USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 2
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SECTION 2. Section five of said chapter, prohibiting the burial or removal of a human body until a proper certificate is furnished, is amended so as to read as follows : - Section 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased person 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 can not 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 forthwith countersign and transmit the same to the clerk or register for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the de- ceased, 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.
230
r
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
5. Age, . Years, ....
Disease or Cause of Death, (l', imary 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,
200
1
Signature of Undertaker or other person making the Return,
11
DATED at 1221 , On
" 18
* If a Married Woman or Widow. 1 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. September, 1892 .- 5,000.
30 % Caddes first
j vuller
---
49
Months,
14
Days.
/
,
[ Public Statutes, Chapter 32, as amended by Acts of 1838, Chapter 305; Acts of 1339, Chapter 224.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, 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 deceasc. If a physician neglects or refuses to make a certificate, as aforesaid, 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 the body of a deceased person 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 recorde 1, together with the certificate of the attending physician, if any, as required by section threc 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 cnough 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 siid board, agent or clerk, make such certificate as as 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 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.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Addie M. Hamilton
Age, 49"2"14
Date and Place of Death, -
died at.
Nuittrol, January 305
1893
Disease or Cause of Death, - of. Cancer
Duration of Sickness
Six months
I certify that the above is true, to the best of my knowledge and belief.
ame and Residence of Certifying Physician,
A.B. Domman ML.
Date of Certificate,
Jan. 31 St
18931
*Or Sex of Infant (not named).
[May, 1888.]
[Acts of 1888, Chapter 306.]
SECTION I. Section three of chapter thirty-two of the Public Statutes, requiring attending physicians to furnish for registration certain facts relating to deceased persons, is amended so as to read as follows : - Section 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, 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. If a physician neg- lects or refuses to make a certificate, as aforesaid, he shall be punished 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 furnished, is amended so as to read as follows : - Section 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom the body of a deceased person 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 can not 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 forthwith countersign and transmit the same to the clerk or register for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the de- ceased 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.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Hebmany 15 " 1893 Nellie Small
2. Name,
(Maiden Name),*
(Name of Husband), *
3. Sex, and whether single, Married, or Widowed,
Female
4. Color,t
While-
House
5. Age,
~ Years,
Months,
8
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . (By whom certified, .
Dr. Horace & Soule
North avenue
7. Residence,
·
8. Occupation, .
9. Place of Death, .
north avenue
10. Place of Birth, . Joshua C. Small
11. Name of Father,
Oklara E. Tracy
12. Name of Mother, (Maiden Name),
autun maine
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person-making the Return, .
Summer Floyd
DATED at
Northrop
... , on
Feturar 16 1893
* 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.
St John Or B,
Hinttraf Cemetery
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, 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. If a physician neglects or refuses to make a certificate, as aforesaid, 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 the body of a deceased person 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 no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for 1. 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 boar 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 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.
PHYSICIAN'S CERTIFICATE.
Viellie Small
Age, 8 Hours
me and Age of Deceased,* te and Place of Death, 1 -
Vi Strap (, avenue) .tel. 15. died at.
189.3 .
sease or Cause of Death, - (Primary and Secondary.)} ration of Sickness, - -
of Malformation & Heart.
I certify that the above is true, to the best of my knowledge and belief.
nature and Residence of Certifying Physician,.
Date of Certificate,
189
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 regi: tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which h 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 dcad. 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 exccedin; 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. If a physician refuses or neglect: 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 hc
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 cnough 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 excecd- ing fifty dollars.
RETURN To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
#215, 1893 Edward Cloud
2. Name,
(Maiden Name),
(Name of Husband),*
3. Sex, and whether single,
Married, or Widowed,
-
4. Color, t 1.3
5. Age,
Years, „
(222 Months, Chce Days.
Disease or Cause of Death, (Primary and Secondary),
CHiment -
Forrace . You've
Centre St. Wirthich, Was
7. Residence, .
8. Occupation, .
9. Place of Deathı, .
10. Place of Birth, .
11. Name of Father, .
. 11-
12. Name of Mother, .
(Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker . por other person making the Return, .
Summer
Flager
DATED at
, on
Felway 16 1899
1
* 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.
Diverse:
H. Floyd
Vittivuole Iwaski.
6. Duration of Siekness, . By whom certified,
Clicautomation
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for registration, 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. If a physician neglects or refuses to make a certificate, as aforesaid, 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 the body of a deceased person 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 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.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
April 8 th 189 3,
Forma DI. Stautlow Ag. 7 yrs. 7 mos.
Name and age of deceased :
.dys.
Date and place of death :
April 8th, 1893, Struther ok, mars,
Disease or cause of death :
Duration of disease :*
twenty four hours
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician. Horacel Doule M. D.
* It is very desirable to be informed of the duration of the disease.
The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A. M. till 2 P. M .; Sundays, 10 A. M. till 12 M .; Holidays, from 10 A. M. till 12 M .; other days. from 9 A. M. +ill 5 P. M.
1
UNDERTAKER'S RETURN .- Boston.
Date of death
tabul 8 ª
193, Name, John P. Stautou
Maiden name,*
Married, single, or widow of
Sunglar
Sex, 221
wife of. (
Color: 22 Age 2 years, 7 mos., -Ways.
Residence,
Huthrop
1 ee of death (
street and ) number
Bodlow Occupation, Carpenter
ame of father,
ther, Harpuder Maiden name of mother, barris
irthplace of father, Morrall F &, , Birthplace of mother,
. Fokus A. B.
Place of interment,t Holy
Grows, malden
* If a married woman or a widow.
t Give the name of the burial ground.
Signature of Undertaker : Frank . Maloney
'jace of birth,
Ocean View It- ward
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Mene 18 " 1893 1. Juin Pierson
2. Name, (Maiden Name), · (Name of Husband) ,*
3. Sex, and whether single, Married, or Widowed,
Tauxle
1. Color,t Méré
5. Age,
.Years, ....
.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, . .
Milles Ve Queno
11. Name of Father,
12. Name of Mother, .
(Maiden Name),
13. Birthplace of Father, .
Lym .
11. Birthplace of Mother, .
15. Place of Interment,
Winthrop Cemetery,
Signature of Undertaker or other person making the Return, .
Summe
Floyd
DATED at
, on
Clique 19 "1893
* 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.
many & pearson
(leyes)
[ 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 h 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 therein, 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 bot. the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglect 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 h 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 cit or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent o 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 chapter, or in lie thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physicia cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or an physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as i. required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same When snch 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 tl 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.
If the deceased was a soldier or sailor who served in the war of the rebellion, give both the primary and secondary cause of death. See Chap. 224, Acts of 1889.
PHYSICIAN'S CERTIFICATE.
1
Name and Age of Deceased,*
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