USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1900-1901 > Part 4
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SECTION TO Any nereon having charge of the funereal rites preliminary to the interment of a human body
with the facts re- curred.
i
144
Commonwealth of glassachusetts.
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,
almira Stearns
Sex.
Color,
W.
Date of Death,
april 6 1900
; Age, 92
_. Years
9
Months, 24 Days.
Maiden Name,
{ If married, widowed }
or divorced.
almira Bancroft
Husband's Name,
Charles Stearno
Single, Married, Widowed or Divorced,
Cordoned Occupation,
Housewife
*Residence, { If out of town, )
¿ also state fully. §
Chelmsford
Place of Birth,
Rindge U.A.
*Place of Death,
Chelmsford
Name of Father,
John Bancroft.
Birthplace of Father,
Maiden name of Mother,
Elizabeth Coburn
Birthplace of Mother,
Place of Interment, (Give name of Cemetery),
Lowell Cemetery
Dated at
Chelmsford
Signature and
Natten Parhan
on april 6 1900 189
place of business
of Undertaker.
2
3
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, ¡
Place and Date of Death,#
Disease or Cause of Death, §
died at
Chelmsford mass, a/r. 6th Ise 1900
Pneumonia
.
Duration of sickness,
one week.
I certify that the above is true to the best of my knowledge and belief.
Cimasa Howard
M. D
Signature and Residence
of
S
Chumeford
Certifying Physician.
1900
Date of Certificate,
189.
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.
almira Stearns
Age, 92 8. 9 M. 24D.
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 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. (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 sections 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
145
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 Henry Hagen
Sex,
Color,
w.
Date of Death,
april 6 9900
189
; Age, 59 Years,
0
.Months,
24 Days.
Maiden Name,
{ If married, widowed }
or divorced.
Husband's Name,
Single, Married, Widowed or Divorced,
Single
Occupation,
Farmer
*Residence, { If out of town, )
Chelmsford
¿ also state fully. §
Place of Birth,
Hartford 18
*Place of Death,
Chelmsford
Name of Father,
Sanford Hagen
Birthplace of Father,
HartFord KA.
Maiden name of Mother,
Sarah Word
Birthplace of Mother,
Heet Lebanon TS
Place of Interment, (Give name of Cemetery),
Chelmsford
Dated
Chelmsford
Walter Resham
Signature and
on april 6 1900 189
place of business
of Undertaker.
Chelmsford
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
James H. Hazin
Age,
59 8. 0 M 24D.
Place and Date of Death, #
died at.
Chelmsford Mars. apr. 6
sg 1900
Disease or Cause of Death, §
Pneumonia.
Duration of sickness,
8 days.
I certify that the above is true to the best of my knowledge and belief.
Amasa Itaward.
M. D.
Signature and Residence S
of
Certifying Physician.
Chelmsford.
Date of Certificate,
1900
Give also street and number, if any.
+ 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.
No
RETURN OF THE DEATH
OF
at
Date,
189
Filed,
189
The provisions of chapter 444 of the Acts of 1897 require that cvery 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 elerk of the city or town in which the death occurred. (See section 6.)
The commanding offieer 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 sueh death. (See section 7.) Penalty for neglect to comply with the requirements of seetions 6 and 7, five dollars. (See section 8.)
A physieian 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 negleet, ten dollars. (See seetion 11.)
Anne nawann having shores of the funeral rites preliminary to the interment of a human body shall obtain the physician's
· I hr ception 1, to the board of
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.) 7
Name,
Josch alfred Exigences gombert
Sex, " vale Color,
7
Date of Death,
189 ; Age,
........... Years, ..
Months,
23 Days.
Maiden Name, { If married, widowed } or divorced.
Husband's Name,
Single, Married, Widowed or Divorced,
Vingle
Occupation, -
* Residence,
{ If out of town, }
# Wesh Chelmsford. Grass
(also state fully )
Place of Birth,
* Place of Death,
Track Chelmsford Brass
Name of Father,
Edmond Jantar
Canada
Birthplace of Father,
Poranna Gruves
Maiden Name of Mother,
Birthplace of Mother,
Banana Woonsocket R. J.
Place of Interment, (Give name of Cemetery),
Dated :
awell Grass
Signature and
S
0 11
April 7
1900
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Place and Date of Death,
died at
Disease or Cause of Death, #
Duration of sickness,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
1 M. D.
of Certifying Physician.
Maxi
Date of Certificate
1900.
* Give also street and number, if any.
t Give sex of infant not named. If still-boru, 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.
M ..
3. D.
1900
place of business
of Undertaker.
