USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 3
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MPIn case of an Interment taking place without the Certificate of Registry of the Clerk of the City or Town in which the death oceurred (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 of returns, and Physician's Certificates, may be obtained from the City Clerk.
PHYSICIAN'S CERTIFICATE.
To the Clerk of the City of Malden.
JEceased, Alguna O Hilliamo lied at Ocean Spray Winthrop Place of Death, . .. 188 6 Cause of Death, .. of Codema Lungo Duration of Sickness. s. Three weeks
I certify that the above is true, to the best my knowledge and belief. idence of Certifying Physician 0 malden
Date of Certificate July 26 th 1886
* Or Sex of infant (not named).
A physician who has attended a person during his last illness shall-when requested within fifteen days after the decease of such son-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the of his disease, as nearly as he can state the same. - ( Extract from Chapter 32 of the Public Statutes, Section 3.)
Section 4 of the same chapter provides that "no human body shall be buried or removed from any city or town, until a proper cert has been given by the clerk or registrar to the undertaker or sexton, or other person performing the burial or removing the body. certificate shall state that the facts required by this chapter have been returned and recorded ; and no clerk or registrar shall give sud tificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the sickness of the deceased, and placed in the hands of said clerk or registrar."
If therc has been no physician in attendance. or in case of death by dangerous contagious diseases, or in any other event where til tificate of the attending physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local bo 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 knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.
1. Date of Death,
aug. 3" 1886. Harry M. S. marble
2. Name,
(Maiden Name),'
3. Sex, and whether single. Married, or Widowed,
Mp.
4. Color, t
5. Age, .
1
Years, ...
Months, .
Days.
6. Disease or ( First or Primary
Cause of { Secondary (if any)
Death,
By whom certified
7. Residence,
8. Place of Death,
9. Occupation, .
18. Driving It. Boston
Seashore Home
10. Place of Birth, . (Boston
11. Name of Father,
Deneme à. Jaraf
Waldeboro Maino Waldebord Maine
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return,
L Winthrop
DATED at.
,
on.
(ing. 4'
188
6.
.
* 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.]
12. Name of Mother, .
13. Birthplace of Father, .
MA Hoke
S'in kham.
The Undertaker, or other informant, is requested to report the facts-together with th 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 perso having charge of such Interment must FORTHWITH GIVE NOTICE thereof - or report these facts - to sai Clerk. Penalty for neglect, twenty dollars.
Blank forms for Returns of Deaths may be obtained from the Town Clerk.
PHYSICIAN'S CERTIFICATE. To the Clerk of the City of Cambridge. 7- throp.
of Deceased,*
Harry 16. J .: Har be
and Place of Death, . died at Hi there Eine Clicar"
188 6
se or Cause of Death,
of Cholera Infantun Duration 3 weeks
I certify that the above is true, to the best of my knowledge and belief.
ad Residence of Certifying Physician
R.M. quece
Date of Certificate ...
188 M
* Or Sex of infant (not named).
A physician who has attended a person during his last illness shall-when requested within fifteen days after the decease of s person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person dicd, and date of his decease, as nearly as he can state the same .- [Extract from Chapter 32 of the Public Statutes, Section 3.]
Section 4 of the same chapter provides that "no human body shall be buried or removed from any city or town, until a proper certifi has been given by the clerk or registrar to the undertaker or sexton, or other person performing the burial or removing the body. S certificate shall state that the facts required by this chapter have been returned and recorded ; and no clerk or registrar shall give such certifi or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sicknes the deceased, and placed in the hands of said clerk or registrar.
If there has been no physician in attendance, or in case of death by dangerous contagious diseases, or in any other event where certificate of the attending physician cannot, for good and sufficient reasons, be carly enough obtained, the chairman of the local boa 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 knowledge and belief. In case of death by violenec, the medical examiner shall furnish the certificate
NO.
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
Quanat 6" 1880 Flakie Carter
(Maiden Name),*
3. Sex, and whether single, Married, or Widowed,
tennale
4. Color. t .
5. Age, Years,
Months, ..
21 Days.
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified.
fremund
7. Residence, . .
8. Place of Death, . O
9. Occupation,
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 or other person making the Return, .
DATED at on
8
18
1
LaListe
85,-
Chant
965.1
11 ::
* If a Married Woman or Widow. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
[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 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.
S.B. Collier to
Fraijer Per Imberg. unday 2. 0. 212.
PHYSICIAN'S CERTIFICATE.
ze of Deceased,*
and Place of Death, - ase or Cause of Death, -
Alessie Carter died at Wenthref2, 57 ,
18$ 6. of Cholera Inpartier Duration of Sickness Four weeks,
I certify that the above is true, to the best of my knowledge and belief. .... ...
and Residence of Certifying Physician M. S. landi h.t. Winthrop
Date of Certificate Aus 14" 1886
* Or Sex of Infant (not named ).
Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease o person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, a date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]
Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Regis of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performi burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Ca Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands clerk or local registrar."
If there has been no Physician in attendance, or in case of death by dangerous contagious disease, or in any other event whe certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Bo Health, or any Physician employed by any city or town for such purpose, shall sign the Certificate of the Cause of Death, to the b his knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death.
