USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 7
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1
PHYSICIAN'S CERTIFICATE.
of Deceased,* -
nd Place of Death, - e or Causeof Death, -
Ms. Frances B. Sanderson
1885 died at Winthrop Mas 2 Feb. 8, of Hemorrhage & downloadsituation of Sickness
alors death was the result of complicated chcel birth I certify that the above is truc, to the best of my knowledge and belief.
Goo E. Mailearthy MIX Hinthing tras 2
nd Residence of Certifying Physician,
Date of Certificate, Feb 10 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 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, he 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 c or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit 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 elerk 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. IIe 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 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 fine not exceeding twenty-five dolla
UTVI OT A DUATIL.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
125- Dai 12,
(Maiden Name),
3. Sex, and whether single, Married, or Widowed,
4. C'olor. t .
5. Age,
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,
1.1. Birthplace of Mother,
15. Place of Interment, .
Signature of Undertaker or other person making the Return, .
DATED at .4
18
* If a Married Woman or Widow.
* If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks. 1
2
5
..
-
-
L
[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, 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 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 dead to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificatc, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot f goud 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.
of Deceased,* -
und Place of Death,
Female Infant of Geo. C., \ frances B. Sanderson, died at Writting, mass feb. E.
188 ).
e or Cause of Death, - of
Duration of Sickness
The above mentioned infant was stillborn I certify that the above is trute, to the best of my knowledge and belief.
nd Residence of Certifying Physician,
Geo. E. Niclas thy ME Wittrup Ma22
Date of Certificate, tel. 10 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 dece 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 refuses or neglects to make such certificate, lie 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 clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that t 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, a 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 f 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.
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. Аде,
75 Years, 6 .. Months, 27 Days.
Disease or Cause of Death,
6. Duration of Sickness, · By whom certified,
7. Residence, .
bija00
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, . 0
DATED at
,
7.
16
1×8
* 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
Chelsea Inaso
Chebra 9
[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 certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deccased, at. 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 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 appli lion, 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 fine not exceeding twenty- dollars.
Fameal Thursday 2. 30Pm / Carriage
81-8-9 - 97 811
PHYSICIAN'S CERTIFICATE.
De of Deceased,*
James In Welcher
and Place of Death,
died at
se or Cause of Death, .
of Inlargement of
Heut 188
Duration of Sickness
I certify that the above is true, to the best of my knowledge and belief.
und Residence of Certifying Physician, A. I. Loulé
Winthrop
Date of Certificate, feb 16. V
*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 die 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 sha 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 clerl or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit uo 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 elerk or registrar; and in citics 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 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 de to the best of his knowledge and belief, if there has been no physician in attendance. He 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 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.
To the Clerk of the Town in which the Death occurred.
1. Dato of Death,
Mich 15" 185
2. Name.
(Maiden Name),
3. Sex, and whether single, Married, or Widowed,
4. Color, t .
5. Age,
27 Years, .. Months, Days.
Disease or Cause of Death,
6 .. Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation.
10. Płace 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 of'ter 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.]
[Public Statutes, Chap. 32, Sect. 5.1
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 f 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, 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 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 d to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon appl' 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 t. requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-li dollars.
Rockwell & Churchill, City Printers, 39 Arch Street, Boston.
CS
Botin Winthrop Mch 17'18 7 This Certifies, That Edna Mo. Meston
died on the 15 day of Noch 1884, aged 27 years, months, days.
CAUSE OF Primary, Aleule Tuberculose.
..
Duration 6 wap.
Duration
DEATH.
Secondary,
Physician.
To the Clerk of the Town in which the Death occurred.
1. Date of Death.
2. Name,
march 28 " 1887 mary of
(Maiden Name),* 11 Fond
3. Sex, and whether single, Married, or Widowed,
1. Color, t .
5. Age,
79 Years,
Months.
~ Days.
6. Duration of Sickness, By whom certified, C Anthrop Snaze.
7. Residence, .
8. Place of Death,
Telnou
theet
9. Occupation,
10. Płace 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 the person making the Return,
DATED at On march 29.
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.]
Female Hule-
Disease or Cause of Death,
Elijah
Share
20
Role Bri- = Cafe =
[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 of 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, al 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 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 appi -- 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 e requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-hy dollars.
PHYSICIAN'S CERTIFICATE.
of Deceased,* -
and Place of Death,
Mary J. Blake died at at Winthrop March 28
188 %.
sse 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,
H. S. Soule Winthrop
*Or Sex of Infant (not named).
Date of Certificate, .. tificate, Dec 21. 188
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 negleets 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 elerk 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 contagions 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."
VO.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
Smay 20. "1887
1. Date of Death.
2. Name.
(Maiden Name).
3. Sex, and whether single, Married, or Widowed,
4. Color, t .
20 Years,
83
Months,
Days.
5. Age,
Disease or Cause of Death,
6. Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation,
Janne
10. Place of Birth,
11. Name of Father,
12. Name of Mother, Truck 212
13. Birthplace of Father,
14. Birthplace of Mother,
15. Place of Interment, .
Signature of Undertaker
7 C
making the Return, .
DATED at thuthy
Spray 21 "188%.
+ Ifa 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. ]
1
Cheles mass
[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 deatl. 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-tive dollars.
Carrera3-9
C
S. date on Und rehin. 7
r Vueltoof Besten,. Dare 2D'
188/ This Certifies, That The ip Jacksin died on the 20 day of n. .. 188%, aged .. .years, months,
days.
CAUSE OF Primary , Degeneration of the beast . DEATII. Duration S Secondary, B. H Campbell Phys
Duration Center
Physician.
2.00
@
Rockwell & Churchill, City Printers, 39 Arch Street, Boston.
A
/
1
1
NOTICE .- Fill out in Ink.
RETURN OF DEATH TO THE CITY REGISTRAR.
CITY HALL, BOSTON.
1887
Date of Death,
18 L.
Name,
June2 Blair
Color, t 21
Age.
28
.. years
Months days
Place of Death
Street and No.
Residence, e Brachmant · .. Sex. . IN Single,
. . Married.
Occupation, Back RistiEr Who
Birthplace*
Porland
. Widow of ..
Name of Father,
...
Golin /Black
Name of Mother,
Martha
01/1922
Birthplace of Father,
Ausland
Birthplace of Mother, *
Griland
Cause of
) Primary,
Duration,
Death Secondary
Duration,
Place of Interment, ENERE
Date of Interment or removal,. MIRE 6
Undertaker or Informant,
....
...
*Insert Town and State.
+ State whether white or black.
WARD
Y
6 ª- 1887 This Certifies, That June Blair died on the.
Boston,
day of Lech 1887, aged 28 years,
months,
days.
CAUSE OF 1 Primary,8
Duration
II.
DEATHI. Secondary,
Duration.
Physician.
Rockwell & Churchill, City Printers, 39 Arch Street, Boston.
No. 5 .1
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name, (Maiden Name),*
George
July 7' .8%.
3. Sex, and whether single. Married, or Widowed,
4. Color, t .
5. Age,
Years,
Months,
Days.
( Disease or Cause of Death, 6 .. Duration of Sickness, · By whom certified, ·
7. Residence, . ·
8. Place of Death,
Mariner
9. Occupation,
10. Place of Birth, 3. Bouton Wann.
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father,
14. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker or ot'ver 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.]
[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 deccased, 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 chairmar 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 fc 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-fiv dollars.
Boston, July 7 188 %. This Certifies, That Georgs to Meisner
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