146
$ 1900
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.]
1 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
.. In. the interment of a human body shall obtain : 1
quire(
ē-
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,
Edward & Richardson
Sex,
m.
Date of Death,
mar 25 1909 189 ; Age,
68
Years,
Months,
Days
Maiden Name, { If married, widowed ) or divorced.
Husband's Name,
Single, Married, Widowed or Divorced, .......
Occupation,
Farmer
*Residence, { If out of town, )
Chelmsford mask
Place of Birth,
4
* Place of Death,
Name of Father,
Francis Richardson
Birthplace of Father,
Chelmsford Mass
Maiden Name of Mother, ..
many Blodget
Birthplace of Mother,
unknown
Place of Interment, (Give name of Cemetery),
Chelmsford Centre domb
Dated at
Lawell
Blumen
1
on mar 26 1900
I
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Place and Date of Death,
Disease or Cause of Death, #
la Grippe
Duration of sickness,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
Et Sacker
M. D.
of Certifying Physician.
Date of Certificate
March 26
1900
* 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.
Ir Packer
147
Edward H HishandsonAge, 65
Y.
.M.
D.
died at
Chelmsford Mass man 25 1960
Signature and
place of business
of Undertaker.
Lowell
Color,
( also state fully )
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 require l 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.
SEDA . al obtain the p quired by section ... ! Doar )
ts re-
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,
Eenos Hort Hankou
. Sex, Color,
Date of Death,
abril 9
1900
189 ; Age, 77 Years,
1
Months,
5
.Days.
Maiden Name,
or divorced.
vidowed į
Husband's Name,
Single, Married, Widowed or Divorced,
Occupation,
Farmer
*Residence, { If ont of town, }
? also state fully.
Place of Birth, Maine
* Place of Death,
Chelmsford
Name of Father,
Birthplace of Father,
Maiden name of Mother,
Birthplace of Mother,
Place of Interment, (Give name of Cemetery),
Jowell Cemetery
Dated at chebuafino
Signature and
Walter Perham
on Bevil 96
1900
189
place of business
of Undertaker.
-
Chelmsford
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, f Place and Date of Death, }
Once Stoyt Stanson
Age, 77 Y. 1 M. 5 D.
died at. Chelmsford, Theace, apie gt 1900 189-
Disease or Cause of Death, §
Senile Cerebral atrophy
Duration of sickness,
a gradual decline for many months
I certify that the above is true to the best of my knowledge and belief.
@ award It. Chambouler
M. D.
Signature and Residence S
of
Chelmsford Vass.
Certifying Physician.
1900
Date of Certificate,
apie at
189.
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 Cansc.
148
1
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 oecurs, 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. (See section 6.)
The commanding offieer 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 sections 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 rafnaal or neglect, ten dollars. (See section 11.)
Any person ha: " 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 regrired by section 1, to the board of health or to the elork of the city or town in which the death occurred.
Rel
FORM C.
Commonwealth of Massachusetts.
No. .....
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
Name,
Oliver 18 Deale
Sex, An Color,.
Date of Death,
,Am 11th
789 , Age, 70 Years, 3 Months, 11 Days.
Maiden Name, { If married, widowed }
or divorced.
Husband's Name,
Single, Married, Widowed or Divorce Accessed Forencussed
Occupation,.
Leamenter
* Residence,
( If out of town, {
(also state fully )
Place of Birth, Nashua MM
*Place of Death,
Name of Father, unknowit
Birthplace of Father,
Maiden Name of Mother, . .
Birthplace of Mother, Place of Interment, (Give name of Cemeteryy, So Chehufund
Dated at.
A Chelmsfords
John biasinel 98
011 Apri 12th
1900
place of business of Undertaker. I.A. Chelmsford maar
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Oliver St Itale
Age, 70. Y.
9 M. // D.
Place and Date of Death,
died at
nors Chebus find april 11 900.
Disease or Cause of Death, #
Paralysis woulling fim Kemployee
Secondary Disease of Theart
Duration of sickness,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S
FE Janney
of
M. D.
Certifying Physician.
Not Chellerfinal
Date of Certificate april 12. 1900
* 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.
149 1
( (FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
1900
/
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 the same. Penalty for refusal or neglect, ten dollars.
SECTION 12 Aby person having « 'rge 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 re- quired by section r, to the board of health or to the clerk of the city or town in which the death occurred.
Ret
Ed. Jan, 23, 1894. 5,000.
[ACTS OF 1889, CHAP. 208.] AN ACT IN RELATION TO THE RETURNS OF BIRTHS AND DEATHS.
