USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 37
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4 Carriages dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Maggie Lapham
Age, 33 mrymliga
Date and Place of Death, t - died at.
Winterap mass Can 3, 1800, of Toute nephritis and Tubercular of
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness,
meningitis - Que Munita
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate,
. 1896 .
* Or Sex of Infant (not named). If stillborn so state.
[ If child died immediately after birth so state. Plate. Ed. October, 1895. - 5,000.
{ If a soldier or sailor who served in the War of the Rebellion .
1
[ 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 kuowledge 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 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 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 neglects to make snch certificate he shall forfeit to the treasurer the sum of teu 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 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 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 caunot 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 examiucr shall, if requested, make the samc. 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.
5-3 Carl
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,
Thanol 10/1896 ann Maria Hicele. ferfines
(Maiden Name),*
(Name of Husband),*
Oliver Ileder Sin
3. Sex, and whether single, Married, or Widowed,
Okidared
Thay 24
4. Color,t
5. Age, 66 .... Years, .. 4 Months, .. Days.
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, (Mai-len Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, ·
1
Signature of Undertaker Wrother persas making the Returng .
DATED at
, on
¢ 18
* 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.] l'late. Ed. September, 1892. - 5,000.
9
7
0
Charlatan
[ Public Statutes, Chapter 32, as amended by .Acts of 1883, Chapter 305 ; Acts of 1839, Chapter 22.4.]
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 lecease. If a physician neglects or refuses to make a certificate, as aforesaid, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary for 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, scaton or other person shall bury in a city or town or remove therefrom the body of a deceased person until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board bf health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deccased 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.
OH
F
PHYSICIAN'S CERTIFICATE.
am Maria Wheeler
Name and Age of Deceased,*
Date and Place of Death,t -1 died at
of
Disease or Cause of Death, - (Primary und Secondary.)} Duration of Sickness, -
Age, 66-9-15 Winthrop ( Florence are) Mich 10" 1896, 0 10 days 0
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate,
Intercep Year 13 1896.
* Or Sex of Infant (not named). If stillborn so state.
[ If child died immediately after birth so state. Plate. Ed. October, 1895. - 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 lie 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 immédiate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate lie 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 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 city or town elerk. No snel 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 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 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 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 deatlı, as the elerk 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.
RETUR F A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
(Maiden Name),* (Name of Husband) ,*
Mch 17, 1896 mary. a. Squires Many a. Bidwell Mastur Squires diemale Widow
...
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age,
9 0 Years, ..
Months, .._ _
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. (Duration of Sickness, . By whom certified, .
Johnson
Mass
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, ·
auchet
Mass
Signature of Undertaker or other person making the Return, .
ODMarch
DATED
Winthrop Mass, on
Much 17th
189.6
* If a Married Woman or Widow. { If a Soldier who served tu 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. Jan. 1895. - 5,000.
Mars
Hartford Foran
Junothy Bidwell
Noxeyt Eran
wane
) Bidund
[ 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 neglect to make such 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 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 age clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returne 1 recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or i . thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending phy cannot be obtained, for good and sufficient reasons, early 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 as required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall 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 pashed by a fine not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Date and Place of Death, t - died at
C "ase or Cause of Death, - A Primary und Secondary.)} ation of Sickness, - -
of
mary a. Siquires Age, Vimettras (Strictlyist) War17, 1896. Heart Disease. 1/2 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,
1890
* Or Sex of Infant (not named). If stillborn so state.
1 If child died immediately after birth so state. Plate. Ed. October, 1895. - 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 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 furnislı for registration a certificatc, 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 lic can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sumn 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 perinit 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 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 deatlı, as the clerk or registrar may require. Any person violating any of the provisions of this seetion shall be punished by a fine not exceed- ing fifty dollars.
RETURN A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death, . Pareto 21, 1890 --
2. Name,
(Maiden Name),* evitecon le fonman
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
Female married
4. Color, t
1
1
ny Years, ....
9
Months,
8
..... Days.
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, .
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, K2:
Signature of Undertaker Hackerperson making
Summer Floyd
DATED at
Fiultrop
, on
Mch 22
1896
* 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. Jan. 1995 .- 5,000.
1
antena "(el iimani 2 Vertcical VChiamano
5
Muasó.
the Return,.
1 metros
Tuvais.
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306; Acts of 1889, Chapter 224; Acts of 1893, Chapter :
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for r tration, a certificate statiug, 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 fact 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 ' the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neg' 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 unt' 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 sucl or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agel. 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 physic cannot be obtained, for good and sufficient reasons, early 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 as 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 fort 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 manuer 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 finc not exceed- ing fifty dollars.
10- 2 0% 67- 31/4
PHYSICIAN'S CERTIFICATE.
Jame and Age of Deceased,*
Rebecca Sampson
¿te and Place of Death, t - died at.
-
"sease or Cause of Death, - : (Primary and Secondary.) } turation of Sickness, .
of acute
Age, IHyaqms 8de Winthrop (Shirley Street) Mch 21", 1896, Brandhitis with
C
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate,
Ziar 23 1896.
* Or Sex of Infant (not named). If stillborn so state.
[ If child died immediately after birth so state. Plate. Ed. October, 1895 .- 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 dieu, 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 certifieatc, stating to the best of his knowledge and belief thic fact that such a child died after birth or was born dead. If a physician neg- Iccts 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 deecased 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 hc 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 licalth 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 elcrk, 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 threc of this chapter, or in lieu thereof a certifieatc 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 clerk, make such certifieatc 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 certifieatc arc 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 eause of the deatlı, as the elerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not cxeeed- iug fifty dollars.
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