USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1853-1885 > Part 16
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died at tanathereof tefal >> of Tales Hesenteriece Duration of Sickness
1885.
I certify that the above is true, to the best of my knowledge and belief.
and Residence of Certifying Physician, He, Se Forclé thiruthree
Date of Certificate, .. 6. 1 3€
*Or Sex of Infant (not named).
188
[ 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 unti 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 contagions 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 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, .
Depelember- 22 "1886 Amox il Parte
(Maiden Name) .*
3. Sex, and whether single, Married, or Widowed,
Ferraris Arhite
4. Color, t .
5. Age,
2
Years, 13 Months.
Days.
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified, ·
7. Residence, .
estintoripo 7 anos
Savaria Steen
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 making the Return,
DATED at
Princtivos
Jefer 23
1885.
6
Cruz d. Parte Hattie & Parks 1 L
Verschwenden Lazz 1
1 A.H.
Summer Floyd
* 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.]
[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.
ame of Deceased,*
Dona J. Pak Ministrafe september
ate and Place of Death, died at
1885. isease or Cause of Death,
Diabetes Duration of Sickness
5.2
I certify that the above is true, to the best of my knowledge and belief.
ne and Residence of Certifying Physician,
Date of Certificate, Sept. 23 1883
*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 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. 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, n. y: (Maiden Name),*
2 15"1885 ana Maria Setinstoria
3. Sex, and whether single, Married, or Widowed,
C1
4. Color, t .
5. Age,
24 Years,
Months, .. 27 Days.
Disease or Cause of Death,
6 ..
Duration of Sickness,
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 on
17 th- 18
* 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.]
Q
James P. Q
Shelburne M.
76 alifax 91.5
if ingle
.
L
Telegraph Operator Shelling
[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 belicf, 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 excecdling twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
ame of Deceased,*
mma. ito. lowestou
ate and Place of Death, died at 1
1 Miultimo's Delavar 5 Th 1
1885
isease or Cause of Death, - of
Duration of Sickness Deveu mouths
I certify that the above is true, to the best of my knowledge and belief. Franke & svin Ma. Hutrop. Tivas.
tone and Residence of Certifying Physician,
Date of Certificate, Quiában 6th 1885
+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 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."
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death.
2. Name,
..
(Maiden Name),
3. Sex, and whether single, Married, or Widowed,
4. Color, t .
8€
Years, 11
Months,
Days.
Disease or Cause of Death,
6. Duration of Sickness, By whom certified,
7. Residence, .
Primitivo13 mas
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, . ·
Prinstroje Tom cemeteries
Signature of Undertaker er other person making the Return,
Summer Florid
DATED at Monthitp, on
35 11. 188
* If a Married Woman or Widow.
{ If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
vonen ber 20 1859 Elizabeth Richardson
00 Otemale
5. Age,
cd.Ce
Elexams Sheis
-
[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 registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the fa required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, a 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 death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairi 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 dle to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon appl tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish requisite medical. certificate. . Any person violating the provisions of this section shall be punished by fine not exceeding twenty- dollars.
gres
5-5
1
measure
aswang
1
Otmeral 2,30 Pm. 5ch ..
PHYSICIAN'S CERTIFICATE.
El gatothe Richardzen
ame of Deceased,*
ate and Place of Death,
died at N C
1885
isease or Cause of Death, . of Old age Duration of Sickness
I certify that the above is true, to the best of my knowledge and belief.
te and Residence of Certifying Physician, He, J. bouclé It. three
Date of Certificate. . 1885.
ish
IT
*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."
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