USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 16
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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 under-
PHYSICIAN'S "CERTIFICATE OF THE CAUSE OF DEATH.
Name of Deceased Abner
Date and Place of Death, .
Disease or Cause of Death,
Wanting? Typhoid Fever
Oct. 141986
* Duration of about 6 weeks
I certify that the above is true, to the best of my knowledge and belief.
Name and Residence, B. Hlampbell No. D.23 Invecelow heat PR
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 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 lien 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, carly 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 snch 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 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 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 section shall be punished by a fine not exceeding fifty dollars. [ Approved May 4, 1888.
18 8
UNDERTAKER'S RETURN TO THE BOARD OF HEALTH, BOSTON.
Oct-III Name, aber Dour Served Sex, Locale
Date of Death, Maiden Name 1888 Married, single or widow of. Color, While Age, 31 years, mos. Place of death, St. and No. Worth are Witha . Ward. Place of Birth, Boston Name of father, Birthplace of father, Place of interment, t
wifeof days. Residence, Winther Ma
trumcistern
*If a married woman or a widow.
Signature of Undertaker, or other person making the return. - Ten; F. Smith
· Occupation, Pilot- . Name of mother, . Gostow. Birthplace of mother, Viorellaws ¡Give the name of the burial ground.
[CHAPTER 306.]
Commonwealth of Massachusetts.
In the Year One Thousand Eight Hundred and Eighty-eight.
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, 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 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
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name of Deceased Einge l'era
Date and Place of Death, .
( Summeguide (ME)
Disease or Cause of Death,
after Game nurkowie to live.
*Duration of Havedubey , I certify that the above is true, to the best of my knowledge and belief.
Name and Refdence, William Hulle East BostonMass.
taker, sexton or other person suatt bury in a city of 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 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 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 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 are 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 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 section shall be punished by a fine not exceeding fifty dollars. [Approved May -1, 1888.
This Adt takes effect June 3. 1888.
SECRETARY'S DEPARTMENT, BOSTON, May 4, 1888.
UNDERTAKER'S RETURN TO THE BOARD OF HEALTH, BOSTON.
Dale of Death, Maiden Name
188 frame.
Morgen Vicina . Sex, M
Married, single wow of. wife of Color. Vr. Age, - years, - mes. Place of death. St. and No. Sunny side ao Place of Birth, Wennleroy Name of father, auto Birthplace of father, Picko
(0) Lavs. Residence,
Ward Fisher man
. Occupation, . Name of mother, Da . Birthplace of mother, staral
Place of interment, +
*If a married woman or a widow.
¿Give the name of the burial ground.
Signature of Undertaker, or other person making the return.
[CHAPTER 306.]
Commonwealth of Massachusetts.
In the Year One Thousand Eight Hundred and Eighty-eight.
ANAOT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted by the Senate and House of Representatives in Generat 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 faets relating to deeeased 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.
No. 20
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 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,
Afinal stormingitis
1 brecce it de Dolarimal
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, . "
11. Name of Father,
12. Name of Mother, ·
13. Birthplace of Father, .
1.1. Birthplace of Mother, .
15. Place of Interment,
Lyfthip. €. 1
cal.
Signature of Undertaker or other person making the Return, .
DATED at
.... , Oll
Dian 13, 188.8.
* 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.]
Nov. 12 1888 Grove Creavel und Halloun
11xxxx
Years,.
Months,
21 Days.
162
[Publie 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.
No. DE
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),*
1. one 1 ber 191888 (DZ valler (A)
Max red.)
3. Sex, and whether single, Married, or Widowed, C
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, Moura Lene
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker se atho pass making the Return, .
١
Quinnentered.
DATED at
0
* 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
38 Years, ... ... .. Months, Days.
Conel Gelale Og 7 de Persif 1.
tand tv. Der
Pound turkey
[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 regis to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts requ by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificat 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 hut of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall als approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of he: 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 knowk and belief, if there has been no physician in attendance. He shall also sign such certificate, upon application, in case of death by dan ous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons beef enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any pe 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 twen line of said section the words : - if the deceased was a married woman the name of her husband.
