USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 25
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SECTION 5. No nudertaker, 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 case may be, a satisfactory written statement containing the facts required by this chipter to be returned and recorded, together with the certificate of the attending physician, if any, as required by scetion three of this chapter, or in lich 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 licalth 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 manner and canse 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,*
Caccelia M. Campbell
Age, 38 gps 5 ms 18de
Date and Place of Death, t -
died at.
Vinetwoje(Overmain Street+ Meh 14 1805. Pulmonary Tuberculosis.
Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness, -
of
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
DE Johnson MD
Date of Certificate,
Zar 16
.. 189 5.
* 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 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 negleets to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a 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 issned 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, npon 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.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and age of deceased :
alonzo B. Fisk
Boston,
Winthrop Jear 24 5
189 ..... 5
Age ... yrs .............. mos. dys.
Date and place of death : a musterap, Mast. March 24 /1895 ReadStr
Disease or cause of death :
Heart Disease (Cortico Jutal)
Duration of disease :*
Duration of lastillum, 4mas,
I certify that the above is true, to the best of my knowledge and belief.
Name and residence of physician.
W incterap. Mars
M. D.
* It is very desirable to be informed of the duration of the disease.
UNDERTAKER'S RETURN .- Boston.
Date of death,
Jav. 24'
1895. Name, Hanzo. Jack
Sex,
Maiden name, *.
Married, single, or widow of
wife of
Nunchup
Color, 2. Age, 7 years, mos., days? Residence,
Read
Jerald ward.
Place of death ( street and ) number
Place of birth,
Eact
welove Occupation,
Slavi
Builder Sarale S. Mirull
Name of father,
, Maiden name of mother,
Samaricotta ME
vodlaune
lace of interment,t
* If a married woman or a widow.
+ Give the name of the burial ground.
Signature of Undertaker :
Malchance MacBirthplace of mother
Birthplace of father.
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
51
(Maiden Name),*
(Name of Husband),
3. Sex, and whether single, Married, or Widowed,
....
00-3
1. Color,t
j. Age,
82 Years,
6
Monthis,
3 Days.
Disease or Cause of Death, (Primary and Secondary), #
6. {Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father, .
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
13. Place of Interment,
Signature of Undertaker or other person making the Return, . .
DATED at
, 011
* 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.
Third
Check M.
11 (Cole Corner)
Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 26
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for re 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 deceasc; and a physician who has attended at a birth of a child dy immediately thereafter, or at the birth of a stillborn child, sliall, when requested, forthwith furnish for registration a certific 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 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 b the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or negl 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 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 recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physi cannot be obtained, for good and sufficient reasons, carly enough for the purpose, the chairman of the board of health or physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate a required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the sa When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall fo with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so gi shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exc ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
.29. fame and Age of Deceased,*
Date and Place of Death, t - died at. Winthrop
ajeul
6'
1895.
:0 Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness, -
of
Pneumonia. + Hepleritis
Days
I certify that the above is true, to the best of my knowledge and belief.
-
ignature and Residence of Certifying Physician,
Date of Certificate,
- april 9
1895.
* Or Sex of Infant (not named). If stillborn so state.
{ If child died immediately after birth so state.
{ If a soldier or sailor who served in the War of the Rebellion.
Plate. Ed. May, 1893. - 5,000.
-
Richard Thackford)
82-6-3 Agd
[Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263. j
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 containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the 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, Abril 6 189 .. 5.
Name and age of deceased :
Elizabeth Lockwood Age 60 grs 11
.mos .. 15 dys.
Date and place of death: April 6, 1895 Beal St. Wintherh
Disease or cause of death : Jmen na
Duration of disease .
12 days
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
M. D.
of physician.
728 Saratoga &8
* It is very desirable to be informed of the duration of the disease.
UNDERTAKER'S RETURN .- Boston.
