USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 15
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Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49
[ 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 certifleate 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 siekness, 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 ehild 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 physician shall give both the primary and the secondary or immediate cause of death as nearly as he ean state the same. If a physician refuses or neglects to make such certifieate 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 eity 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 eity or town elerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the ease may be, a satisfactory written statement containing the faets 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 certifieate 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 elerk, make such certificate as is required of the attending physician; and in ease 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.
No. ...
RETURN OF A DEATH. .
To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
May 5 " 1894 Still for anfall
(Maiden Name),*
(Name of Husband), *
3. Sex, and whether single, Married, or Widowed,
4. Color,t
J. Age, 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 at May.
, (12 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. 1 I'late. Ed. May, 1893 .- 5,000.
1bale
While
Stilltur Months,
SMOaman
Beach Road Edith Cal"
Beach Reach
Charles Daniela Mary Hanilla Bait Marie
"1 markus ·Ninthey Gemele Summer Rod
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 2
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 i died, the duration of his last sickness, and the date of his deeease; and a physician who has attended at a birth of a child dyil immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith 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 exceedil fifty dollars. In case the deccascd 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 samc. 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 icmove 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 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 an recorded, together with the certificate of the attending physician, if any, as required by section three of this ehapter, or in li thereof a certifieate 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 al 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 the 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 g' shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as elerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not ex( ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Boy Nunatiere
Age, Para Pract
trots Jahr Hunmettons Beach Road.
Date and Place of Death, t - died at. enij Suis after partte 189 of Breech present ative" d only mas. child.
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.
Signature and Residence of Certifying Physician,
Daniel MEDzier
ormand 722.
Date of Certificate radary May of the
189%.
Șex of Infant (not named). If stillborn so state.
{ If child died immediately after birth so state.
Į If a soldier or sailor who served in the War of the Rebellion.
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 203.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, fortliwith 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 kuowledge 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 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 negleets 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 eity 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 elerk, 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 elerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deecased 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 scetion 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, .
DIac 97.124 maría total 250
Fin
(Maiden Name), .
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed, K ...
4. Color, t
5. Age,
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . By whom certified, ·
7. Residenee,
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
, on
200 27- 1814
* 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. Nov. 1890-5,000.
1
-
tyle 4021
65,
Years .............
Months, .......
Days.
1
:
[ACTS OF 1888, CHAP. 306.] AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL BODIES OF DECEASED PERSONS.
Be it enacted, etc., as follows :
SECTION 1. Section three of chapter thirty-two of the Public Statutes, requiring attending physicians to furnish f registration certain facts relating to deceased persons, is amended so as to read as follows : - Section 3. A physician who li attended a person during his last illness shall, when requested, forthwith furnish for registration, a certificate stating, to tl best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his la sickness, and the date of his decease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be pur ished by a fine not exceeding fifty dollars.
SECTION 2. Section five of said chapter, prohibiting the burial or removal of a human body until a proper certificate is fu nished, is amended so as to read as follows : - Section 5. No nndertaker, sexton or other person shall bury in a city or tow or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or i dnly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No snch perm shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written stat meut containing the facts required by this chapter to be returned and recorded, together with the certificate of the attendin physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there i no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, earl 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 de livered to the board of health or to its agent, the board or agent shall forthwith 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 exceeding fifty dollars.
[Approved May 4, 1888.
PHYSICIAN'S CERTIFICATE.
Mamy Hopkins
Age, 6.5
Name and Age of Deceased,*
Date and Place of Death, t - died at
of Heart 0
May 27
1894.
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.
sture and Residence of Certifying Physician,
Date of Certificate,
may 28th 1894⑇
* Or Sex of Infant (not named). If stillborn so state.
t 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 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 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 sun 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 given shall thereafter furnish for registration any other information as to the deceased or to the manner 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.
on 18.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
duras /2"1896
2. Name,
(Maiden Name),* .
(Name of Husband),*
L
3. Sex, and whethersingle, Married, or Widowed,
4. Color,
85
Years,
5
Months,
19
Days.
5. 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,
Signature of Undertaker or other person making the Return, .
DATED at
30
* 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.
C
udia ganzen L
7
[ Public Statutes, Chapter 32 as amended by Acts of ISSS, Chapter 30G ; 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 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 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. 1
₹
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
William H. Wordy
Age, 83-5-19
Date and Place of Death, t - died at ..
Vienttrafo(Main () June 121804.
Disease or Cause of Death, - (Primary and Secondary.)}
of long
Is tion of the Brain
Duration of Sickness, -
I certify that the above is true, to the best of my knowledge and belief.
ignature and Residence of Certifying Physician,
Date of Certificate, June 14
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.
į If a soldier or sailor who served in the War of the Rebellion .
[ 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 lie 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 thic 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 bary 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 eity or town elerk. 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 hereiuafter 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 eity or town for the purpose shall, upon request of said board, agent or elerk, 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 tlie 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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