Deaths 1900-1901, Part 18

Author: Chelmsford (Mass.)
Publication date: 1900-1901
Publisher:
Number of Pages: 308


USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1900-1901 > Part 18


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


82 Years,


6


.Months,


16 Days.


Maiden Name, { If married, widowed ) or divorced.


Husband's Name,


Single, Married, Widowed or Divorced,


Occupation,


Harmer


*Residence, also state fully.


{ If out of town, {


Chelmsford


Place of Birth,


er


*Place of Death,


Name and Birthplace of Father,


Azariah Procter, Chelmsford


Maiden Name and Birthplace of Mother


Suey Hodgeman "


Place of Interment, (Give name of Cemetery),


Forofaction Com.


Dated at


Chelmsford


Halten Penhamn


on


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.


Chelmsford


Oct. 18th 190).


Suile Debility


Duration,


Primary,


Disease or Cause of Death, ţ Secondary,


Duration,


I certify that the above is true to the best of my knowledge and belief.


Edward It. Chambulun


1


M. D.


Signature and Residence 3 of Certifying Physician. 183 Sivity Str. Sowell, Wars


Date of Certificate, Gelaten 19th 190 7.


* Give also street and number, if any. t Give sex of infant not named. If still born, so state.


t 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.


2


Age, 82 8. 6 M. /6 D.


No.


RETURN OF THE DEATH


OF


at


1


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 oceurs, 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 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 are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.


SECTION 5. Penalty for violation not exceeding fifty dollars.


Rec


FORM O.


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 Paul


Sex,


Hade Color,


Date of Death,


Oct 234


190/ ; Age,


4


.. Years,


.. Months,.


.Days.


Maiden Name,


3


or divorced.


Husband's Name,


Single, Married, Widowed or Divorced, Occupation,


*Residence, { If out of town, )


? also state fully. 3


West Chelmotorer


Place of Birth,


Thancheater


*Place of Death,


West Chelmoland mass


Name and Birthplace of Father,


Sao head Nauls Canada.


Maiden Name and Birthplace of Mother,


Julia Thran Canada


Place of Interment, (Give name of Cemetery),


Catholic Cinestar Lowell


Dated at


West Chelmsford


Albert of Lowell


on


Oct 27th


190 4


Signature and


place of business


of Undertaker.


3


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased,


Henry Mault-


Age, 4 Y.


M. D.


Place and Date of Death,


died at


West Chelmsford


Oct-27


190 ).


Disease or Cause


of Death, }


Secondary,


- Primary,


Membranous Crook


Duration,


24 hours


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.


ninth Chelivsfare


Date of Certificate,


Qel-27-


,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.


C


Agent of Board of Health.


1


-


1


{ If married, widowed }


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 eity 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 tlic 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 eity 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 are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.


SECTION 5. Penalty for violation not exceeding fifty dollars.


Rec


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, ...


Visitor abrahamson


Sex.


Color,


Date of Death,


1890/; Age, 2 Years, - Months,.


- Days.


Maiden Name,


{ If married, widowed }


or divorced.


Husband's Name,


Single, Married, Widowed or Divorced,


Occupation,


*Residence,


{ If out of town, }


( also state fully. §


Place of Birth,


Stich Efectuadoed Mar.


*Place of Death,


Name of Father,


Carlos 2. abrahamsson.


Birthplace of Father,


Maiden name of Mother,


Ida Charlot.


Birthplace of Mother,


C) weder.


Place of Interment, (Give name of Cemetery),


Great len atory Ih est Chuchusford Mark.


Dated at


Stort Schusford Mare


Signature and


4. Jagkhural


on


1890/.


place of business


of Undertaker.


Wert Che trasford Max


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, f


Place and Date of Death, }


Disease or Cause of Death, §


died at


When Chelmsford Nov. 7, 19:01.


accidental Burning_


Duration of sickness,


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


IN theigs hesruato medical Examiner


of


Certifying Physician.


160 Merrimack Is. Lowel Mass.


Date of Certificate,


now


7,


100%.