Date of death, April 6 1896 Name, ERzabeth Lockwood. Sex, Female
Maiden name,* Elizabeth Boylan
Married, single, or widow of James Lockwood wife of
Color, Y Age, 60 years, / mos. 15 days. Residence, Bral It Winthink
Place of death (street and), number Bral It
e of birth, Charlestown P. G.S.
ward
Occupation, Youaru orle .
Name of father,
Edward
Maiden name of mother,
" Catherine Murplus.
Birthplace of father Miland
Birthplace of mother,
Sacland
Place of interment,i
Holy Cross
Mealden.
* If a married woman or a widow. Give the name of the burial ground.
Signature of Undertaker : m. J. Kelly
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
13" 1875
2. Name,
(Maiden Name),
(Name of Husband),
3. Sex, and whether single, Married, or Widowed,
-
1. Color, ț
5. Age,
69
.Years, ...
9
.Months,
2d 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, .
asidicio
Palle A:
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, ·
Signature of Undertaker Problemperson making the Return, .
DATED at
, on
april 14"
187.5
* If a Married Woman or Widow. # If a Soldier who served in the War of the Rebellion. t If other thau White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.] Plate.º, Ed. May, 1893 .- 5,000.
Cada 2010
12. Name of Mother, . (Maiden Name),
.
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 300; 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 h died, the duration of his last siekness, and the date of his deeease; and a physician who has attended at a birth of a ehild 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 ehild 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 ease 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 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 eity or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the eity or town elerk. No such permit shall be issued until there has been delivered to sueh board, or agent or clerk, as the ease may be, a satisfactory written statement containing the faets required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by seetion 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 eannot be obtained, for good and stiflicient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a eity or town for the purpose shall, upon request of said board, agent or 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 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.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Charles Bushman Vinitrajo aferie 13h "1
Age,
69-9-23 1895.
Date and Place of Death,t e
- died at
Disease or Cause of Death, - (Primary and Secondary.); Duration of Sickness, -
of
Pulmonary Tuberculosis.
I certify that the above is true, to the best of my knowledge and bellef.
ignature and Residence of Certifying Physician,
Date of Certificate,
afuit 15
1895
Or Sex of Infant (uct namned). If stillborn so state.
¡ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.
Į If a soldier or sailor who served in the War of the Rebellion.
[ Public Statutes, Chapter 32 as amended by Acts of 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 ean state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the suin 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 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 cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a eity or town for the purpose shall, upon request of said board, agent or 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 fortli- with conntersign 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 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.
april 20
5 189.
Boston Name and age of deceased : Sarah Docaling Age 58 yrs Kalle Age
... mos ... .. dys
Date and place of death:
Jaful 20195
Disease or cause of death.
Duration of disease :*
I certify that the above is true, to the best of my knowledge and belief.
Name and residence )
of physician. 33 Weah freMault Betty
* It is very desirable to be informed of the duration of the disease.
UNDERTAKER'S RETURN .- Boston
Date of death, .. In20 189 .5 Na
Thenthrow all Dayling
arat
Maiden name,*
Sarah mckean
arah
Sex,
Finale
Married, single, or widow of
e of Mark Dowling
Color, Age & years, .... mos., ...
days.
dence, Lacual St Huth
Place of death (st (street and number
ward
Place of birth,
Occupation, Hausen Le ..
Name of father, John M "Heque, Maiden name of mother,.
Birthplace of father, belaud
Birthplace of mother,
Place of interment,t Calvary
der ....
* If a married woman or a widow.
t Give the name of the burial ground.
Sarah Garylan
Signature of Undertaker :
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
20"1995
2. Name,
(Maiden Name),*
(Name of Husband),*
3. Sex, andwhethersingh,
Married, or Widowed,
1. Color,t
5. Age,
.. Years, Montly, 26 Days.
Disease or Cause of Death, (Primary and Secondary ), #
6. Duration of Sickness, . By whom certified, .
7. Residence, .
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father, .
12. Name of Mother, ·
· (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Retmand.
DATED at
0 , On
20 189.5
$ 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.
2 Maria.
61
11
C
Winter
Ł
B
Fennel
[ 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 iliness 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 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 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 whoin 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 iug fifty dollars.
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