Town of Winthrop : Record of Deaths 1886-1892, Part 25

Author: Winthrop (Mass.)
Publication date: 1886
Publisher:
Number of Pages: 726

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 25

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

zme and Residence of Certifying Physician, S.A. Aoughton Sea Shore Some Winthrop

Date of Certificate, Crugust. 14, 1890.

*Or Sex of Infant (not named).

[May, 1888.]

[Acts of 1888, Chapter 306.]

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 liis 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.

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

1. Date of Death, .

auquel 21 "1890 William I rotter

2. Name,

(Maiden Name),*

· (Name of Husband) .*

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

Male (Widower) Shiv-

4. Color, t

5. Age, Disease or Cause of Death,

62 Years, Months, Days.

Typhoid Fever

7. Residence, England Engineer

8. Occupation, .

9. Place of Death, .

10. Place of Birth,

Peatland Robert

11. Name of Father, Ellen D.

12. Name of Mother,

13. Birthplace of Father, . Scotland

11. Birthplace of Mother. .

Seatland

15. Place of Interment,

Signature of Undertaker

Summer Head

the Return, . ١

· DATED at

anghel 22 x 9.0

, O11

* 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. ]

6. Duration of Sickness. . By whom certified, .

[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 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. Section five of said chapter, prohibiting the burial or removal of a human body until a proper certificate is for- 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 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 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 clert 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 Muy A, ISSS.

PHYSICIAN'S CERTIFICATE.

Ind Age of Deccased,

Age ... 6h

id Place of Death, - died at

or Cause of Death, - of off hotel fever Duration of Sickness

1889. Three Weeks

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

" Residence of Certifying Physician,

Date of Certificate, 21 232

188

)r 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 certa facts relating to deceased persons, is amended so as to read as follows : -- Section 3. A physician who has attended a person during last illness shall, when requested, forthwith furnish for registration, a certificate stating, to the best of his knowledge and belief, the nas of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his deceasc. If a physician ne 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 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 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 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 se board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be retur and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu the a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician can not be obtain for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a ci town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate 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 reg for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the 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 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,

2. Name,

(Maiden Name),*

(Name of Husband) .

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

4. Color. j

5. Age,

Disease or Cause of Death,

6. Duration of Sickness. . By whom certified.

7. Residence,

8. Occupation. .

Sea Shore Hamie

9. Place of Death, .

10. Place of Birth. .

11. Name of Father,

12. Name of Mother. ·

Daniel Lottie Ireland

13. Birthplace of Father. .

14. Birthplace of Mother. .

15. Place of Interment.

Signature of Undertaker 1 Lunner teor

mother persone making

the Return, .

DATED at

Winther

august 25 1890

* If a Married Woman or Widow.

T If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.

auquel 24"1890 minnie Dencien

Female

While

Yeary, 6 Months,

Days.

Membranous Groups

Biston mars

Destino

England

malder

[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 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 negleets or refuses to make a certificate, as aforesaid, lie 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 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 deceased person until he has received a permit so to do from the board of health or its "(huly 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 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 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. [Approred May 4, 1888.

the deceased was a soldier or sailor who served in the war of the rebellion, give both the primary and secondary cause of death. See Chap. 224, Acts of 1889. PHYSICIAN'S CERTIFICATE.

ne and Age of Deceased,*

and Place of Death, -

Moinnie. Denieen died at Winthrop, aug. 24.

Age, 18 months 1890.

se or Cause of Death, -

of Membranous Crown Duration of Sicknes. 4 days

I certify that the above is true, to the best of my knowledge and belief. l Residence of Certifying Physician, .A. Houghton Sea Shore Home Winthrop

Date of Certificate, ficate, aug. 24

*Or Sex of Infant (not named).

1890.

[Ed .- 10 M - Oct. 9, 1889.]

[May, 1888.]

REI.A

[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.

>COMMONWEALTH OF MASSACHUSETTS.

No 18 RETURN OF A DEATH.

To the Clerk of the City of Malden.

1. Date of Death .

2. Name of Deceased (Maiden Name) (Husband's Name)*

3. Sex. .

4. Colort

5. Condition, whether Single, Married or Widowed

6. Age .

7. Disease or Cause of Death,

8. By whom Certified

9. Residence

10. Occupation

11. Place of Death

12 Place of Birth

13. Name of Father

14. Birthplace of Father

15. Maiden Name of Mother .

16. Birthplace of Mother . ·

17 Place of Interment ·

Signature of Undertaker or other person making the return.

Aug 275 1890 Many Gray Lawrence

Jensale

-.... Years - Months My Days.

Portland

Portland Effic J. Gray

Kalden Mali

#Antrop aug 271890

* If a Married Woman Or a Widow.

+ (W.) White ; (A.) African ; (M).) Mixed White and African. If other Race, specify what.

Be very particular to fill all Blanks in Ink.

The Undertaker; or other informant, is requested to report the facts - together with the Physician's Certificate of the Cause of Death - to the City Clerk, BEFORE THE INTERMENT, and receive the Clerk's Certificate that the return has been made.

In case of an Interment taking place without the Certificate of Registry of the Clerk of the City or Town in which the death occurred (or the deceased resided) having first been obtained, the person having charge of interment must FORTHIWITH GIVE NOTICE thereof - or report these facts - to said Clerk. Penalty for neglect, twenty dollars.

Blank forms of returns, and Physicians' Certificates, may be obtained from the City Clerk.

PHYSICIAN'S CERTIFICATE.

To the Clerk of the City of Malden.

Lawrence

... yrs.

-mes .

19 dys.

aug. 27 1890. Duration of Sickness one week

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

Date of Certificate,

aug- 27 the 1800.

Age of Deceased,*

mary gray

Place of Death, .

Cause of Death,

of Diarrhoea

Died at No. Mermaid ave. Street,

* Or Sex of Infant (not named).

EXTRACT FROM SECTION 1 OF CHAPTER 306 OF THE LEGISLATIVE ACTS OF 1888.

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 deccase. If a physician neglects or refuses to make a certificate as aforesaid, he shall be punished by a fine not exceeding fifty dollars.

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) .*

3. Sex, and whether single,

Married, or Widowed.

4. Color, t ( 31)

31 Years. 5 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. . L

14. Birthplace of Mother. .

15. Place of Interment, Gloucester mass

Signature of Undertaker 1

the Return. .

/ DATED at

14"1891

* 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.]

)

5. Age. Disease or Cause of Death,

[Acrs of 1888, CHAP. 306.] CHUAN 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 I'nblic 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 ha- 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 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 fin- 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 duly 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 issned 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, 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 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 eanse 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. Llpprored May 4, 188S ..

PHYSICIAN'S CERTIFICATE.

31 1 3molida Age,

Vame and Age of Deceased,*

Date and Place of Death, - died at. Primagy Pneumonia Heart failure

Sept 14 F

1870

Disease or Cause of Death, - 1

Duration of Sickness

four days

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

Yame and Residence of Certifying Physician,

Date of Certificate, . ... Seht 13th

188 (.

*Or Sex of Infant (not named).

[May, 1888.]

[Acts of 1888, Chapter 306.]

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Town of Winthrop : Record of Deaths 1886-1892, Part 25

Author: Winthrop (Mass.) Publication date: 1886 Publisher: Number of Pages: 726

Author: Winthrop (Mass.)
Publication date: 1886
Publisher:
Number of Pages: 726