Give also street and number, if any. t Or 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.


1


Victor abrahamson


Age, 2 Y.


M. D.


If I selbstord Aline


No.


RETURN OF THE DEATH


OF


at


Date,


189


Filed,


189


The provisions of chapter 444 of the Acts of 1897 require that 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 oceurs, shall, within five days after the date of sueli a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred. (See section 6.)


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. (See section 7.) Penalty for neglect to comply with the requirements of seetions 6 and 7, five dollars. (See section 8.)


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. (See section 10.)


Penalty for refusal or neglect, ten dollars. (See section 11.)


Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certifieate 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 clerk of the city or town in which the death oeeurred.


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,


Otro 15


.100%; Age, 37


Sex,


Color,


Date of Death


{ If married, widowed }


Maiden Name,


or divorced


Michael f. Tenden


at home


Single, Married, Widowed or Divorced,


Q Arth Chelunsford


* Residence


If out of town {


[ also state fully, f


Place of Birth,


*Place of Death,


Name of Father,


Owen In. Brath


Diehand


Birthplace of Father,


Maiden name of Mother,


Aley M. Cabe


Birthplace of Mother,


...........


Place of Interment, Ngive name of cemetery)


St Patricks Cemetery


Dated at.


Signature and


place of business


on 1901


of Undertaker


324 Majet St


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased + Sarah a Dayden Age 37 x. 6


.M,


D.


Place and Date of Death,


died at


North Chelineford Nov. 15th 9mg


Disease or Cause of Death, #


Bright's Disease 1 Kidney


Duration of Sickness.


one year


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


JE Varney


M. D.


of


City Physician


H. chelmsford


Date of Certificate


november 16


1907


Agent Board of Health.


* 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.


TRADE COUNCIL) 5


.Years,


6 Months,


.....


Days.


Husband's Name,


Occupation


Queband


No. RETURN OF THE DEATH


OF


at


Date,


I


Filed,


I


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 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 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. 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 human body shall obtain the physician's certificate made in accordance with 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.


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,


rgaret Duffy


Sex


Color,


Date of Death


five 16


190 ; Age,


38 Years,-


Months,


Days.


Maiden Name,


or divorced


Husband's Name,


Thomas Duffy


Single, Married, Widowed or Divorced,


Occupation,


If out of town


North chel sford


*Residence


{ also state fully,


Place of Birth,


dieland


* Place of Death,


North chehisford


Name of Father,


Patrick die Nellay


Birthplace of Father,


dieland


Maiden name of Mother,


Sarah diebabe


Birthplace of Mother,


Juland


Place of Interment, (give name of cemetery)


At Patrick


Dated at ..


on Nove 16


I


of Undertaker


To Goslan


PHYSICIAN'S CERTIFICATE.


Margaret Duffy


Age,


38 %.


M.


.....


D.


Place and Date of Death,


died at


north Chelin ford


nov 16


I.


901


Duration of Sickness.


two years


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


JE Varney


M. D.


of


City Physician


n. Chelmsford


Date of Certificate


nov 16h


1907


Agent Board of Health.


* Give also street and number, if any.


t Give sex of infant not named. If still-born, so state. If chiid died immediately after birth, so state.


# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.


Read 100, 17


6


Name and Age of Deceased t


Consumption


Disease or Cause of Death,#


C


place of business


Signature and


IHMle Dernott


5


( If married, widowed }


No. RETURN OF THE DEATH


OF


at


Date,


1


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 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. 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 human body shall obtain the physician's certificate made in accordance with section ro, 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.


Recu


FORM C.


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,


Olive Bales


Female Color: White


Date of Death


nov 16


190 /; Age,


80 Years,


10


Months,


Days.


Maiden Name,


{ If married, widowed )


or divorced


Olive Blanchard


Husband's Name,


Samuel Bales


Single, Married, Widowed or Divorced Cudow Occupation,


North Chelmsford


§ If out of town }


*Residence


falso state fully, y


Place of Birth,


State Ful Wilton n. H


*Place of Death,


north Chelmsford


Name of Father,


Luther Blanchard


Birthplace of Father,


Milton n &f.


