USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 6
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Ci Minshrop.
*Or Sex of Infant (not named).
Date of Certificate, efe/ 23'" 188 6
[ 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 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 fur 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.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),*
October 9" 1886. Jay Wallin Paul
3. Sex, and whether single, Married, or Widowed.
Male
C
4. Color, t
5. Age, .
Years,
5 Months,
1.3Days.
6. Discase or First or Primary
Cause of { Secondary (if any)
Death,
By whom certified
7. Residence,
Ninths 1 Proto mais
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, .
.
mars
Sev. Paul
auf
Many & G. Paul
Ellitel.
Mer
Nouveau
Mars
Nonword
Mais
.
DATED at.
Winthrop mark on Oct 10th
1886.
* 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.]
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.
PHYSICIAN'S CERTIFICATE.
ime of Deceased,* -
-Jury W Paul
ute and Place of Death,
1886. died ac Winthrop Get ge
sease or Cause of Death, - of 1. Sharmadie Gerek Duration of Sickness
I certify that the above is true, to the best of my knowledge and belief.
Ame and Residence of Certifying Physician ....
Date of Certificate, . Ochge 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 so 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 Registrati 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 performing th burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have beea 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.
To be reported before interment.
Return of a cath to the Öfterk.
CITY HALL, CHELSEA.
Date of Death,
188
6
Name,
Eunice B. Gray
Color,
29
Age, .. years, .months, days.
* No. Charles St 1 shop
Residence, (St. & No.)
Sex, whether single, married, or widowedge
manuel
Occupation,
Birthplace, Deny
Barrett
Names of Parents. dnes + SarahJ.
Aile of I Jongl ans
Wife or Widow of
Melrose mass
Birthplace of Father,
Birthplace of Mother,
Canton one
Place of Interment,
Nordland
Undertaker or Informant,
Roth S. G. Manden
Chelsea 18th Och "15 6
This Certifies, That Onniee B. Say on the 150 day of Color
1856, aged 29 years,
-months, days.
E OF ATH
Tuberculosis
Primary, Secondary, Vichercular. Intentar
Duration,
Duration, 1 3em
Physician.
cour crevo
RETURN OF DEATH TO THE CITY REGISTRAR.
36
CITY HALL, BOSTON.
Date of Death, .L . cc 2 nd Name, f Months
1.8 $6
white
Age 2 years
days
Place of Death Hacker ave WithupWARD
Street and No.
Residence, Henthrop Sex.
Single,
.. Married.
Occupation,
Wife of
Birthplace*
Widow of
Name of Father, Orasties 26. 1
Name of Mother,
unez.
Birthplace of Father,*
Birthplace of Mother, *
Saugor
orlittle avbitte mass maine
Cause of ) Primary, Duration,
Death
Secondary,
Duration,
Place of Interment, Heuttrop
L'ecamber Stk 1886
Date of Interment or removal, Undertaker or Informant, BENJ. F. SMITH, UNDERTAKER, NO.251 TREMONT ST., RE -* Insert Town and State. BOSTON. MASS + State whether white or black.
Dcc 2 1886
Boston,
Chis Certifies, That nez Rimbaud colette died on the
2 day of Lec 2 188 6, aged 2 years, 8 2
months,
days.
Burns
CAUSE OF Primary, DEATH. Secondary, Newman, Shocks
BENJ. F. SMITH, UNDERTAKER, NO. 251 TREMONT ST., BOSTON, MASS.
A. S. Seule 1 0%
Duration
Duration 21 hour
Physician.
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,
Die 2
C
2. Name,
(Maiden Name),*
3. Sex, and whether single, Married, or J Widowed,
Female
4. Color, t
5. Age,
1 Years,
Months,. 3 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,
1
DATED at .. 7 mithus
on
28
188
* 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.]
The Undertaker, or other informant, is reque: Physician's Certificate of the Causes of Death-to the Town
In case of an interment taking place, without th Town in which the Death occurred (or the deceased res having charge of such Interment must FORTIIWITH GIVE NO' Clerk, Penalty for neglect, twenty dollars.
Blank forms for Returns of Deaths may be obtain
PHYSICIAN'S CERTIFICATE.
Deceased,* -
Place of Death,
died at
Cause of Death, of
Mary & Wickwire Winthrop Dec 28 Hoping Cough
Duration of Sickness
1883 Five months
I certify that the above is true, to the best of my knowledge and belief.
sidence of Certifying Physician, A, B, loulé MO
Date of Certificate, .
ale Jan 1m
1887.
