USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 13
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9. Place of Death, .
10. Place of Birthi, .
11. Name of Father,
12. Name of Mother, ·
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, ·
Signature of Undertaker or other person making the Return, . .
1
, on
26'18 8.
DATED at
. ......
...
3.
* If a Married Woman or Widow.
t lf 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 require l 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 application, in case of death by danger- ous 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.
[Acts of 1887, Chap. 202, Sect. 5.]
Section one of chapter thirty-two of the Public Statutes is hereby amended by inserting after the word "burial" in the twentieth line of said section the words: - if the deceased was a married woman the name of her husband.
1
PHYSICIAN'S CERTIFICATE.
Jame of Deceased,*
1
Yunan T. Burrell
ate and Place of Death, - died at
Winthrop May 25
.
of
1888,
I certify that the above is true, to the best of my knowledge and belief. · and Residence of Certifying Physician
A. P. Soule Winthrop
* Or Sex of Infant (not named).
Date of Certificate, May 26"
1888
... ....
sease or Cause of Death, -
Old Age ... Dur Duration of Sickness -
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.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
Siban 26 . 188%
2. Name, (Maiden Name),*
(Name of Husband),*
1 bale
3. Sex, and whether single, Married, or Widowed,
2.2
1. C'olor, t
5. Age, Disease or Cause of Death,
10 Years,
Months, Days.
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker aEtherpermon making the Return, .
Summer tron
DATED at
, 011
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.]
Heures 2
0
......
11
[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 certificate shall state that the facts require 1 by this chapter have been returned and recorded such dereficare 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 aby physician employed IN any city or town for such purpose shalldign the certificate of the cause of death to the lest please ous 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.
[Acts of 1887, Chap. 202, Sect. 5.]
Section one of chapter thirty-two of the Public Statutes is hereby amended by inserting after the word "burial" in the twentieth line of said section the words : - if the deceased was a married woman the name of her husband.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Marine b, Allen
Age, 10
Date and Place of Death, - \ died at Disease or Cause of Death, -
Winthrop May 26 of Inflammation of Brain Duration of Sickness .. 1. Week
188 8.
I certify that the above is true, to the best of my knowledge and belief. He. I Soule
une and Residence of Certifying Physician,
*Or Sex of Infant (not named).
Date of Certificate,
1888.
[ May, 1888.]
[Acts of 1888, Chapter 306.]
SECTION I. Section three of chapter thirty-two of the Public Statutes, requiring attending physicians to furnish for registration certain facts relating to deceased persons, is amended so as to read as follows : - Section 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease. If a physician neg- lects or refuses to make a certificate, as aforesaid, he shall be punished by a fine not exceeding fifty dollars.
SECTION 2. Section five of said chapter, prohibiting the burial or removal of a human body until a propcr certificate is furnished, is amended so as to read as follows : - Section 5. No undertaker, sexton or other person shall bury in a city or town or remove thercfrom the body of a deceased person until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in licu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician can not be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate arc delivered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or register for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the dc- ceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceeding fifty dollars. [Approved May 4, 1888.
No. 33
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
me 10"
2. Name,
( Maiden Name),
(Name of Husband) ,*
Leonard Lan
3. Sex, and whether single, Married, or Widowed,
15
4. Color, t
5. Age, 68 Years, - Months, IT ! Days.
(Disease or Cause of Death, 6. {Duration of Sickness, . By whom certified,
7. Residence, Bran denee It
8. Occupation, .
9. Place of Death, .
10. Place of Birth,
11. Name of Father,
12. Name of Mother, . ·
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, ·
Signatureof Emtertuker" or other person making the Return,.
1 1
DATED at /
* 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.]
18
L
- séland!
-
Puntendam
1
[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 application, in case of death by danger- ous 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.
[Acts of 1887, Chap. 202, Sect. 5.]
Section one of chapter thirty-two of the Public Statutes is hereby amended by inserting after the word "burial" in the twentieth line of said section the words : - if the deceased was a married woman the name of her husband.
Winthrop June 10ch 1888
This Certifies That Martha Laweb 2 gral 68 years. 3 days. died france 0th 1888 of apoplexy - duration 3 days Samuel Honigin www. attending Rhypresen
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
(Maiden Name), .
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
Mule
4. C'olor, t
-Years,
4
Months,.
