USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1853-1885 > Part 13
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4. Color. f .
5. Age,
.Years, ..
S .. Months, ..
.Days.
Diarrhoea
Disease or Cause of Death,
6. Duration of Sickness, By whom certified,
7. Residence, .
6, Faxcon Polloy
8. Place of Death, .
St. Have Thuthey
9. Occupation,
10. Place of Birth, ·
11. Name of Father,
12. Name of Mother,
bathune mi basthy
13. Birthplace of Father,
Oreland
14. Birthplace of Mother,
Roxhus
15. Place of Interment, .
Signature of Undertaker weather New veron making the Return,
S. Floyd
DATED at
on July 23 1813
* If a Married Woman or Widow. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
IBe very particular to fill all Blanks.]
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtaincd. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
ame of Deceased,* -
Timothy Mis Carty. Hihitrop, Mass. July 22 , 185- died at
ate and Place of Death, -
iscase or Cause of Death, - of Diaschova
Duration of Sickness
6 days.
I certify that the alge is true, to the bestof my knowledge and belief. V. A. otte, ein Ph. Kothuy
ne and Residence of Certifying Physician,
Date of Certificate, that July 31. 188%.
*Or Sex of Infant (not named).
-
[ Extracts from Chapter 32 of the Public Statutes.]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he ean state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical cxaminer attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death.
Only 25 " 1885
2. Name,
(Maiden Name),*
3. Sex, and whether single, Married, or Widowed,
male
4. Color, t .
5. Age,
Years,
3
Months,
Days.
franshoek
Disease or Cause of Death,
6. Duration of Sickness, By whom certified,
7. Residence, .
malden mars
8. Place of Death, .
9. Occupation,
10. Place of Birth, Malden Balon
11. Name of Father,
12. Name of Mother,
13. Birthplace of Father,
14. Birthplace of Mother.
15. Place of Interment, .
Tempoun defeaus~ Im Ree Dank
Signature of Undertaker or other person making the Return, .
DATED at , on
Jul 26
185-
* If a Married Woman or Widow. t If other than White. (M.) Mulatto. (I.) Indian. IY of other Races, specify what.
[Be very particular to fill all Blanks.]
Carrie Buenas
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
Name of Deceased,*
Henry Brown.
Date and Place of Death, - died at of Diacchova! Disease or Cause of Death, - Duration of Sickness.
Minutiok, Mark July 105 1886. 3 wks.
I certify that the above is truly, to the best of hy knowledge and belief. I'd. Potter . evine Ph. Pentru.
Jame and Residence of Certifying Physician,
Date of Certificate, t: July 31 1885- Mark.
*Or Sex of Infant (not named).
[Extracts from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. Ile shall also sign such certificate, upon applica- tion, in ease of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
A'A
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name.
July 25 dues Franklin Tyler
(Maiden Name),
3. Sex, and whether single, Married, or Widowed,
male
4. Color. t .
While 1
5. Age. Years, ..
2
Months. Days.
Dia in /200.
Disease or Cause of Death,
6. Duration of Sickness, By whom certified,
7. Residence. .
Povatin Smag 360ale
8. Place of Death.
9. Occupation.
10. Place of Birth,
11. Name of Father,
12. Name of Mother,
Bali mars Tyler angie Tyler
Maine
13. Birthplace of Father,
14. Birthplace of Mother.
15. Place of Interment, .
Signature of Undertaker or other person making the Return,
DATED at druhy 25 , on
185
* If a Married Woman of Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
Franklyn Ingles.
Name of Deceased,*
Date and Place of Death, died at
Hintof, Mass. July 25 18 5 .- 2 cups.
Disease or Cause of Death, of Viasshova, Duration of Sickness
I certify that the above is true to the best of ull knowledge and belief.
me and Residence of Certifying Physician,
mats.
Date of Certificate, 188 5.
*Or Bex of Infant (not named).
