Town of Winthrop : Record of Deaths 1893-1896, Part 10

Author: Winthrop (Mass.)
Publication date: 1893
Publisher:
Number of Pages: 798

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 10

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SECTION 5. No undertaker, scxton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city, or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or. clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agcut or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of healthor to its agent, the board or agent shall forth. with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thercafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.

PHYSICIAN'S CERTIFICATE.

e and Age of Deceased,*

and Place of Death, t -

se or Cause of Death, - Primary and Secondary.)} tion of Sickness, -

France) R Monahan

died at Winthrop' november

Age, 1gr 11 days 189 3.

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

re and Residence of Certifying Physician,

H. S Soule Winthrop

Date of Certificate,

ificate, Non 11

1893

of Infant (not named). If stillborn so state.

[ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.

# If a soldier or sailor who served in the War of the Rebellion .

of Membrane Group

[ Public Statutes, Chapter 32, as amended by Acts of 18SS, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for reg tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dyi immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certifica stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician ne lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceedi fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give bo the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or negle to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.

SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such c or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned a recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in 1 thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physic cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health ora physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate a. required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the sa When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall for with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so gi shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exce ing fifty dollars.

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, i

5. Age, 72 Years,

Months, .......... C. Days.

Disease or Cause of Death, (Primary and Secondary), #

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, (Maiden Name),

13. Birthplace of Father,

11. Birthplace of Mother, .

15. Place of Interment,

Signature of Undertaker or other person making the Return, . ·

DATED ALL .... 1.

, Oll

...

. If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. { If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.

[Be very particular to fill all Blanks. ] Plate. Ed. May, 1893 .- 5,000.

[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.

SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so give shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as t' clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceu ing fifty dollars.

PHYSICIAN'S CERTIFICATE.

Vame and Age of Deceased,*

Willian Blender

Age 2 4-81-280.

Date and Place of Death, t -

died at. Muchrap Class

100-13 1893 .

Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness,

of ..

myocarditis

June 11 '93 to tor 13 '93

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

gnature and Residence of Certifying Physician,

Date of Certificate,

- for- 15- 1893

Or Sex of Infant (not named). If stillborn so state.

¡ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.

{ If a soldier or sailor who served in the War of the Rebellion.

[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]

SECTION 3. A physician who has attended a person during his last illuess shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he (lied, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- leets or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physiciau shall give both the primary and the secoudary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.

SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or iu lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the samc. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall fortli- with countersign and transmit, the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manuer and cause of the deatlı, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.

RETURN OF A DEATH.

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

1. Date of Death,

2. Name,

November 13.1893 Still 01

(Maiden Name),

(Name of Husband),*

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

1. Color, ¡

3. Age, Years, ~ Months, Days. .

Disease or Cause of Death, (Primary and Secondary), ;

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, . (Maiden Name),

13. Birthplace of Father, .

14. Birthplace of Mother, .

15. Place of Interment,

Signature of Undertaker or other person making the Return. .

DATED at , 011

189.2

* If a Married Woman or Widow. # If a Soldier who served in the War of the Rebellion. { If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.] Plate. Ed. May, 1893 .- 5,000.

Le Cl

Ofilleis 1. 26 TELL ...... .

[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]

SECTION 3. A physician who lias attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the discase of which he died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that snch a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement thcrein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate canse of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides. SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body nntil lie has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No sucli permit shall be issued nntil there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lien thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enongh for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, npon request of said board, agent or clerk, make such certificate as ic required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall fortì with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so giv. shall thereafter furnish for registration any other information as to the deceased or to the manner and canse of the death, as ti clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed ing fifty dollars.

PHYSICIAN'S CERTIFICATE.

Stilllow

Infant

Age,

Date and Place of Death, t - died at

Winthrop (Twain Steel) Por 13 "1893.

Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness, - -

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

Anature and Residence of Certifying Physician, & Jordli Winthrop

Date of Certificate, Die 11

1893.

Or Sex of Infant (not named). If stillborn so state.

¡ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.

{ If a soldier or sailor who served in the War of the Rebellion.

Name and Age of Deceased,*

[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regi tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which I died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dyin immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg lects or refuses to make a certificate as aforesaid, or makes a false statement thereiu, he shall be punished by a fine not exceedin; fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give botl the primary and the secondary or immediate cause of death as nearly as he can state the same.

to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the usc of the town in which he resides. If a physician refuses or neglects

SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until lic has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to sueh board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician. if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.

...

Commonwealth of Massachusetts.

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

1. Date of Death, .

2. Name,

r 29"1893 Still

(Maiden Name),

(Name of Husband), *

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

4. Color.t

5. Age,

.Years, Months, Days.

Disease or Cause of Death, (Primary and Secondary), ;

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, . (Maiden Name),

13. Birthplace of Father, .

11. Birthplace of Mother, .

15. Place of Interment,

Signature of Undertaker w other person making the Return, . . .

DATED at

* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.

+ If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.

[Be very particular to fill all Blanks.] Plate. Ed. September, 1892 .- 5,000.

....

[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 305; Acts of 1839, Chapter 224.]

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registrati certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the durati his last sickness, and the date of his decease. If a physician neglects or refuses to make a certificate, as aforcsaid, he shall be punished fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shal both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or negle make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides. SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased p until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as th may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the cert of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If tl no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough: purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examine if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the or agent shall forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the perr. given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the dea clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not excer dollars.

PHYSICIAN'S CERTIFICATE.

H.C.C --

fame and Age of Deceased,*

Stillborn

livins)

Age,

Date and Place of Death, t - died at ...

Winthrop November

29" 189 3.

disease or Cause of Death, - (Primary and Secondary.)} duration of Sickness,

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

te and Residence of Certifying Physician, .. Vi .. 1

2221

d1.

Date of Certificate,

189.3.

of Infant (not named). If stillborn so state.

¡ If child died immediately after birth so state. Plate. Ed. May, 1893 .- 5,000.

# If a soldier or sailor who served in the War of the Rebellion.

[ Public Statutes, Chapter 32, as amended by Acts of 1838, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]

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Town of Winthrop : Record of Deaths 1893-1896, Part 10

Author: Winthrop (Mass.) Publication date: 1893 Publisher: Number of Pages: 798

Author: Winthrop (Mass.)
Publication date: 1893
Publisher:
Number of Pages: 798