USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 15
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This Act takes effect June 3, 1888.
SECRETARY'S DEPARTMENT, BOSTON, May 4. 188
UNDERTAKER'S RETURN TO THE BOARD OF HEALTH, BOSTON.
Dale of Death, Maiden Name
1888
Name, Jennie 9. 1 CHE2; Sex Homale.
1 Married, single or widow,
wife of
Color, W. Age, years. 1 mes. davs. Residence. ITS. Cambridge. Winthrop Ward. Place of death, St. and No. La a Short Homme Father's Occupation. 1 barble fitter.
- Boston
luce of Birth, Name of father, Birthplace of father, Dostaw
.
William J. Name of mother, ..
Birthplace of mother, Factural Inclevie. luce of interment, Golf Groxx Ml
1. Kulden
*If a married woman or a widow.
tGive the name of the burial ground.
Signature of Undertaker, or other person making the return. =16 alten.
84 Cholesterin LA Breton
Commonwealth of Massachusetts.
In the Year One Thousand Eight Hundred and Eighty-eight.
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHIS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted by the Senate and House of Representatives in General Courl assembled, and by the authority of the same, as follows :
SECTION 1. 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 neglects 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
No. 15
Commonbocalth of glassachusetts.
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),
722022 - Inzuid
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, .
11. Birthplace of Mother, .
15. Place of Interment, ·
Signature of Undertaker orotherperson making the Return, . f
DATED at
, On
aug. 19.
18 FP
* 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.]
.
Edwin F.Dunham
3. Sex, and whether single, Married, or Widowed,
While
30 Years,
6 Months,
20
Days.
Builder
Ezra
Manuel
[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 uo 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 fast 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 an Dee ChapOG Acts Of 888 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.
PH' SICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Date and Place of Death, -
died at Offinitivate (canada 18'"
1888
Disease or Cause of Death, - of Typhoid fever
Duration of Sickness
I certify that the above is true, to the best of my knowledge and belief.
me and Residence of Certifying Physician,
A. Sfauli M.D. Wanthry.
*Or Sex of Infant (not named).
th
Date of Certificate, Han ye
188%.
[May, 1988.]
[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 proper 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 therefrom 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 lieu 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
tov 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 are (lelivercd 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 de- ceased or to the manncr 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.
Commonwealth of Ettassathuscits.
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,
4. Color,t
5. Ago, 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 *other person making the Return, .
DATED at
, on
Que 24" 1888
* 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.]
male
Years, . 11 Months, Days.
...
Montreal Conada
Ennhan eler England
[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 1 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 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.
PHYSICIAN'S CERTIFICATE.
Name of Deceased,* -
Date and Place of Death, -
· Disease or Cause of Deathi, - of
John Portlock died at
Sea Shore arme, Winthrop, Aug. 23 1885 Broncho- neumonia Duration of Sickness 5 days
I certify that the above is true, to the best of my knowledge and belief.
Name and Residence of Certifying Physician, Audi S. Thayin, M.D., Haitrop
*Or Sex of Infant (not named).
Date of Certificate, tate, Aug. 24 188 8.
L
[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 elerk 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 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 medieal certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
No ....
.22
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,
Hersale
Widow
27.
4. Color, t
5. Age, .
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, . ly Mana
11. Name of Father,
12. Name of Mother, a .
13. Birthplace of Father, .
Marthhad
14. Birthplace of Mother, .
15. Place of Interment,
Medfad
Signature of Undertaker or other person making the Return,
DATED at.
, on
188 8.
* 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.]
Deful
3/88 JAannali MAdance
65
Years,
Months, ..
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 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.
Boston, C'est 4 1888.
This Certifies, That tamah M. Idame dicd on the
day of & Mit, 1888, aged 65 years . years,
months,
days.
CAUSE OF ) Primary,
Duration.
DEATHI. Secondary, Dropry.
Duration One year
..... He f foule
Physician.
Kunmy Ride
7
Rockwell & Churchill, City Printers, 39 Arch Street, Boston.
No.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
Plat 27" 1888. Edwina butter.
...
(Maiden Name), ·
(Name of Husband),*
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, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker ws other person making the Return, . .
1
9
18 .
DATED at
.. .
temiz 6
Breuse 18 Months Days.
Edmond
Thortino hansen
* 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 bo ly: Suor itdicate shall state that the facts required by this chapter have been returned and recorded such graficate 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 hf any city or town for such purpose shaft sign the certificate of the cause of deat mo the bestof
and belief, if there has 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.
No. 18
Commonwealth of Massachusetts.
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,
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, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return, .
1980
male mais
64 Years, 5
Months, ..._ Days.
In 18,5
boas 12,
Solchia
1
1
..
DATED at
... , on L'a1- 30 .18
* 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.]
[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 bartat ar rang iny the body. Nach artisticate shall state that the facts required by this chapter have been returned and recorded, and no clerk ortregistrar 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 byany city or town for sud purpose, shall sign the codificate of the cause of death the best of bes hvor lenge
ang- 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.
No. 19
Commontocalth of Massachusetts. usetts. to Perer Jeme Out
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 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, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker hpmaking the Return, .. -
(
f
Qununer et. a.16
DATED at ... , Onl
f
30' 188 8
A'la. . ...
t'en: il
Years, ..
Months, .. 8 Days.
t
..
...
...
... .
18 5 .~
* If a Married Woman or Widow. f If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
1
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 certificatc. 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 OF THE CAUSE OF DEATH.
Name of Deceased
Och' 10 Boston, learn Fall.
1888
Date and Place of Death, .
Och /10 0 888,
Disease or Cause of Death,
*Duration of
..
I certify that the above is true, to the best of my knowledge and belief.
Name and Residence,
4 Saratoga eft
No.
laker, sexton or other person shall bury in a city or town or remove therefrom the body of a de- ceased 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 sueli eity 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 lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot 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 eity 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 are delivered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the elerk or register for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased 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 seetion shall be punished by a fine not exceeding fifty dollars. [Approved May 4, 1888.
SECRETARY'S DEPARTMENT, BOSTON, May 4, 1888.
This Act takes effect June 3. 1888.
Blake
UNDERTAKER'S RETURN TO THE BOARD OF HEALTH, BOSTON.
Handball Sex.
Date of Death, Och' 10, 1888, Name, Mary Maiden Name' Mary MaDonald/ Married, single or widow of, married wife of Danial Cam bell. Color, IL Age, 49 years, to mos. ~ days. Residence, Winthrop Place of death, St. and No. Ward Place of Birth, Cukr Pratow A. S. Occupation, Housewife Name of father, Daniel It, Donald Name of mother Margaret Mit Birthplace of father Take Metag has Birthplace of mother Exper Matoout,S. Place of interment, t
*If a married woman or a widow.
tGive the name of the burial ground.
Signature of Undertaker, or other person making the return. Stranke et Autoren
[CHAPTER 306.]
Commonwealth of Massachusetts.
In the Year One Thousand Eight Hundred and Eighty-eight.
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHIS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows :
SECTION 1. 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 negleets or refuses to make a certificate, as aforesaid, he shall be punished by a fine not exceeding fifty dollars.
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