USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 20
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0
PHYSICIAN'S CERTIFICATE.
Ist ds
Name and Age of Deceased,*
Theresa # 1101x
Clean
Age, 66-19
Date and Place of Death, t - died at
mange1 Winthrop( Rekleinter get
189 4.
Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness,
Haunorhauch Sociales
of
Lino necks.
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, ...
Date of Certificate,
Sep 1 10
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.
[ Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300 ; 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 (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 physician shall give both the primary and the secondary or immediate eanse 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 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 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 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,
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston ,. Jetzt 11"
1894
Name and age of deceased : Mary t Hours
Age 61 yrs
mos. 29
dys.
Date and place of death : Jetzt9 1844 Winthrop
Disease or cause of death Brights (Lerear
....
Duration of disease :*
I certify that the above is true, to the best of my knowledge and belief.
Name and residence of physician.
.. M. D
* It is very desirable to be informed of the duration of the disease.
--
UNDERTAKER'S RETURN .-- Boston.
Date of death,
189 ... / Name,
Maiden name,*
Sex,
Married, single, or widow of " wife of
Color, Mile Age, 61 years, 2 mos., 29 days. Residence,
Place of death ( number
2 treet and), C ..... -
ward
Place of birth,
Occupation,
Name of father Nathaniel
Maiden name of mother, mother, Referen Brzes
Birthplace of father,
Birthplace of mother, vai
Place of interment, ; 1
* If a married woman or a widow.
t Give the name of the burial ground.
Date of Certificate Sep19
Signature of Undertaker :
UNDERTAKER'S RETURN,-Boston.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
(B)
Name and age of deceased : Charlott
Boston, .
Sept-20.
189 X Joyce Age ... 26 urs. Byrs.
Date and place of death :
.. mos .. 18 dys. Sept 20- 18 9% ) Main for Pleasent At Winthrop acuité Intercularis.
Disease or cause of death :
Duration of disease :* 4
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician. Ms M Michael. M. D.
-
* It is very desirable to be informed of the duration of the disease.
[ 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 liis last illness shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belicf, 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 thercafter, 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, tlic physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the samc. 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 tlierefrom 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 certificatc 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 tlie 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.
0
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
There ea =$ 1. l Cleany
Ist ds
Age, 66-19
Date and Place of Death, t -
mange1 jed at Winthrop ( Defleiter get 189 4.
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness, -
of Honorhago Borneles
Live necks
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate,
Sep 1 10
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 .
-
Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300 ; 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, 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 refnses 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 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 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 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 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 deceased or to the inanner 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 OF THE CAUSE OF DEATH.
Winghut Boston , .
1894
Name and age of deceased : Mary & Hooks
Age ... 61 yrs 2 mos. . mos ... 29 dys.
Date and place of death : Jeff9 1844 Winthrop
Disease or cause of death : Brights (Lexar
Duration of disease :*
I certify that the above is true, to the best of my knowledge and belief.
Name and residence of physician. Winthrop nach
H.S. Ferici .. M. D
* It is very desirable to be informed of the duration of the disease.
UNDERTAKER'S RETURN .- Boston.
Hanthrope
Date of death
189/ Name, Ser
Maiden name, *.
Sex,
Married, single, or widow of
2. wife of
Color, Mali Age, 6 years, 2 mos., 29 days.
Residence, ..
Place of death ( ( street and number ) ward
Place of birth,
Occupation,
· Nathaniel Fragen Maiden name of mother, Rebecca Buro Name of father
Birthplace of father, Dal! . Birthplace of mother, ....
Place of interment, j
...
* If a married woman or a widow.
t Give the name of the burial ground.
Date of Certificate Sep19
Signature of Undertaker :
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
(B)
Name and age of deceased :. Charlott
Sept 20. Boston,
180 X
Age ... 260 yrs. X
Date and place of death:
Disease or cause of death : acité
.. mos .. 18 dys. Sept 20- 18 gy to Main for Pleasent at Winthrop ubercularis.
Duration of disease :
of works.
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician. MT.3. Michael. M. D.
* It is very desirable to be informed of the duration of the disease.
UNDERTAKER'S RETURN .- Boston.
