USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 20
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Oceupation, ..
Name of mother, ....
Birthplace of father,
Birthplace of mother,
Place of interment, t Antropo Cemetery
* If a married woman or a widow. + Give the name of the burial ground,
Signature of undertaker, Father person
making the return. Summer it loyd
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death. .
2. Name, Still Born Son
(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, .
Summer tout
DATED at
may
1890
* If a Married Woman or Widow.
f If other than White. (M.) Mulatto. ([.) Indlan. If of other Races, specify what.
[Be very particular to fill all Blanks. ]
Male
White
Month, . Days. Stillborn
Rudy Con Jurtil
...
... ...... ..
aner
Susan 11
Bezla Saga fitzgrillen Of 4
[ACTS OF 1888. CHAP. 80G.]
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted, etc., 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 8. 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 pun- ished by a fine not exceeding fifty dollars.
SECTION 2. Seetion five of said chapter, prohibiting the burial or removal of a human body until a proper certificate is fur- nished, 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 deecased 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 elerk, as the case may be. a satisfactory written state- ment 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, orif 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 such satisfactory statement and certificate are de- livered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar 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 eause of the death, as the elerk 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.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name, (Maiden Name),
may 17 - 1832 George 6. Sincity
3. Sex, and whether single, Married, or Widowed,
Male 1
Archite
4. Color, t
5. Age, .
23 Years, .... 3 Months, 10 Days.
6. Disease or First or Primary
Cause of Secondary (if any)
Death, By whom certified
7. Residence,
8. Place of Death,
-Reail SE
-1/ 1je
9. Occupation, . Datesman C
10. Place of Birth, . charth Orhassett. 1 11. Name of Father, David 12 E Poise CE CVC. tru
12. Name of Mother,
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker -
another person making the Return,
DATED at.
17
,
May
1896
* 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.]
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 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.
Vame and Age of Deceased,*
Grange 6.5
1
Age, 23
Date and Place of Death, - died at
May 17
Disease or Cause of Death, - of
Chilisis
Duration Yof Sickness
I certify that the above is true, to the best of my knowledge and belief.
asmart-
Vame and Residence of Certifying Physician,
Date of Certificate,
May 18
189.1)
*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 discase of which he died, the duration of his last sickness, and the date of his deceasc. 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 therc 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.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death. May 28" 1890 aliet In Burrage 2. Name, Belifier
(Maiden Name ) .
(Ninne of Husband) .*
3. Sex, and whether single.
Married, or Widowed.
FerAnce Shared ... .
4. Color.t
5. Age, .
31
Years, 10
Months,
Days.
Disease or Cause of Death,
6. Duration of Sickness. . By whom certified.
7. Residence,
s. Occupation. .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, Bettran 13. Birthplace of Father. . Chelsea
11. Birthplace of Mother. . Chatten
15. Place of Interment,
Signature of Undertaker 1 or other person making the Returny.
A
18
DATED at
* If a Married Woman or Widow. { If other than White. (M.) Mulatto. (1.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks. ]
1
1
Muthip
[ACTS OF 1888. CHAP. 306.] AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted, etc., 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 deeease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be pin ished 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 fur nished, is amended so as to read as follows : - Nection 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 state. ment 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 sueh satisfactory statement and certificate are do- livered to the board of health or to its agent, the board or agent shall forthwith contersign and transmit the same to the clerk or registrar 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 elerk 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.
PHYSICIAN'S CERTIFICATE.
me and Age of Deceased,* 'e and Place of Death, - died at. Peritoiulia
Age, 32 . ...
.89.0
Disease or Cause of Death, - of ...
Duration of Sickness One Month
I certify that the above is true, to the best of my knowledge and belief.
ime and Residence of Certifying Physician, .
Charles A Castman.
*Or Sex of Infant (not named).
Date of Certificate; ' Create Labe 20189.)
[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.
No.
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 ),*
Ligne 9 " 1890 Eliza A. Sunderland. Win 1 Pickering Sunderland
3. Sex, and whether single, Married, or Widowed,
4. Color,t
White. 80. Years. X Months, Days.
5. Age, Disease or Cause of Death,
6. Duration of Sickness, . (By whom certified,
7. Residence, 94. Shawmot St Chelsea mais
8. Occupation. .
9. Place of Death. . 10. Place of Birth, Newbury p.N.pt iclearing
11. Name of Father,
12. Name of Mother, .
Portsmouth N.H. "
13. Birthplace of Father. .
14. Birthplace of Mother. .
15. Place of Interment,
Signature of Undertaker or other person making the Rotude, .
Chelsea Maïs James finde the 1
DATED at
Chuluca
10th ghwa 1890
* 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. ]
[ACTS OF 1888, CHAP. 306. ]
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL (1 BODIES OF DECEASED PERSONS.
Be it enacted, etc., as follows :
SECTION 1. Section three of chapter thirty-two of the Public Statutes, requiring attending physicians to furnish 1 registration certain facts relating to deceased persons, is amended so as to read as follows :- Section 3. A physician who lia 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 1 e. sickness, and the date of his decease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be ' ished 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 nished, is amended so as to read as follows : - Section 5. No undertaker, sexton or other person shall bury in a city or or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or les 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 ste ment containing the facts required by this chapter to be returned and recorded, together with the certificate of the atte physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If t] no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, car enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose sha 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 do- livered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar 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, 1885.
I
Bostina June 10th 1890
This Certifies that
Eliza Sunderland. age. 80 years
June 9 the 1890
Wed at Winthrop
of death
Amwoning
Med. Affaris . Trancio
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
une 19"1890
2. Name,
(Maiden Name) , (Name of Husband),*
3. Sex, and whether single, Married, or Widowed, marcel
4. Color.t
5. Age, SS Years, -Months, Days.
Disease or Cause of Death,
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation. .
9. Place of Death. .
10. Place of Birth, Bio
11. Name of Father,
12. Name of Mother, 2 .~
13. Birthplace of Father. .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker. 1 or other person making the Return, y S
DATED at
1
2 0-19 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.]
[Acrs OF 1888, CHAP. 306. ] AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted, etc., 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 certifleate, as aforesaid, he shall be pun- ished by a fine not exceeding fifty dollars.
SECTION 2. Section five of said chapter, prohibiting the burial or removal of a human body nutil a proper certificate is fur- nished, 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 dluly appointed agent, or, if there is no board of health in such city or town, from the city or town elerk. 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 state- ment 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 such satisfactory statement and certificate are de- livered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar 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 canse 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.
PHYSICIAN'S CERTIFICATE.
Vame and Age of Deceased,*
Date and Place of Death, -
died at Winxthach punk 19
1
Edward & Loring
Age,
88 pour 18890
Disease or Cause of Death, - 1 of of Old age Duration of Sickness.
I certify that the above is true, to the best of my knowledge and belief.
ume and Residence of Certifying Physician, de & Soulé Winthrop.
*Or Sex of Infant (not named).
Date of Certificate, func LO 188
[May, 1888.]
on
[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 ncg- 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.
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