Marguerite la Recherche
2. Name.
..
(Maiden Name),
3. Sex, and whether single, Married, or Widowed,
Terraza
4. Color, t .
5. Age, Years, ... 5 Months, 25 Days.
Disease or Cause of Death, 6 .. Duration of Sickness,
By whom certified,
7. Residenee, .
8. Place of Death.
9. Oceupation,
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 or other person making the Return, .
DATED at
on
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.]
Landede
/
Stanthing?
1
a
12
..
9.5000
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 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.
R
Sr.
PHYSICIAN'S CERTIFICATE.
Deceased,*
Place of Death,
" Cause of Death, - of
Magnito Richardo died at Sea Star Anne, Winthrop, Mars. Una, 10,886 Malaria termin Antiza Cchness in Cholera Infatime Sick al ' Hiver home 13 days. I certify that the above is true, to the best of my knowledge and belief. R.M.Seine- Sea thur Aum-
Residence of Certifying Physician, :
Date of Certificate, any 11 th 189 C
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 t of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the pe and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificat 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 or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state facts required by this chapter have been returned and recorded; and no elerk or registrar shall give such certificate or burial p the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the dece placed in the hands of said elerk or registrar; and in eities and towns where there are boards of health, the certificate of the death shall also be approved by such board before a permit to bury is given by the registrar or elerk. U'pon application, the of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause to the best of his knowledge and belief, if there has been no physician in attendance. Ile shall also sign such certificate, upo tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician c good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall fi requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five
No. 4
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,
4. Color, t . .
5. Age, .
Years, G Months, Days.
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation,
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 or other person making the Return,
DATED at
.....
on
( Luc, 12
1886
* If a Married Woman or Widow.
tlf other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
·
aug 11:15℃ Kellie Malehead Aarhusite Richarde
marcela
griee 20
-
VinnieWhitehead
000 Geland
Ttoud
[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 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.
C
Printing Department, Deer Island, Boston Harbor.
Whitting ,Ma aug. 11. 1886
This Certifies, That. Jellie Whitehead
died on the 11 th day of any. 1886, aged. 8 months,
CAUSE OF) Primary,
Cholera Enfantus Duration 1 min
DEATII.
S Secondary,
Duration
Edvd +. William I.p. Physician.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
august 11 "1886) Eldon Ferdinand 6. Tale
(Maiden Name).
3. Sex, and whether single, Married, or Widowed,
male
4. Color, t .
Years,
Months,
20 Days.
5. Age,
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation,
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 or other person making the Return, .
Floyd
1.
DATED at
on
18 5€
* 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.]
322002
Pleasant Stuurt
Charles CH, Pat Susan 12 grade
Charleston,
212.2001 Thathon Tan Cemety
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 perinit 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
1
1-4
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
To the Clerk or Registrar of the Town or City in which the Death occurred.
nd Sex of Deceased, ed Place of Death, .
e h,
First or Primary, Secondary, .
Ferdinand Elden Tale- male Winthrop, Mask, Ungust 12, 1886
Duration of,* Cerebral Meningitis Duration of, two days
I certify that the above is a true Return, to the best of my recollection and belief.
ofessional Title, and Residence, George & Mccarthy M 2 Wanthad Mach
Dated at. Winthrop, august 14 188C.
y particular to fill all Blanks.]
* Reckoned to the time of death.
Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [EXTRACT FROM CHAPTER 21 OF THE GENERAL STATUTES, 1859. ]
The attending Physician is requested to make out his Certificate as promptly as possible, for the information and use of the Undertaker, or other person making return of the case to the Town Clerk.
Physicians may obtain BLANK CERTIFICATES from the Town Clerk or Registrar.
Copies of the STATISTICAL NOSOLOGY, adopted for the purposes of Registration, may be obtained on application to the SECRETARY OF THE COMMONWEALTH.
..
To the Clerk of the Town in which the Death occurred.
1. Date of Death.
2. Name.
aug 13 -1886 Esbel 1
(Maiden Name), ·
3. Sex, and whether single, Married, or Widowed,
4. Color. t .
5. Age, 02 Years, / Months,
Days.
Disease or Cause of Death,
6. Duration of Sickness, · By whom certified,
7. Residence, . ·
8. Place of Death, ·
9. Occupation,
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 or other person making the Return.
DATED at
august 14 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. ]
ب 21200
A.
Dudie
220
[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 registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the fac required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until th certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, an 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 death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairma 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 deal to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applic tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot f good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish th requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-ti dollars.
PHYSICIAN'S CERTIFICATE.
Emily Einhale
Name of Deceased,*
Date and Place of Death,
d at Winthrop Aug 13,
Disease or Cause of Death, -
Paralysis
Duration of Sickness Four das. ...
I certify that the above is true, to the best of my knowledge and belief.
Name and Residence of Certifying Physician
Date of Certificate, Aus 14℃ 1886.
* Or Sex of Infant (not named).
Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]
Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Registration of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, until a proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performning the burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have been returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Cause of Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of said clerk or local registrar."
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