Town of Winthrop : Record of Deaths 1853-1885, Part 6

Author: Winthrop (Mass.)
Publication date: 1853
Publisher:
Number of Pages: 592


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1853-1885 > Part 6


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Name and Residence of Certifying Physician


Her J. Perele. U.A. 1402,4h30/.


Date of Certificate, .


(dec 31


1881.


Or Sex of Infant (not named).


Dee 30. 188.


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 Registration 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 perforining the burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have been returned and recorded; and no clerk or local 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 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 the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local 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. In case of death by violence, the medical examiner shall furnish the certificate.


No. 21


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


(Maiden Name),*


DEletember 7 "1882 Ana SieA Day. anna Detacht


3. Sex, and whether single. Married, or Widowed,


4. Color,


Finale, Nidermed


While


68


.Years, .....


Months,


Days.


5. Age, .


6. Disease or First or Primary


Cause of Secondary (if any)


Death, By whom certified


otremont St, Minttrofe Ware,


otremont St. Martinof More


7. Residence,


8. Place of Death,


9. Occupation, .


10. Place of Birth, .


@andonnalefl.


11. Name of Father,


Leonard drost


(Bedec


13. Birthplace of Father. .


14. Birthplace of Mother, .


15. Place of Interment,


Jemenburg Maco


Signature of Undertaker or other person making


Summer thanzde


the Return,- ~


DATED at.


,


on Self- 8th 188 2


* If a Married Woman or Widow.


+ If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]


12. Name of Mother,


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 TIIE 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.


No ..... 29


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name, (Maiden Name),1


7


3. Sex, and whether single. Married, or Widowed,


1, Dair 1


4. Color, ț


.Years,


Months, ..


18


Days.


5. Age, .


6. Discasc 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, .


Selon Mass


.


11. Name of Father,


12. Name of Mother,


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


camperary deposit in ·


Juma Receiving Jomb


Signature of Undertaker


person making


the Returny,


Savner card 1


DATED at.


on


(January 28 188 3.


* 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.]


1


f


11


·


T Miaw 28",883


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 OF THE CAUSE OF DEATH.


To the Clerk or Registrar of the Town or City in which the Death occurred.


Name and Sex of Deceased,


AC, Via


Cdrrund t vixijas


(Tr vaic:)


Date and Place of Death, .


Jan 28 ",883. Afinita 2's


Disease,


First or Primary,


Listotheria


Duration of,* Que sicili


or Cause of Death, Secondary, .


Duration of,


I certify that the above is a true Return, to the best of my recollection and belief.


· Name, Professional Title, and Residence,


Dated at Minhthrede ju c 28


18 5%. 18


[Be very particular to fill all Blanks.]


* Reckoned to the time of death.


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 slekness, the disease of which the person died, and the date of his deecase, as nearly as he can state the same .- [EXTRACT FROM CHAPTER 21 OF THE GENERAL STATUTES, 1850.]


The attending Physician is requested to make out his Certificate as promptly as possible, for the information and use of the Undertaker, or other person making return of the case to the Town Clerk.


Physicians may obtain BLANK CERTIFICATES from the Town Clerk or Registrar.


Copies of the STATISTICAL NOSOLOGY, adopted for the purposes of Registration, may be obtained on application to the SECRETARY OF THE COMMONWEALTII.


.


No. 50


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name, (Maiden Name),*


February 12 "1883 John H. Jen Kelly


3. Sex, and whether single. Married, or Widowed,


Tale (ffidoner)


4. Color, t


85


Years, ...


5


Months,


3


.. Days.


6. Disease or [ First or Primary


Cause of Secondary (if any)


..


Death, By whom certified


7. Residence,


8. Place of Death,


"Main Street Anthrop.


Maria Street Miniture18


9. Occupation, .


10. Place of Birth, . Chelsea Mase


11. Name of Father, andrew denketury


12. Name of Mother, . Deer Seland- Balon Harbor Mace


13. Birthplace of Father,


14. Birthplace of Mother Lovenose Island Bulon Herto Mars /


15. Place of Interment, Minitrope mo bencelery;


Signature of Undertaker another pron making pers


Summer' loud.)


the Return,


DATED at ..


10:


, on etabruary / 3 1883.


* 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.]


. .


5. Age, .


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 FÖRTHWITH 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 Cierk.


PHYSICIAN'S CERTIFICATE.


Name of Deceased,*


Date and Place of Death, - died at


187 3,


Disease or Cause of Death, - \ of


.... Duration of Sickness.


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


Name and Residence of Certifying Physician H. f. forcle 11


Date of Certificate,


187 >


* 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 Registration 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 been returned and recorded; and no clerk or local 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 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 the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local 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. In case of death by violence, the medical examiner shall furnish the certificate.


No .... /


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name, (Maiden Name),


March 11" 1883. annie Belcher mille !) Clarence a, Welchert


3. Sex, and whether single. Married, or Widowed,


4. Color, t .


5. Age, .


Months, ............... Days.


6. Disease or ( First or Primary Cause of { Secondary (if any) Death, By whom certified


7. Residence, ·


Winthrop Street Winthrope Street


..


8. Place of Death,


9. Occupation,


10. Place of Birth, . Charlottelon G.E. deland alexander Wo thee 11. Name of Father, 12. Name of Mother, Sarah De The


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment, Hinthope Slow Cemetery .


Signature of Undertaker or other peroow making


the Return,.


Summer et loyd)


DATED at .. on. March 12th 1883.


* 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.]


étemale (Married)


White


21 Years,


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.


March 11 "1883


PHYSICIAN'S CERTIFICATE.


Name of Deceased,*


1. ,


187 ,


Date and Place of Death, - died at. .....


Duration of Sickness.


