Town of Winthrop : Record of Deaths 1886-1892, Part 8

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1886-1892 > Part 8


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died on the. day of xml1 188, aged? years,


months,


days.


CAUSE OF


Primary,


Duration


DEATHI. Secondary, Le Guilental Duration


Pursuing Head of Special column Goth aque Physic


Rockwell & Churchill, City Printers, 39 Arch Street, Boston.


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


1. Date of Death, .


2. Name, .


(Maiden Name),*


(Name of Husband),*


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


4. Color, t


1


Years,. 4 Months, 3 Days.


5. Age,


Disease or Cause of Death,


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


7. Residence,


8. Occupation, .


9. Place of Death, .


10. Place of Birth, .


11. Name of Father,


12. Name of Mother, ·


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Signature of Undertaker Mallorquin making the Return, .


2


DATED at


, On


guy . 9 20 187


* 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. ]


.


81.


J


2


combide Cemely Summer Ford


[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 registra to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts req.iirc by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate 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 hand 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 1 approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of healt 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 knowled and belief, if there has been no physician in attendance. He shall also sign such certificate, upon application, in case of death by dange ous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be ea enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any pers violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.


[Acts of 1887, Chap. 202, Sect. 5.]


Section one of chapter thirty-two of the Public Statutes is hereby amended by inserting after the word "burial" in the twenti line of said section the words: - if the deceased was a married woman the name of her husband.


PHYSICIAN'S CERTIFICATE.


1


of Deceased,* -


and Place of Death, ise or Cause of Death,


alfred David Fox


Mass, July 19 at Children's Sea Shore, Some, Winstruk 1887! died at of Letolera Infantuna Duration


Iness five days.


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


and Residence of Certifying Physician, all. Stanard, 38, Columbus Que. Barton.


Date of Certificate,


188 7.


[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 deceas 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, 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 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 chain 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 o to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon ap] 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 visite medionLiver


h


No. 10


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


1. Date of Death,


2 % 188


2. Name,


........ 166 1


(Maiden Name),*


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


Sinzda


1. Color, t .


5. Age,


/5 Years,


11


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, 1


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,


Summer Floral


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.]


,


that


[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.


Vounathrop Maso July 27 189 This Certifies, That Arthur M. Celisty. did on the 27th day of July 1887, aged 10 years, 4


months,


days.


CAUSE OF


Primary, Information Domach&


Bowels


Duration 2 days


DEATH. Secondary, Gastric Lever Duration


Hvordan Physician.


Rockwell & Churchill, City Printers, 39 Arch Street, Boston.


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


1. Date of Death,


2. Name,


( Maiden Name),


(Name of Ilusband),*


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


1. Color, t


5. Age, Disease or Cause of Death,


6. Duration of Sickness, . By whom certified,


7. Residence,


8. Occupation, .


9. Place of Death, .


10. Place of Birth, .


11. Name of Father,


12. Name of Mother,


13. Birthplace of Father, .


11. Birthplace of Mother, .


15. Place of Interment,


July 27 5- 1887 William Sovou?


male Single. White


0 .... Years, 8 Months, ~ Days. Tubercular meningitis. Eight deup a Stanard


28 Clark Sc


Lea Slune Home Winther Bestera


Rubina Monica


Signature of Undertaker orother person making the Return, .


Sumner


DATED at


, On


188.


* 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 certifieate 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 require ! by this chapter have been returned and recorded; and no clerk or registrar shall give sueh 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 cleath 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. Ile shall also sign such certificate, upon application, in case of death by dlanger- ous 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 violenee, 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.


[Acts of 1887, Chap. 202, Sect. 5.]


Seetion one of chapter thirty-two of the Publie Statutes is hereby amended by inserting after the word "burial" in the twentieth line of said section the words: - if the deceased was a married woman the name of her husband.


PHYSICIAN'S CERTIFICATE.


ame of Deceased,*


ate and Place of Death,


isease or Cause of Death, -


William Morison Sea Shore Icome. Winterop War, July 27048).


died at of Mercular Meningitis , Duration of Sickness eight days.


I certify that the above is true, to the best of my knowledge and belief. all Stanard 381 Columbus lot. Boston


one and Residence of Certifying Physician,


Date of Certificate, July 2 fete 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 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."


" SEcr. 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."


RETURN OF DEATH TO THE CITY REGISTRAR.


CITY HALL, BOSTON.


Date of Death,


1.89-


Name,


Color, t


Age 1 years


Months days


Place of Death


WARD


Street and No.


Residence,


Sex,


Single, ..... Married


Occupation,


Wife of


Birthplace*


Jus


Widow-of ......


Name of Father,


Name of Mother,


Birthplace of Father,*


Birthplace of Mother,*


Cause of ) Primary,


Duration,


Death Secondary, $


Duration,


Place of Interment,


Date of Interment or removal,


Undertaker or Informant,


F


-


-* Insert Town and State.


A, Bade Ford


+ State whether white or black.


PHYSICIAN'S CERTIFICATE.


Vame of Deceased,* -


ilaria


Date and Place of Death, -


188 Discase or Cause of Death, - of this season. Duration of Sickness 1


1


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


.7


ame and Residence of Certifying Physician,


Date of Certificate, 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 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 finc not exceeding twenty-five dollars."


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


1. Date of Death.


2. Name,


July 29" 1887 1) Franke 6. George


(Maiden Name) .


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


male


4. Color, t .


Schile


5. Age,


Years, 14 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, Venetolo bras2 Halter E. George 11. Name of Father.


12. Name of Mother,


13. Birthplace of Father,


1.1. Birthplace of Mother,


15. Place of Interment, .


Toutharp Cemetery


Signature of Undertaker wother person making the Return,


DATED at


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.]


Perco Strão stereo


//


..


East Beslut


Tikai 1. 8.in, / barrage -


[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 applic 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-fi dollars.


PHYSICIAN'S CERTIFICATE.


Name of Deceased,*


Date and Place of Death,


Disease or Cause of Death, -


Frank & George ied at Minithread Jeel, 21 of Cholera Infantum Duration 188


I certify that the above is true, to the best of my knowledge and belief. zone and Residence of Certifying Physician, A. S. Soule Winthrop May


*Or Sex of Infant (not named).


Date of Certificate, Atze 6ª


188 ?


U


[ 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 discase 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 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. 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 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."


RETURN OF A DEATH.


To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


Why 29 1887 Glet Schere


(Maiden Name),*


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


4. Color, t .


Female Mulei 1


5. Age.


The 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, .


Holy cross i metany


Signature of Undertaker making the Return,


Summer Floyd


DATED at . Winthrop


, On


July 202.9.18


* 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.]


Perry !!


1


Char the


Cholera


infantun SeuiPhone Hamettenuns 21)


[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 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-i dollars.


PHYSICIAN'S CERTIFICATE.


Name of Deceased,*


Ella Shea


Date and Place of Death,


Sea Shore House Withrop, illas. Jul, 29 th,


Disease or Cause of Death, -


died at of lebolera Infantun Duration of Sickness ten days


188 7. lays I certify that the above is true, to the best of my knowledge and belief. All Stanard 381 teolumbus Que,


ime and Residence of Certifying Physician,


*Or Bex of Infant (not named).


Date of Certificate, fícate, July 29 th


Boston


1887;


[ 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 citics 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."




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