Winthrop
Date of death, Defit 20 R Maiden name,“
1894 Name Charlott B Joyce
Sex, Finale
Married, single, or widow of wife of Surge W
ColoWhite Age, 26 years, 4 mos., 18 days. Residence,
Winthrop Mass
Main Con Placent It ward Place of death street and number
Place of birth North Cohasett Mouse Occupation, house wife Name of father David (2-Lineal Maiden name of mother, Laura Cooper
Birthplace of father, Harnghan (MarBirthplace of mother!
other Provincetown Mars
Place of interment, i Wrodearon Cent
* If a married woman or a widow.
+ Give the name of the burial ground.
Signature of Undertaker :
Fate of Certificate Seper 21
٠
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Somerville,
189 4.
Name of Deceased, Nellie of Razzie,
Age, 40 Yrs.,. 9 Mos. Days
Place and Date of Death: Died at Crystal Gove are
Sorryervitle, Wirthord 189
Disease or Cause of Death. Jumaline Barely
If a Soldier who served in the War of th Rebellion, both ) * the primary and secondary causes of dea .h must be given.
Duration of Disease,t Que year, at inine
I certify that the above is true, to the best of my knowledge and belief,
Signature of Physician,
And Soule M. D.
Residence, (No.)
(Street.) Winthrop De
(Town or City.)
2
UNDERTAKER'S RETURN.
SOMERVILLE, MASS.
Date of' { Death. 1
Spf 2 2189 4 Name, Nellie A. Rymes
Maiden Name, Fellin et ArayHusband. )
Name of 1º Jaum G
Rymer
Sex, Hierale Color,+
Single, Married or Widowed, Manuel
Age, 4 0 Yrs., 7 .... Mos.,
Days. Residence, 286 Htey Lland Sommille (No.)
(Street.) (Town or City and State.)
Place of Death (Street and), Crystal
Occupation,
Place of Birth,
Vame of Father.
graph I, Gray
Birthplace of Father. sheffield It
Maiden Name of Mother. Birthplace { of Mother. S Cambridge
,
(Town or City and State.)
* If a Married woman or a Widow.
t If other than White, (A) African, (M) Mulatto, (I) Indian; if of other races, specify what.
12129 ate of certificate
1
Signature of Undertaker,
EAMarch
Residence, 24 Cincohust Sonville
(No.)
(Street.)
(Town or City.)
Jeruska & Peber ellorgan It Samendy?
Place of Interment,
(Cemetery.)
١
10.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name, .
11
(Maiden Name),
·
(Name of Husband),
3. Sex, and whether single, Married, or Widowed,
Females
Hidmed
4. Color, t
5. Age, GC 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, .
-
1
DATED at
Smithy
, on
Lefal 27 1895
* 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.
.
7
1.1
2200
. 26.894
[ACTS OF 1888, CHAP. 306.]
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF 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 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 neglects or refuses to make a certificate, as aforesaid, he shall be pun- 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 fur- nished, 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 state- ment 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 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.
Name and Age of Deceased,*
Charlotte Un Learned
Age, 66-3-2d2
Date and Place of Death, i - died at.
(Main Sheet) Sejet 26" 1894.
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness, -
of Heart Disease Twenty four hours
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
H & Sauce NO Winthrop. 1ch
Date of Certificate, cate, Sept 28
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.
[ 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 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 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 licu 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 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
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Oct-2 1894 Herbert- 6. 53420112
2. Name,
(Maiden Name),* (Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
CK 1
4. Color.t
5. Age, 21 Years, J Months, 2,5 Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . By whom certified,
7. Residence,
500 numbers
1
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 wother person making the Return, .
1 Surmer
Floyd
DAATED at (
on
18/4/
* 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. Nov. 1890-5,000.
/
Cambrid
1
[ACTS OF 1888, CHAP. 30G.]
AN ACT
RELATING TO THE CERTIFICATES AND REGISTRY OF DEATHS, AND THE BURIAL AND REMOVAL OF BODIES OF DECEASED PERSONS.
Be it enacted, etc., as follows :
SECTION 1. Seetion thrce of eliapter thirty-two of the Publie 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 aud 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 deeease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be pun- 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 fur- nished, is amended so as to rea'l 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 elerk, as the case may be, a satisfactory written state- ment 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 py a city or town for the purpose shall, upon request of said board, agent or clerk, make such certifieate 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 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 eause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this seetion shall be punished by a fine not exceeding fifty dollars. [Approved May 4, 1888.
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