Disease or Cause of Death, - of


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


Vame and Residence of Certifying Physician


Date of Certificate, Har th 187 9


* 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 Registration 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 been returned and recorded; and no clerk or local 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 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 the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local 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. In case of death by violence, the medical examiner shall furnish the certificate.


No .......


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


(Maiden Name),*


May 11 " 1883 Hannah B. Floyd Hannah DO. Statigés


3. Sex, and whether single. Married, or Widowed,


4. Color, + .


5. Age, .


6. Disease or [ First or Primary


Cause of { Secondary (if any)


Death, 1 By whom certified


7. Residence,


Percre Street


Revere Street


8. Place of Death,


9. Occupation, .


10. Place of Birth, . Boston mare


11. Name of Father, Samuel Sturgis


12. Name of Mother, . Lucretia Sturgis Barnetable Mark


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Hinttrofe Joan Cemetery


Signature of Undertaker another person making the Return,


Summer Floyd


DATED at Monthrope


on May 15th 1883.


* 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.]


Female (Widowed)


Mute


78.


Years,-


Months, ..


11


Days.


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 oeeurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTIIWITH GIVE NOTICE thereof - or report these faets -to said Clerk. Penalty for neglect, twenty dollars.


Blauk forms for Returns of Deaths may be obtained from the Town Clerk.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


To the Clerk or Registrar of the Town or City in which the Death occurred.


ne and Sex of Deceased,


Hannah Floyel


Ne and Place of Death, . ·


May 11th Wine therock


ase, zuse kath,


First or Primary, -


Disease of the heart


Duration of * Jeval ye


Secondary, .


Parálisis


Duration of, 5 days


I certify that the above is a true Return, to the best of my recollection and belief.


Samuel Legally Mig Mittisch


Professional Title, and Residence,


Dated at ... Printhead May 16th 1883.


ty particular io fill all Blanks.]


* Reckoned to the time of death.


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the deecase 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. ]


The attending Physician is requested to make out his Certificate as promptly as possible, for the information and use of the Undertaker, or other person making return of the case to the Town Clerk.


Physicians may obtain BLANK CERTIFICATES from the Town Clerk or Registrar.


Copies of the STATISTICAL NOSOLOGY, adopted for the purposes of Registration, may be obtained on application to the SECRETARY OF THE COMMONWEALTH.


No. 2


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


£ May 29 " 1883. Samuel F. Dickinson


(Maiden Name),*


3. Sex, and whether single. Married, or Widowed.


male


Ahile


4. Color, t


5. Age, .


13


.. Years, ....


//


Months, .


21


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, . Ommerville mais 11. Name of Father, Daniel H. Dickinson Sarah a. Dickinson Gestión mass forth Berwick me. mount autum Cemetery Cambudge mack Summer Floyd


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Signature of Undertaker or other person making the Return,


DATED at. Monthrole


on. May 30 188 3.


* 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.]


Death occurred at recidence of Hilux + Belcher


Winthrop &1 - Auchwife Winthrop St- Stintrop


12. Name of Mother, .



1


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 FORTIIWITH 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,*


tomuch Helichenrene C died at Hi/4/2ite


Date and Place of Death,


1875 ,


Disease or Cause of Death, - of


Duration of Sickness U'il 1 l " 2


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


Name and Residence of Certifying Physician


Het teule Hat it undhref


Date of Certificate, ...


187, 3.


* 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 Registration 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 been returned and recorded; and no clerk or local 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 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 the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local 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. In case of death by violence, the medical examiner shall furnish the certificate.


No ...


13


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


June 5 "1883. Carleton dreworgy


(Maiden Name),*


3. Sex, and whether single, Married, or Widowed,


male


White


4. Color, t


5. Age, ·


/ Years, 11 Months, Days.


6. Disease or First or Primary


Cause of Secondary (if any)


Death, [ By whom certified


7. Residence,


8. Place of Death,


9. Occupation, .


Pauline Street Winthrop Pauline Street Winthrop ...


10. Place of Birth, . Winthropo mace.


11. Name of Father,


12. Name of Mother, .


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Minitrop Jom Cemetery


Signature of Undertaker


Summer Floyd


or other person making


the Return,


DATED at ... Winthrope


, on ...


June 6th 1883 .


* 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.]


Nesse (@, Inenargy. Koffie L. Jenagy Slurry Maine Minitrope mars.


WANNAD.


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 persou having charge of such Interment must FORTHWITHI 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,* CuEtter


....


Date and Place of Death,


died at Hind//2 rue4


187) },


Disease or Cause of Death, - of Duration of Sickness fever clc


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


Name and Residence of Certifying Physician.


Hs. f. forall


Date of Certificate, feeney


1875 5.


* 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 Registration 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 been returned and recorded; and no clerk or local 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 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 the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local 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. In case of death by violence, the medical examiner shall furnish the certificate.


No. .. .!


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name, (Maiden Name),*


tume 6 "1883 Harrold a. Frey enargy


3. Sex, and whether single. Married, or Widowed.


male


4. Color, t


White


3


Years, /1


Months, ..


10


Days.


6. Disease or [ First or Primary


Cause of Secondary (if any)


Death, ( By whom certified


7. Residence,


8. Place of Death,


9. Occupation, .


Pauline Street Anthropo


Pauline Street Winthrop


10. Place of Birth, . Winthrop Mares


11. Name of Father,


12. Name of Mother, .


13. Birthplace of Father, .


14. Birthplace of Mother, .


Inenargy Ofie J. Trewargy manie. Minitrope Mass


15. Place of Interment, Winthrofo Down Cemetery Summer Floyd Signature of Undertaker -


other person making the Return,


DATED at .. Trinitrop


.. ,


on June yet. 188 3.


* If a Married Woman or Widow.


+ If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]




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