah L Beasley Mary A. Perry BranGEL 41
Parthurst Mary 8, 3, 63
Harhan, Hannah X.
Peterson Alice C. Parkhurst Derhaus Javid &
156 Pierce Priscilla 167 Need Sarah 3. 165 166
Pendergast Elia 168 Rochefort Alice See next Page
Parkhurst George a 172
Putman Mary 2.
Penniman Robert-
Perry abby- Parkhurst Tiske Ring
2 Quist Carl A. Quigley Elizabeth
R 2 Ralarge Alexander 20 Redmond William 24 Ripley Marion B. 37 Kand Vercy
10 22 42 63 Riley James 66
95 94 Ready Bridget 101 103 Richardson Alvah Howard 108 150 Reardon Michael 129
176 Shamphan Shades 213 Stevens Samson
215 Second Laura B. -225 Santamour Chrank Spaulding Mary A. L. Stevens Mesures.
Steams Margaret
Spaulding Julia A. Berton Matilda Schiefle George 89
Smith Elbridge 2 98
107 189 Shrinkwww. William F. 131 Stevens WilliamJ. 132 Sway Joseph 1351 Stade Prima Ml 137 Shields Alice 2.
Page
. 50 55 57 64 P Q 69 32 R
S
16 77
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1
Stackpole James f. Sargent Luther H. Salmon Clara A. Sullivan Margaret Spaulding Harriet a.
Sheehand mary
Sheehan
Symmes almira H.
Stickney Sylel H. Stuart John Lewis Sweetser Mary maria
Swift Robert A. 230
1
R Richardson William 186 Sutherland Maggie 139 146 153 155 173 178. Spaulding Benjamin & 193 197 198 208. 209 224 227
jt
:
Spaulding albert 78. 241 Spaulding Elizabeth I 244
1
T
Tucker Mary F. Thayer Homer &.
Tremblay Aberauch 154 Taylor William 182
Jyder George 76: 2.23
53 Yerville Eva 1/05
St- Vickery Yerville yvonne 14-4
Vinal Loggia a.S. 235
W
Webster William At. 1
Walsh Alicia & Wright Hannah A. Ward HElaw &
Westburg frederick 16 44 79 93 136 Whitman Charles IV 158 Winship Clara B. 164 184
Hyman John 71.
Walsh Joseph 229
-
T U V
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Rue
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
John H. Jeffreys
Sex,
Male Color,
white
Date of Death,
Oct 15
190/ ; Age, ..
88 Years
5 Months, 3 Days.
Maiden Name,
or divorced.
towed
Husband's Name,
Single, Married, Widowed or Divorced Wederved Occupation,
Farmer
*Residence, { If out of town, )
also state fully.
West Chelmsford Mass
Place of Birth,
Canada
*Place of Death,
West Chelmsford mass
Name and Birthplace of Father, unknown
Maiden Name and Birthplace of Mother, .. West Chelinsford 1
Place of Interment, (Give name of Cemetery),
Dated at
Lowell
Signature and
I. m young tles
33 Prescott St-
place of business
of Undertaker.
on
Act
16.
190 €
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Shut Jeffrays died Week Chaleurfort
Age, 88 4. 5 M 3 D.
Det-15 1907.
Disease or Cause of Death, ţ Secondary,
Primary,
Hemiplegia
Duration,
4 days
Duration,
I certify that the above is true to the best of my knowledge and belief.
JE Varney
M. D.
Signature and Residence
of
Certifying Physician.
north Cheleurfen
Date of Certificate,
Od-15-
190/.
* Give also street and number, if any. t Give sex of infant not named. If still born, so state.
{ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No.
-
RETURN OF THE DEATH
OF
at
Date,
190 ...
Filed,
190
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a deathi oceurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In easc the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the faets required by section 1, to the board of health or to the elerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate arc delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the cie town for registration.
" SECTION 5. Penalty for violation not exceeding fifty dollars.
Rue
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Henry B Proctor
Sex,
Color,
To
Date of Death,
Cer, 8
1900 ; Age,
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