Town of Winthrop : Record of Deaths 1893-1896, Part 24

Author: Winthrop (Mass.)
Publication date: 1893
Publisher:
Number of Pages: 798

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 24

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1 Coming

PHYSICIAN'S CERTIFICATE.

Name and Age of Deceased,*

Helen Homer Pendleton

Age, .

4mos

Date and Place of Death,t - died at.

acuto

Northrop (Hordeide are) Fel 151895- Bronchitis

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,

Charles a Arffert For R CP. Low

...

Date of Certificate,

Worthof 236 16, 1895-

* Or Sex of Infant (not named). If stillborn so state.

¡ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.

# If a soldier or sailor who served in the War of the Rebellion.

[ Public Statutes, Chapter 32. as amended by Acts of 1888, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for 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.

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,

Februar: 20 1/89. 2

(Maiden Name),

(Name of Husband),*

3. Sex, and whether single, Married, or Widowed,

4. Color,i

5. Age, 24 Years, 11

Months, : Days.

Disease or Cause of Death, (Primary and Secondary), #

6. {Duration of Sickness, . By whom certified, · Dan That

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 w other person making

the Return,. %

DATED at

, on Febras 21 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. ] l'late, Ed. May, 1893 .- 5,000.

Sweet

dblanco

[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 statiug, 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 iminediately 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 iu 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 iu a city or towu 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 elerk, 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, 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, agcut or clerk, make such certificate as is required of the attending physiciau; and iu 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.

Society 9

PHYSICIAN'S CERTIFICATE.

24 NR 11 mos

Age,

ne and Age of Deceased,*

Winhugo (Pranthrope Twee1) Feb 201805.

e and Place of Death, t - died at.

base or Cause of Death, - (Primary and Secondary.)} tation of Sickness, -

This was treti , u cle (Consumption)

I certify that the above is true, to the best of my knowledge and belief.

ature and Residence of Certifying Physician,

Date of Certificate, V 189

· Sex of Infant (not named). If stillborn so state.

[ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.

1 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 deccase; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.

SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hercinafter 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 incdical 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.

Commonwealth of Etlassuchusetts.

RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred. 1.

1. Date of Death, .

2. Name, ·

(Maiden Name),*

(Name of Husband),*

('rugs Tercetta l'addubord. Orichards Marehall Carter, Cesnale Harried

3. Sex, and whether single, Married, ++ Winlowest,

4. Color, t

5. Age, 60 Years, 5 Months, 10 Days.

Disease or Cause of Death, (Primary and Secondary), ;

6. Duration of Sickness, . (By whom certified, .

7. Residence,

Marshall it Winthrop Abase)

8. Occupation, .

Foruse wife,

9. Place of Death, . Winthrop

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 weather person making the Return, .

Summer Floyd

DATED at

, on

Feb 212/" 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. {Bo very particular to fill all Blanks.] Plate. Ed. May, 1893. - 5,000.

.....

Isaac Hadde ford. Farah Allée

Laletou, drid

Littleton d: d

No.

Lily 21.02 1890.

ucetta° Carter

[ Public Statutes, Chapter 32 as amended by Acts of ISSS, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he 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 dicd 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 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 nntil 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 : required of the attending physician; and in case of death by violence the medical examiner shail, 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 fortl 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 th 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.

ame and Age of Deceased,*

ate and Place of Death,t 1.

Disease or Cause of Death, - (Primary and Secondary.)} uration of Sickness, -

died at.

Age, 65 ype= 15 de Hartum (Marshall Shee) /21895.

Cancer of Bread-

of chant- que yras

I certify that the above is true, to the best of my knowledge and belief.

O.E. Saluson

gnature and Residence of Certifying Physician,

Date of Certificate,

tel 2 2 1895.

Lucella Y Carter

Or Sex of lufant (not named). If stillborn so state. ¡ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.

# If a soldier or sailor who served in the War of the Rebellion .

[ Public Statutes, Chapter 32. as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]

SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of hls decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg .. lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.

SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whoin the perinit 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.

Commonwealth of Etlassuchuseits.

RETURN OF A DEATH.

To the Clerk of the Town in which the Death occurred.

1. Date of Death,

2. Name,

Mar. g. (5.20 Pln) . 895 That. Sturgis Turi carry

(Maiden Name),* ·

(Name of Husband),*

Male

3. Sex, and whether single, Married, or Widowed,

Iharmed

4. Color, ¡

5. Ago,

73_Years .......

2 Months,

... Days.

Disease or Cause of Death, (Primary and Secondary), ;

6. Duration of Sickness, . By whom certified,

7. Residence,

Marshall St. Withron /

8. Occupation, .

9. Place of Death, .

Haithrow ~-

10. Place of Birth, .

Chelsea

11. Name of Father,

Nancy Materiais

12. Name of Mother, (Maiden Name),

13. Birthplace of Father, .

1.1. Birthplace of Mother, .

15. Place of Interment, ·

Punmer Floyd

Signature of Undertaker or other person making the Return,

Parton

Vinthrob

DATED at

, on

mich 11 " 1895

* 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.] l'late. Ed. May, 1893. - 5,000.

Incommonna

Len days

Farma

[ Public Statutes, Chapter 32 as amended by Acts of ISSS, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter 203.]

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 sainc. Wheu 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 registrastar regulation The Person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceaseday to De manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed ing fifty dollars.

PHYSICIAN'S CERTIFICATE.

Name and Age of Deceased,*

Date and Place of Death,t

Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness, -

Age, 73 cx-2ms 8do ed at Printtrop (Marchale SI) Ich q" 1895. Brancho Pneumonia

12 Days

I certify that the above is true, to the best of my knowledge and belief.

Signature and Residence of Certifying Physician, .. . ..

Date of Certificate,

War . 11

1895-

"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 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- 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 eause of death as nearly as he can state the same. If a physician refuses or neglects to make sneh certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.

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Town of Winthrop : Record of Deaths 1893-1896, Part 24

Author: Winthrop (Mass.) Publication date: 1893 Publisher: Number of Pages: 798

Author: Winthrop (Mass.)
Publication date: 1893
Publisher:
Number of Pages: 798