[ Extracts from Chapter 32 of the Public Statutes.]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the cler or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot fo good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish th requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
Only 25" 1885 Montana Sealt
(Maiden Name),
3. Sex, and whether single, Married, or Widowed,
tennale Black
4. Color, t .
5. Age,
Disease or Cause of Death,
6. Duration of Sickness, By whom certified,
2 14 anderenBomber
8. Place of Death,
9. Occupation,
10. Place of Birth,
11. Name of Father,
12. Name of Mother,
Elisabeth Scott
13. Birthplace of Father,
14. Birthplace of Mother, .
Berlin mars
15. Place of Interment, .
Signature of Undertaker or other ther perso rson making
the Return, .
S. Fryd
DATED at
.
Jul 26
1885-
~
* If a Married Woman or Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
Years,
2 Months,.
Days,
Diarrhoea
7. Residence, .
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the causc of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of (leath shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. Ile shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
ame of Deceased,* -
Minous Scott. Winthrop Mars. July 25. 188 5 .-
ate and Place of Death, - died at
isease or Cause of Death, - of Diaschora,
Duration of Sickness
5 days.
I certify that the above is triff, A. J . Potter, o Versiune I Modbury.
me and Residence of Certifying Physician,
Mikes.
Date of Certificate, July 31. 188 5.
*Or Sex of Infant (not named).
[Extracts from Chapter 32 of the Public Statutes.]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),*
Only 35" 1885- Row autory Plussince
3. Sex, and whether single. Married, or Widowed,
male Ichelé
4. Color, t
5. Age, .
Years, 11
.Months, ..
2
Days.
Jabee. mezoneer cc.
6. Disease or [ First or Primary
Cause of Secondary (if any)
Death, By whom certified
7. Residence, ·
8. Place of Death,
9. Occupation, .
10. Place of Birth, . Berlin
11. Name of Father,
12. Name of Mother, . ...
13. Birthplace of Father. .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return,
DATED at.
on
188 ..
* If a Married Woman or Widow.
t If other than white. (A.) African; (MI.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
..
Cambridge
Ocean View Slutt The
Robert 2. Colaul
2 Suis <
The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Death -to the Town Clerk, BEFORE THE INTERMENT.
In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE NOTICE thereof - or report these facts -to said Clerk. Penalty for neglect, twenty dollars.
Blank forms for Returns of Deaths may be obtained from the Town Clerk.
PHYSICIAN'S CERTIFICATE.
me of Deceased,*
Key ( They
te and Place of Death,
died as Wintherign Auch, 26 .... 1888,
ease or Cause of Death, -
of Jahres mesenteric Duration of Sickness
. . ....
I certify that the above is true, to the best of my knowledge and belief.
and Residence of Certifying Physician
Date of Certificate, free & 16
1895.
· Or Sex of Infant (not named).
Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]
Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Registrati of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, until a proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performing the burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have bee returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Cause Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of san clerk or local registrar."
If there has been no Physician in attendance, or in case of death by dangerous contagious disease, or in any other event where to certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Board Health, or any Physician employed by any city or town for such purpose, shall sign the Certificate of the Cause of Death, to the best a his knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.
O ingennaze Kat RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),*
July 27 815. Siggie Patrick
3. Sex, and whether single. Married, or Widowed,
4. Color, t
5. Age, .
Ycars, .... 5 Months, 18 8 Days.
6. Disease or | First or Primary
Cause of Secondary (if any) .
Death, By whom certified
7. Residence,
8. Place of Death,
9. Occupation, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return,
DATED at.
7 ,
188 9.
* If a Married Woman or Widow.
t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
-
. .
-
-
The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THE INTERMENT.
" In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTIWITH GIVE NOTICE thereof -or report these facts -to said Clerk. Penalty for neglect, twenty dollars.
Blank forms for Returns of Deaths may be obtained from the Town Clerk.
PHYSICIAN'S CERTIFICATE.
Name of Deceased,* -
Date and Place of Death, - | died at Disease or Cause of Death, -
Lizzie, Patrick Orfinchrop, Mase- July 27. 18J. os Diaschova. Duration of Sickness 4 roles-
me and Residence of Certifying Physician,
I certify that the apque is truch to tif best of my knowledge and belief, 40 Persin St. Nrflury. July 31. Date of Certificate, 1880. Theass.
*Or Ser of Infant (not named).
[Extracts from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the discase of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.'
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