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 of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, 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 clerk or registrar shall give such certificate or burial pera 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 «leath shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon 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. 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 call good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall fu requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five
DUALL.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
January 6" 188% Willie it, Crosby
(Maiden Name),*
3. Sex, and whether single. Married, or Widowed,
4. Color, t .
male Ahile
Years,
Months, 14
.. Days.
5. Age,
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified,
7. Residence, .
Read Street "
8. Place of Death,
9. Occupation.
10. Place of Birth.
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father,
11. Birthplace of Mother,
15. Place of Interment, .
Caes Orton Charles J. branky annie 6, Conaby Gast Salon ErRR Besten mars Minst 1trafo cam benoles
Signature of Undertaker
the Return,
J
DATED at
January/ 187
* If a Married Woman or Widow. { If other than White. (M.) Mulatto. (I.) Indian. If ofother Races, specify what.
[Be very particular to fill all Blanks.]
unner floyd)
2. Name,
-
2. Pm
Femoral Saludã
/ Carriage
Ziare
[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 cler registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the caus death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chair 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 d to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon app tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician canno good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty dollars.
PHYSICIAN'S CERTIFICATE.
ne of Deceased,* -
Willie Custe
and Place of Death, -
ase or Cause of Death, -
died at Withup, Inder Jan ç 1888. of Groupsous Pneumonic Duration of Sickness
Six days
I certify that the above is true, to the best of my knowledge and belief.
and Residence of Certifying Physician, Geo. E Mccarthy A& l'instant,
Fra 21
Date of Certificate, Jan .. !. 1887
*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 decea of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the discase of which the person dies and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificatc, he sh 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 cler or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that th facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit un the 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 dleath 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 cansc 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 fi 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 cxcceding twenty-five dollars.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name, (Maiden Name),*
1 ada Leur
3. Sex, and whether single. Married, or Widowed.
4. Color, t
5. Age, .
Years,/
Mouths, .
Days.
6. Disease or First or Primary
Cause of { Secondary (if any)
Death, By whom certified
}
7. Residence,
8. Place of Death,
9. Occupation, .
1
6
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,
11
r
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.]
1
The Undertaker, or other informant, is requested to report the facts-together with Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THIE INTERMENT.
In case of an interment taking place, without the Certificate of Registry of the Clerk of th Town in which the Death occurred (or the deceased resided) having first been obtained, the pers having charge of such Interment must FORTHWITHI 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.
2-30 - dbg 8
- 7
PHYSICIAN'S CERTIFICATE.
of Deceased,*
-
d Place of Death, -
Ola Hattie Freud. died at
Jan?"
pr Cause of Death, -
of Consumption
188
Duration of Sickness
three months
I certify that the above is true, to the best of my knowledge and belief.
Residence of Certifying Physician,
Her S. Soule Winthrop.
Ir Box of Infant (not named).
Date of Certificate, rtficat, Jun gel 18/
1
[ 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 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.
Na
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
Clauman 2.5 "18.7
2. Name,
( Maiden Name),
3. Sex, and whether single, Married, or Widowed,
f.
7
1. Color, t .
15
5. Age. 89 Years,. 2 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,
detturant 200
11. Name of Father.
12. Name of Mother, ·
12 Birthplace of Father,
14. Birthplace of Mother, 0
15. Place of Interment, .
Signature of Undertaker -wother person making the Return,
DATED at . on
2
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.]
Prea 3.02
[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 hecn 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 belie", if there has been no physician in attendance. Ile 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 obtaincd. 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.
13 151
PHYSICIAN'S CERTIFICATE.
of Deceased,*
and Place of Death, -
died at
Maria Gidlectores Winthrop Jan 25" 188 1
se or Cause of Death, - of Old age
Duration of Sickness
I certify that the above is true, to the best of my knowledge and belief.
and Residence of Certifying Physician,
He, P. Saucli Winthrop
Date of Certificate, Jan 26 11
188
*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 di 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 sh forfcit 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 cl or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that tu facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit u the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, 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 chair 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. Ile shall also sign such certificate, upon appli tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish requisite medical certificate. Any person violating the provisions of this section shall be punished by finc not exceeding twenty-five dollars
YO.
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death.
tel. 8: 18
2. Name.
(Maiden Name),
L
3. Sex. and whether single, Married, or Widowed,
4. Color, t .
5. Age,
37
Years, 7 Months. Days.
Disease or Cause of Death, 6 .. Duration of Sickness,
By whom certified, .
3. Residence. .
8. Place of Death,
9. Occupation,
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, .
. On
18
DATED at
* If a Married Woman or Widow.
* If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks. ]
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried of 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 fact 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 clerlt. 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 dea 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 goud and sufficient reasons be early enough obtaincd. In case of death by violence, the medical examiner attending shall furnisli t requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-fi dollars 9690
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