USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 5
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3. Sex, and whether single, Married, or Widowed.
4. Color, t .
10
5. Age,
Years,
Monthy.
Days.
10 merkes
Disease or Cause of Death,
6. Duration of Sickness, · By whom certified, ·
7. Residence, . .
8. Place of Deathı,
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. .
4.
LE
1
7112222262
tigel
DATED at
on
1856
* 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.]
Levy
Signature of Undertaker or other person making the Return, .
.
3
[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 chairm 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 de 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 tie requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
f Deceased,* - { Place of Death, r Cause of Death, -
Many? Gear died at of
Duration of Sickness 10 days I certify that the above isytrue, to the best of my knowledge and belief. R.M.
Residence of Certifying Physician,
Date of Certificate, Luft 2 188 6
Ur Bex 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 de of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the persei and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certif itc, h 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 or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state t facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial peru the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceas placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the c death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the c of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the eause to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cal good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall fur requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
The as morecraft-
3. Sex, and whether single. Married, or Widowed.
male
4. Color, t
5. Age, .
.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, .
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, .
7
U
DATED at ... on
188 0
* 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.]
..
0
11
Sinos +
3. 1986
(Maiden Name),*
1. Pst
The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Deathi-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 FORTHWITHI 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.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
O
1. Date of Death,
2. Name,
(Maiden Name),*
3. Sev. and whether single, Married, or Widowed,
1. Color. + .
5. Age. Fears, -Month's. 10 Days.
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified, .
7. Residence,
Sea ? 1
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. .
Kenmal & 184 / 2 01 -1
Signature of Undertaker or other person making the Return, .
Underán
DATED at .
* If a Married Woman or Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
TBe 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. Hc 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.
PHYSICIAN'S CERTIFICATE.
ime of Deceased,*
sease or Cause of Death, -
Ellen Me kann Mit Leaflere Have A wallof Man. Ryph 786
Lite and Place of Death, - died at of Double Pneumonia Du
Duration of Sickness 10 days
I certify that the above is truc, to the best of my knowledge and belief.
ie and Residence of Certifying Physician,
Date of Certificate, Supp 2 188 6
+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 disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit unti 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 o 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 deat 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 fo 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-five dollars.
nic Deain occurred.
1. Date of Death,
2. Name,
(Maiden Name),*
3. Sex. and whether single. Married, or Widowed.
Female
While
4. Color, t
5. Age, .
3
Years, ....
5
Months, ..
9
Days.
6. Disease or First or Primary
Cause of
Secondary (if any)
Death,
By whom certified
0%
7. Residence, ·
8. Place of Death,
Cor Belsker- Mintha1 9
9. Occupation, .
10. Place of Birth, .
11. Name of Father, Bacon
12. Name of Mother, : Electa Bacon
13. Birthplace of Father,
Charlestown There Sembol
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making
2. Royal
the Return, .
DATED av melhor
,
on.
... 188
6
* If a Married Woman or Widow.
t If other than white. (A.) African; (MI.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
3' 1886
Charleston
PerLu.
The Undertaker, or other informaut, is requested to report the facts -together with Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE TIIE INTERMENT.
In case of an interment taking place, without the Certificate of Registry of the Clerk Town in which the Death occurred (or the deceased resided) having first been obtained, the having charge of such Interment must FORTHWITH GIVE NOTICE thereof - or report these facts - to Clerk. Penalty for negleet, twenty dollars.
Blank forms for Returns of Deaths may be obtained from the Town Clerk.
PHYSICIAN'S CERTIFICATE.
alice Bacon
Winthrop, Mass Scht-3,
of Dysentery
1886. Duration of Sickness 6
I certify that the above is true, to the best of my knowledge and belief.
fame and Residence of Certifying Physician,. ian CO. C. Me Carting, M. D. Hniticop, Fraes
Date of Certificate, ertificate, Scht3, 1884.
*Or Sex of Infant (not named).
Name of Deceased,*
Date and Place of Death, -
died at
Discase or Cause of Death, -
[ Extracts from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of. health, the certificate of the cause of (leath 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.'
6Lenis
RETURN OF DEATH TO THE CITY REGISTRAR.
29
CITY HALL, BOSTON.
Date of Death, 7
18 86 Name, France Libre ville Han er Color,+ 1. Age
years
Months days
Place of Death ? Street and No.
WARD
Residence, La
Sex, ~
2. 4 Single,
Married.
Occupation,
Wife of
Birthplace*
€
- Widow of
Name of Father, . ~
Name of Mother, to.
2
Birthplace of Father,
Birthplace of Mother,'
Cause of Primary, { {
Fax++ Duration,
Death Secondary,
Duration,
Medford
Mais
Place of Interment,
Date of Interment or removal,
Left
. Fr. Smith.
Undertaker or Informant,
BENJ. F. SMITH, Wen
UNDERTAKER,
NO. 251 TREMONT ST.
