USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 21
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PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Herbert To. Dyram
Age, .. fronttraj (Bacon Steel) et 2 -189 4.
Date and Place of Death,t - died at
Disease or Cause of Death, - (Primary and Secondary.)} uration of Sickness, -
Typhoid Fever of
about- four weeks
I certify that the above is true, to the best of my knowledge and belief.
Albert B. Norman, M.D.,
Signature and Residence of Certifying Physician,
Date of Certificate,
det- 4th
1894
" Or Sex of lufant (not named). If stillborn so stale.
¡ 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 203.1
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 deceasc; 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 ncg- lects or refuses to make a certificate as aforcsaid, 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 neglec to make snch certificate he shall forfcit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until has received a permit so to do from the board of licalth or its duly appointed agent, or, if there is no board of health in such c or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned alatt recorded, together with thic 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 an 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.
Date of Death,
Oct. 29 H Ch 18961 1894
Name,
az Riel
Averill.
(Maiden Name), . .
(Name of Husband),
Sex, and whether single,
Married, or Widowed,
Color,
6.3 Years,
Months,
Days.
Park our.
Residence, .
leatenetmaker
Occupation,
Richmond mr.
Name of Father,
Christopher averell
Name of Mother,
(Maiden Name).
abby .. Clifford
Birthplace of Father, .
Birthplace of Mother,
Place of Interment,
Woodlawn.
Signature of Undertaker or other person making the return.
Winthrop
Chelsea, Mass., Oct. 31d 18941
6.He. OF-annel
Undertaker.
Age, .
D
Place of Birth,
PHYSICIAN'S CERTIFICATE. Eskil averle
Name of Deceased,
189%. / Date and Place of Death,
Disease or Cause of Death, h, Lemie Convulsion( Indicatifial
Juran.of.
Duration of Sickness, tot
I certify the above is true, to the best of my knowledge and belief
Date of Certificate, 1894 DanielEtster Dorman M.A. Physician.
No.
Commonwealth of ¿ttassatyjustits.
RETURN A DEATH Lovenile gaisgy To the Clerk of the Town in which the Death occurred.
1. Date of Death,
Margaret 21:10
2. Name,
(Maiden Name),* (Name of Husband),
3. Sex, and whether single, Married, or Widowed,
4. Color, 1
5. Age,
Disease or Cause of Death, (Primary and Secondary),
6. (Duration of Siekness, . 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,
Sarah MC Calon
6, Opland 4 8 Opland
Wuithof Cemetery Hummer France 1
Signature of Undertaker Neother person making
the Return,
Otemale Manied Arhite 118. Years, ( ... ~ Months,. 4
14 Days.
DNDW Norman
Winthrop Mars
6 deland
DATED at Startup, on Ninenlug " 189.4
* If a Married Woman or Widow. ; IL 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.
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 20
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for res tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dy immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certifica stating to the best of his knowledge and belief the faet that such a child died after birth or was born dead. If a physician n lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceed fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give be the primary and the secondary or immediate eause of death as nearly as he ean state the same. If a physician refuses or negle to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such c or town, from the city or town elerk. No such permit shall be issued until there has been delivered to such board, or agent clerk, as the ease 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 eity or town for the purpose shall, upon request of said board, agent or elerk, make such certificate as required of the attending physician ; and in case of death by violenee the medical examiner shall, if requested, make the sam When such satisfactory statement and certificate are delivered to the board of healthi 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 giv 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 exeee ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Tame and Age of Deceased,*
Margaret Jane Bell
Age, 48up-14de
Date and Place of Death, i - died at.
Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness, -
Montura (Percre Street) Nor 9 th Pulmonary Sutrieulouis of Eight moneta
189 4.
1
I certify that the above is true, to the best of my knowledge and belief.
Ignature and Residence of Certifying Physician,
27.A
Date of Certificate,
189 .
1
Ur Sex of Infant (not named). If stillborn so state.
t Ifchild 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 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 snch 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 contuming the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
No.
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
November 10 " 1894 James Jours Odunter
2. Name,
·
(Maiden Name),
(Name of Husband),
Male
3. Sex, and whether single, Married, or Widowed,
Ahile
4. Color, 1
5. Age,
.Years,
8 Months,
1
Days.
Disease or Cause of Death, (Primary and Secondary), ; 6. ¿ Duration of Sickness, . (By whom certified,
Winthrop Wars
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, .
1 Summer Floyd
DATED at
Minturno
a
, onl.
Marquito 10% 189.4
' If a Married Woman or Widow. f If a Soldier who served in the War of the Rebellion. f If other than White. (M.) Mnlatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] l'late. Ed. May, 1893 .- 5,000.
Katharine & Landrigan England
(pland
OHoly Cross Comeley
Signature of Undertaker woher per making the Return,
D. M. Michael
[ 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 persou 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 li 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 notexceeding 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 suiu 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, ageut or clerk, make such certificate as is required of the attending physician ; aud 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 aud 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.
Ane and Age of Deceased,* Ve and Place of Death, t - died at ...
amex
Jours Exunter
1-8-7 Age,
ease or Cause of Death, - (Primary und Secondary.)} ration of Sickness, -
of 1
Minitrop (Aintno). Steel) Nor 10 180 4. 1
I certify that the above is true, to the best of my knowledge and belief.
nature and Residence of Certifying Physician,.
Date of Certificate,
11
189 ' .
r 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 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, forthiwith 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 elerk. No such perinit 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 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 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 certifieate 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 dcatlı, 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,
November 11/1894 Benjamin STEluce
(Maiden Name),
(Name of Husband),*
3. Sex, and whether single, Married, or Wiilowed,
Male
married
4. Color,j
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, .
Ship Caulker doma Sheet-
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,
Northrop Cameley
Signature of Undertaker Calhar musson making the Retury ..
Summer Hoppe
DATED at
, o unentre /03/94
* If a Married Woman or Widow. fif 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.
47 Years,
Months,
26
Dr. QBNorman
Monthof Mass
Benjammi Ot Elvel Eunice nonles
.
[ Public Statutes, Chapter 32 as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263'
SECTION 3. A physician who has attended a person during his last illuess shall, when requested, forthwith furuish for regi tration, a certificate stating, to the best of his kuowledge 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 dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furuish 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- 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 botli the primary and the secondary or immediate cause of death as nearly as he can state the same.
If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and 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 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.
me and Age of Deceased,*
Benjamin Cy Clice
Age, 4/ 1or 5mar 27de
te and Place of Death, t - died at.
Winstrol Gora Steel Nor 1" 189 4.
sease or Cause of Death, - (Primary and Secondary.)} tration of Sickness,
of Heach Disease iscase
Rien Suddenly.
Has been sick o tome years.
I certify that the above is true, to the best of my knowledge and belief.
Albert-B. Norman, 2.2.
nature and Residence of Certifying Physician, ..
Date of Certificate, Nov. 13th
1894.
r 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 .
L Public Statutes, Chapter 32, as amended by Acts of ISS8, 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 deecased, his age, the disease 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 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 execeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give hoth the primary and the seeondary or immediate eause of death as nearly as lie can state the same. If a physician refuses or neglects to make suel eertifieate 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 eity 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 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 licu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician eannot 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 eonntersign 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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