21 Days.
5. Age, Disease or Cause of Death,
6. Duration of Sickness, By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
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 **** making
the Return, .
DATED at
.....
Thomas M Karrie.
England England
1855
* 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.]
dame 12 " 108. Beil Ftaines James
[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 require l 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 of 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 application, in case of death by dlanger- ous 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.
[Acts of 1887, Chap. 202, Sect. 5.]
Section one of chapter thirty-two of the Public Statutes is hereby amended by inserting after the word "burial" in the twentieth line of said section the words : - if the deceased was a married woman the name of her husband.
21
PHYSICIAN'S CERTIFICATE.
Name of Deceased,*
Date and Place of Death, -
died at
Disease or Cause of Death, - of
Cecil of Haines Winthrop June 12 Cholera Infanter Duration 1888 .-
Three days
I certify that the above is true, to the best of my knowledge and belief. He. I Could Not Winthrop.
Vame and Residence of Certifying Physician,
Date of Certificate, Ich 18h 1889
*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 uch person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, 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 eit 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 egistrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the s 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, and ed 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 ch shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman he board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death he best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- , in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for d and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the isite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
RETURN OF
To the Clerk of the Town in which the Death occurro
DEATH <
No. 9
...
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Deathı, .
2. Name,
(Maiden Name) , (Name of Ilusband) ,*
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age, Disease or Cause of Death,
6. {Duration of Sickness, . By whom certified, ·
7. Residence,
8. Occupation, .
9. Place of Death, .
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 +++ +her person making the Return, .
DATED at
, on
21/18
12,65,24.
2
Years, Months Days.
.....
selle
Suminis.
* 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 application, in case of death by danger- ous 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.
[Acts of 1887, Chap. 202, Sect. 5.]
Section one of chapter thirty-two of the Public Statutes is hereby amended by inserting after the word "burial" in the twentiet line of said section the words : - if the deceased was a married woman the name of her husband.
PHYSICIAN'S CERTIFICATE.
Name of Deceased,*
Date and Place of Death, died at
Mary &. Bartlette Winthrop June 16" 1888.
Disease or Cause of Death, of Things
Duration of Sickness One year
I certify that the above is true, to the best of my knowledge and belief.
Name and Residence of Certifying Physician, H. I Soul' MA
Winthrop ...
*Or Sex of Infant (not named).
Date of Certificate, 188 9.
[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."
--- ----
NOTICE .- Fill out in Ink.
RETURN OF DEATH TO THE CITY REGISTRAR.
CITY HALL, BOSTON.
1888
Date of Death
20
18
Name, .
Llawie J. Dana
Color, t
Age
years
11
Months
20
day
Place of Death
I reale Sy. With
Street and No.
Residence, ...
Sauce
Sex. a Single, Married
Occupation,
Wife of
Birthplace*
Boston
.Widow of
Name of Father,
Daniel
2. Doc
Name of Mother,
Eller
Birthplace of Father,
Birthplace of Mother,
globe
Mando
Cause of
Primary,
Duration,
Death Secondary,
Duration,
Place of Interment,
Malde
Date of Interment or removal,
2/
Undertaker or Informant,
14.CO.
...
-* Insert Town and State.
+ State whether white or black,
WARD
..
--
281
C
Rockwell & Churchill, City Printers, 39 Arch Street, Boston.
Boston,
e - 201888
This Certifies, That Daniel J. Danaufan died on the 20 th day of June 1888, aqual. / years, Y
months,. 20
days.
CAUSE OF Primary,
Arte cular Meningitas Duration 8 days)
DEATH. S Secondary, Convulsions Duration
da.
1115 Grainger Phyll
Commonwealth of ¿tlassachusetts.
o. 11
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Jeline 2.3"1 f 1: 11m
+ 2. Name,
(Maiden Name),*
(Name of Husband) ,
3. Sex, and whether single, Married, or Widowed,
1
4. Color, t
Years,.
Months,
Days.
5. Age,
Disease or Cause of Death,
6. {Duration of Sickness, . (By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
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 + 1
2 S
-- 7-
4
2
18
DATED at
, (11
* 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.]
-
1 7%
1
fix 04
23" 1
,
1
.1
the Return, .
1
1
1
F 1-
vi
-
[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. IIe shall also sign such certificatc, upon application, in case of death by danger- ous 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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