Be it enacted, etc., as follows :
SECTION 1. The elerk or registrar of each eity and town shall on the first day of each month make a certified copy of the record of all deaths and births recorded in the books of said city or town during the previous month, whenever the deceased person or the parents of the child born, were resident in any other eity or town in this Commonwealth at the time. of said death or birth; and shall transmit said certified eopies to the elerk or registrar of the eity or town in which sueh deceased person or parents were resident at the time of said death or birth, stating in addition the name of the street and number of the house, if any, where such deceased person or parents so resided, whenever the same ean be aseertained ; and the elerk or registrar so receiving sueh certified copies shall record the same in the books kept for recording deaths or births. Sueh certified eopies shall be made upon blanks to be furnished for that purpose by the secretary of the Common- wealth.
SECTION 2. This act shall take effeet upon its passage. [Approved April 5, 1889.
Blank to be used in compliance with the foregoing.
DEATH
recorded in the books of the Town of Dunstable Mass (City or Town.)
during the month of 1899.
1. Date of Death, Sun 28, 1899
2. Name,
Alva Gilson.
(Maiden Name), . (Name of Husband),
3. Sex, and whether single, Married, or Widowed,
male
Married
4. Color,
5. Age, 76.
Years, 8. Months, 21. Days.
Gastric Ular.
Disease or Cause of Death, 6. {Duration of Sickness, By whom certified,.
Six or seven years.
Chas. E. Libby m. 2
Dunstable
8. Occupation,
Blacksmith
9. Place of Death, .
10. Place of Birth,
Vynasboro.
11. Name of Father,
Eben Gilson
12. Name of Mother, (Maiden Name.)
Rebecker Styman
13. Birthplace of Father, .
Vanastora
14. Birthplace of Mother, .
Vienasbora,
15. Place of Interment, Oftest Chelmsford
I certify that the foregoing is a true copy.
Attest : James I Hardward.
Tony Clerk.
(City or Town.)
150
Plate.
Copy of the Record of a
July 15, 1899.
Dunstable
7. Residence,
151
Ret FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
Name,
Benjamim Staveley (Child Sex,
1
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Color,
Date of Death,
Dec Dia
189 7; Age,
............. Years,
.Months,
Days.
Maiden Name, { If married, widowed ) or divorced.
Husband's Name,
Single, Married, Widowed or Divorced, Occupation,
* Residence,
{ If out of town, }
falso state fully §
Place of Birth,
* Place of Death, Chelmsford
Name of Father,
Dentermin Staveley
Birthplace of Father,
Maiden Name of Mother, Leggi Thornton
Birthplace of Mother, Implorand Eden been Sowell france
Place of Interment, (Give name of Cemetery);
Dated at.
Lowell
Signature and place of business of Undertaker.
88 aMiddlece 4 so
011
2 0co
89.9
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Child& Beruf Stirelay Age, Stire Brenne D.
Place and Date of Death,
Disease or Cause of Death, #
died at Chelmsford I Steelfor
Duration of sickness,
Stillborn
I certify that the above is true to the best of my knowledge and belief. 1
Signature and Residence S - of Certifying Physician. Die 3rd 1899 I
* 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.
M. D.
Date of Certificate.
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 the same. Penalty for refusal or neglect, ten 1 11
1
Rev
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,
lateur m& Manomin
Sex,
Color,
Date of Death,
March 30th
lov, Age, 66
Years,.
.Months,.
Days.
Maiden Name, { If married, widowed ) or divorced.
Husband's Name,
Single, Married, Widowed or Divorced,
Occupation,
forth Chelunsford
Place of Birth, Inland
North Chelunsford Mass
* Place of Death,
Name of Father,
Quin m: manomin.
Birthplace of Father,
Maiden Name of Mother,
May An Dade
Birthplace of Mother,
Hatricks Cemetery. Hall hass
Place of Interment, (Give name of Cemetery),
Dated at ...
July Maso
on
march 30th
1 900
Signature and
place of business
of Undertaker.
324 Mauset Of
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceasedt
Patrick Mª ManominAge,
66 y -M -D.
Place and Date of Death,
died at
North Chelmsford Weh 30h, 900
Disease or Cause of Death,
Pneu monia
Duration of sickness,
Lex days
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence 5
FE Janney
M. D.
of Certifying Physician.
Date of Certificate
March 31 :
1900
* 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.
150
alouer
*Residence, { If out of town, { (also state fully )
freband
leland
No. 1
RETURN OF THE DEATH.
OF
1
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 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 secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SER ~~~~~ 1. body
shall of quirey section I to be
to re-
Lee
153
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
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