PHYSICIAN'S CERTIFICATE.
từ-
ame of Deceased,* -
ate and Place of Death, -
isease or Cause of Death, -
died at of Cirrhosis
Grattis
CLT . 1. 1. 1. Ports de 19"1888.
Duration of Sickness
I certify that the above is frucht) the best of my knowledge and belief.
ame and Residence of Certifying Physician, He & Soule M.t. Winthrop
Date of Certificate, Nor 20" 1888.
+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."
No.
22
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
1
2. Name,
Al, dastehen
(Maiden Name),*
(Name of Husband),*
-
Female
3. Sex, and whether single, Married, or Widowed,
4. C'olor, 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 orother person making the Return, .
DATED at , on Toi lets 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.]
+1.
3
2 Charles L" Gardiner addie B. Gardiner 1
.
17 Years, . .. 6 Months, Days.
2,000
[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 regis: AMENDED certicate shall state that the facts requi by this chapter have been returned and recordfedt and as derk of registras shall give sich der ficafe or burial permit until the certificate 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 ha: 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 approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of heapa. or any physician employed ht any city or town for sech purpose and beli
rise ous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be e enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any per 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 twent line of said section the words: - if the deceased was a married woman the name of her husband.
PHYSICIAN'S CERTIFICATE.
jame and Age of Deceased,*
Jennie No. Gardiner
Age,
Date and Place of Death, - died at Monterops (Centre &r) ...
.....
Orar 30"1888.
disease or Cause of Death, -
Ulceration of Intestines Duration of Sickness. One year
1
I certify that the above is true, to the best of my knowledge and belief. :me and Residence of Certifying Physician,
3
Date of Certificate, Non 12 1888.
*Or Sex of Infant (not named).
[ 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 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 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 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 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.
130
To be Reported before, interment.
Jour Kleve 8
RETURN OF A DEATH TO THE BOARD OF HEALTH.
CITY HALL, CHELSEA.
Date of Death,
Dec 2 the
188 8
Name,.
Almire & Dava Color;
Cure Color,
Il hite
Age, 6-3-
years,
2
months,
days.
Residence, (St. & No.)
Sex, whether Angte, married or widowed,
Occupation,
Birthplace,
18 ruffalo 1, 0
Names of Parents,
Davidir
Wife or Widow of,.
Birthplace of Father, ..
Stoning Can
Birthplace of Mother,
Place of Interment,
Undertaker or Informant,
96JE Carter
Chelsea, Mass., , Dec2 1888
This Certifies,
That Almira I Daval
lied on the 2
day of ...
Dec
1886, aged 55 years, 2 months,
days.
ZUSE OF DEATH. Secondary,
Drowsy
Primary,
Que Jear Duration, .
Duration,
Ab, & Sauce
Physician.
I
No.
vommonwealth of grassachusetts.
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. Płace of Death, .
10. Place of Birth, . 11
11. Name of Father,
12. Name of Mother, . ·
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker weatherperson making the Return, .
Dec15-19rx Edna may 12 m2-
Philé
Years, - Months, Days.
1
1
Pine #1 50459
DATED at
18
. L
.....
* 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 AMENDED to the undertaker, sexton, or other person performing the trial or removing the body, Such certificate shall state that the facts required by this chapter have been returned and recordel; and gofler or registar 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 Bymany city or town for such purpose, shaft sign the Certificate of the cause of death to the bes
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 twentic". line of said section the words: - if the deceased was a married woman the name of her husband.
PHYSICIAN'S CERTIFICATE.
Fred of Noyes
Name and Age of Deceased,*
Date and Place of Death, -
died at
Stillborn enfant Age Winthrop Dec. 15€ 1888.
Disease or Cause of Death, - of .
Duration of Sickness
I certify that the above is trye, to the best of my knowledge and belief.
Name and Residence of Certifying Physician,
Date of Certificate, Dec 19" 188%.
*Or Sex of Infant (not named).
[May, 1988.]
T
[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 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 clerk or register for registration. The person to whom the perinit is so given shall thereafter furnish for registration any other information as to the de- 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.
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