USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 13
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15. Place of Interment,
Signature of Undertaker or other person making the Return, .
7
DATED at
, On
18
: If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
t 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.
Macoma, Hable
Sanweek She "
21 Idalle
War 14 "1894 Tran a Dorme
Theodor Din:2
69
Years, 10
.. Montlis,
14
[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 canse of death as nearly as he can state the same. If a physician refuses or neglects to make snch 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 dnly appointed agent, or, if there is no board of health in sncli 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 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 snch 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.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Date and Place of Death,t -
Mary A. Downs died at. Winthrop Mar 14"
Age,
1894. .
Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness, -
of Neuralgier of Heart Three hours
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, HIS Soul Winthrop Man
Date of Certificate, March 15-
1894.
* 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 .
14 do
1 Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 306 ; Acts of 1889, Chapter 221; 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 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 manner and cause of the deathi, 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.
March 20.16 911
1. Date of Death, .
.
2. Name,
·
(Maiden Name),*
(Name of Husband) ,'
K
male
3. Sex, wwwwhethersingle,
Married, or Widowed,
While-
4. Color, t
5. Age,
Years,
Months,
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Siekness, . (By whom certified, .
/ Rufus K Hoyes no
Winthrop mais
7. Residence, .
8. Occupation, .
Cottage Chenne
9. Place of Death, .
Cottage avenue
10. Place of Birth, .
11. Name of Father,
Lyman S. Meston Katherine Ganghu
12. Name of Mother, (Maiden Name),
13. Birthplace of Father,
Boston
Bistro (?)
11. Birthplace of Mother, \
15. Place of Interment,
Summer Florid)
1
DATED at
, on
march 21" 189%.
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
t 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.
Fre alves where marked in leve
Signature of Undertaker or other person making the Return, . .
Nordland Camelens
[ Public Statutes, Chapter 32. as amended by Acts of ISSS, 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 elerk, 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 healthi 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 tlie attending physician ; and in case of death by violence the medical examiner shall, if requested, make the sainc. 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 trausmit 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 thic clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exeeed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age Ajason Date and Place of Death, t - died at.
Theation Winthrop. Mas F. Ebom
Make Age,
March 20
1894/
of 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.
Rufus K. Noyes MC
Signature and Residence of Certifying Physician,
50 E tramber St. Boston
Date of Certificate,
March 20
* 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 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 l 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, fortliwith furnish for registration a certificat 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 exceedin fifty dollars. In case the deceased was a soldier or a sailor wlio 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 neglec 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 1
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 ci 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 li thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physici cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or a physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as required of tlie attending physician ; and in case of death by violence the medical examiner shall, if requested, make the sam When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall fort 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 excee ing fifty dollars.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
March 20 " 1894 Sarah Merrill Johnson
(Maiden Name),*
.
(Name of Husband),*
Benjamin
3. Sex, and whether single, Married, or Widowed,
married While
4. Color, t
5. Age, 65 Years, 8 Months, 26 Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . (By whom certified, ·
Brights Disease
weare
Winthrop Mare
7. Residence, .
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
Harbor avenue (Winthrop)
Charleston que
William, Low
12. Name of Mother, (Maiden Name),
13. Birthplace of Father,
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker other person making the Return, .
Summer Floyd
DATED at
Vienttrajo
, on
March 21
189.4
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
t 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.
Julia a. Com
Sedgewick me
Blanger me
Minitardio Cemeteries
Female (SA)
[ Public Statutes, Chapter 32. as amended by Acts of ISSS, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of whid 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 immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certif 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 lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exce fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neg 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 unt 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 or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or age clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending phys cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health of physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the s When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shallf with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, a clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not er ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Jame and Age of Deceased,*
Dosah. Morale-tot. com died at Minttrato (Haitor (avenue) Mich 20 ch
Age,
65-8 -- 6.
Date and Place of Death,t -
1894.
Disease or Cause of Death, - (Primary and Secondary.)} ration of Sickness, - -
of Brights disease
Two Jens
I certify that the above is true, to the best of my knowledge and belief. ,
nature and Residence of Certifying Physician, And Haughton Charleston
ficate, March 22d
1894
RE
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 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, carly 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 conntersign 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.
No.
Commonwealth of Massachusetts.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
march 21 " 1844. Cruce Minnie tofore fl Wordwell
(Maiden Name), .
(Name of Husband),*
étémale
3. Sex, and whether single, Married, or Widowed,
1. Color,t
3. Age,
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,
Mount autrin Cemetery
Signature of Undertaker other person making the Return, . -
DATED at
(Trinstra)
, O11
March 22, 1814.
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
tlf other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks. ] I'late. Ed. May, 1893 .- 5,000.
married mile
48 „Years, ... 7 .. Months, ... Days. Heart Failure
Trattengo Maxa
Printf ajo Street Cor StenRand
Tren Orleans
Ouvertloyd
/
Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 203.]
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, fortliwith 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 thierein, 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 suchi 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 tlie 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.
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