Maiden name of Mother,


mary Kiniston


Birthplace of Mother,


Milton 728.


Place of Interment, (give name of cemetery)


Wilton n. If


Dated at


Lowell


Signature .and


6.77, young Hleo


nov 16


I


901


of Undertaker


233 Prescott It


on.


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased t


Place and Date of Death,


Disease or Cause of Death, #


Endocarditis


Duration of Sickness.


4 Weeks


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


le Ci Harlow


M. D.


of


City Physician


Tyngobera mass


Date of Certificate


Nev 17


1901


Agent Board of Health.


* 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.


Read More 18


1


at home


........


Olive Bales


Age,


808:10 M, -D.


died at


no, Chelmsford For 16.1901


place of business


Commonwealth of Massachusetts.


5


1


No. RETURN OF THE DEATH


OF


at


I


1


Date,


Filed,


I


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 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 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. 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. 1


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 ro, and re arn 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.


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,


Catherine


Mc Mahon


Sex, ............... Color,


Date of Death


5017


0


190 ; Age,


81


Years,


Months,


........


Days.


Maiden Name,


or divorced


Husband's Name,


...............


Single, Married, Widowed or Divoreed,


Occupation, North Chelmsford


*Residence


( also state fully, §


Ireland


Place of Birth,


* Place of Death,


North Chelunford


Name of Father,


Birthplace of Father,


Maiden name of Mother, ............... "


1.


Birthplace of Mother,


St. Patrick Cemetery.


Place of Interment, (give name of gemetcry)


Signature and


place of business


of Undertaker


1524 Market Sr


on


I


PHYSICIAN'S CERTIFICATE.


Catherine n" Maken


Age,


81 x.


M, ............. D.


Place and Date of Death,


Disease or Cause of Death, #


1 904


Bright disease of Kidneys


Duration of Sickness.


2or 3 years


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


JE Varney


M. D.


City Physician


Date of Certificate


Nor. 18:


1 907


* 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.


Agent Board of Health.


TRADES KAPLI COUMED


Name and Age of Deceased t


died at


North Chelmsford Hor 17


of


Dated at.


Mar. 17


Commonwealth of Massachusetts.


S


{ If married, widowed }


{ If out of town }


No.


RETURN OF THE DEATH


OF


at


1


I


Date,


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 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, furnishi for registration a certificate setting fortli 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 lie can state the same. Penalty for refusal or neglect, teil 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 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.


FORM C.


Commonwealth of Massachusetts.


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,


Catherine Kelley


Sex,


Color,


Date of Death ....


Dec 8


1900 ; Age,


65 Years,


Months,


Days.


Maiden Name,


( If married, widowed }


or divorced


Husband's Name,


Single Married, Widowed or Divorced,


Chel stord Centre


§ If out of town }


*Residence {also state fully, §


Place of Birth,


Juland


*Place of Death,


Chelesford centre


Name of Father,


lucknow


Birthplace of Father,


Vieland


Maiden name of Mother,


Birthplace of Mother,


Ireland


Place of Interment, (give name of cemetery)


St Peters


Dated at ....


Lowell


Signature and


place of business


on


Deet


1901


of Undertaker


yo lochain At


PHYSICIAN'S CERTIFICATE.


Pathi Jully


Age,


65 y


M.


D.


Name and Age of Deceased t


Place and Date of Death,


died at Chelmsford Man.


En. 8


...


I 901.


' Disease or Cause of Death, #


Plithing Pulmonalis


Duration of Sickness.


About 5 march ..


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


Anthon I. Scolonias


M. D.


of


City Physician


Chelmsford Man.


Date of Certificate


Duc. 9,


1961.


Agent Board of Health.


* 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.


TRADES ALOM COUNCIL 5


# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Causc.


Recy Dec, 9- 1401


9


Occupation,.


at Home


....


F


No.


RETURN OF THE DEATH


OF


1


at


I


Date,


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 qr 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 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. 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.




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