*Insert Town and State.
BOSTON. MASS +State whether white or black.
402×452. Juliury
1.
Boston, Sejit e
188 G This Certifies, That Hanneet & Hastings died on the 42
day of Sent
1886, agod 1 years,
months,
days.
CAUSE OF Primary,
Chatury la autour im Duration
DEATII. S Secondary,
Benjamin. F. Smith, Undertaker. No 251 Tramont St.
EM, Calle Physician.
Boston Mass
Printing Department, Deer Island, Boston Harbor.
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.
male
4. Color, t
5. Age, .
74
Years, ..
Months,
Days.
6. Disease or First or Primary
Y
1
Cause of { Secondary (if any)
Death, [ By whom certified
7. Residence,
8. Place of Death,
9. Occupation, ·
10. Place of Birth, .
11. Name of Father, 112
12. Name of Mother, . 01 13. Birthplace of Father, . 14. Birthplace of Mother, . 7/2022
15. Place of Interment,
Signature of Undertaker ar other person making the Return,
DATED at .. on
€
188
* 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.]
a
1. 1
..........
JeAL. 3.1856
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 thercof -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.
1
PHYSICIAN'S CERTIFICATE.
ime of Deceased,* -
ute and Place of Death,
sease or Cause of Death, -
Samuel Have Tewksbury, at Winthrop, Azaz2 Left 5, 1886
died at of Typhoid Dysentery Durati Duration of Sickness Three weeks
I certify that the above is true, to the best of my knowledge and belief.
me and Residence of Certifying Physician,
Date of Certificate, Left 6 1886.
*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, forthiwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuscs 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 fo 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. Date of Death,
2. Name,
(Maiden Name),
13 "100 Gordon it Bell
3. Sex. and whether single. Married, or Widowed.
mais
4. Color, i
5. Age, .
Years,
.Months, ..
Days.
6. Disease or [ First or Primary
Cause of { Secondary (if any)
Death, ¿By whom certified
7. Residence,
8. Place of Deathı,
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,
1 DE Durand
Signature of Undertaker or other person making the Return,
DATED at.
Q121 14 1886.
* If a Married Woman or Widow.
1 If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
Gal
?
C C
The Undertaker, or other informant, is requested to report the faets-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 FORTHWITHI 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.
9-2
0
L
Printing Department, Deer Island, Boston Harbor.
1886. Bostart, Sett- 14
This Certifies, That Gordon H. Beck died on the 13 th day of Sept. 1886, aged 1 years,
months,
days.
CAUSE OF - Primary, Dijountery.
DEATH. Secondary,
Duration 3 week20 Duration 5 days
Samuel . Dunque, Physician.
RETURN OF DEATH TO THE CITY REGISTRAR.
CITY HALL, BOSTON.
(32)
Corinthia
Date of Death,
Name,
Mal
Color, + W. .
Age
years
Months
. days
Place of Death ?
2 feed
Street
WARD
Street and No. S
Residence,
1 Chron Sex,
Single, Married.
Occupation,
floures
Wife of
Birthplace *
Caulvida Widow of
Name of Father,
Name of Mother,
Gary
Birthplace of Father,
Birthplace of Mother,
Cause of ) Primary,
Duration,
Death
Secondary,
Duration,
Place of Interment,
talvidge
21/1/19
Date of Interment or removal,
Undertaker or Informant,
thu A. Kelly
*Insert Town and State.
tState whether white or black.
1.886
PHYSICIAN'S CERTIFICATE.
of Deceased,*
Sarah Truck
find Place of Death, - died at Winthrop Sefer, 19 1886 of Whooping Cough Duration of Sickness Me or Cause of Death, - 5
Three weeks1
I certify that the above is true, to the best of my knowledge and belief.
end Residence of Certifying Physician
Date of Certificate,
1874
* 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 person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, an 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 Registrate of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, u proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performing 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 Cause Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of s. 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 where certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Board 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 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,
1810
2. Name,
(Maiden Name),*
3. Sex, and whether single. Married, or Widowed,
4. Color, t
5. Age, .
45 Years,
Months, ******* Days.
6. Disease or First or Primary
Cause of Secondary (if any)
Death, By whom certified
7
7. Residence,
8. Place of Death,
9. Occupation, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father, . Landereen
14. Birthplace of Mother, .
15. Place of Interment,
Single grape
Signature of Undertaker For other person making 1
the Return,
Emelina a
Biotin
DATED at 6 ............ , on
188
* 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.]
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 FORTHWITHI 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.
01
1
5
-
PHYSICIAN'S CERTIFICATE.
e of Deceased,*
and Place of Death,
died at
se or Cause of Death,
rellene Rich Winthrop Snaze Jeps 22 1886
Duration of Sickness
I certify that the above is true, to the best of my knowledge and belief. ind Residence of Certifying Physician, H. P. Pauli.
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