USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 40
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Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49
NO.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
Shay 8"1896 Diancha Mordu
enviede
(Maiden Name),*
(Name of Husband), *
3. Sex, and whether single, Married, or Widowed,
1. Color,t
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,
1.1. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Returnof
Lumines Pagal
DATED at
, Olì
May 8
187.6
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] Plate Ed. Jan. 1805 .- 5,000.
6A Years, Months, ... 2 Days.
Dr Johnen
Mani Rhet
Vance Kennedy
...
[ 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 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 dyin. immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificat. 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 exceedin fifty dollars. In ease 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 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 city or town or remove therefrom a human body nntil li 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 sueh city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or elerk, as the 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 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 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 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 ease of death by violenee the medical examiner shall, if requested, make the same. When sneh satisfactory statement and certifieate are delivered to the board of health or to its agent, the board or agent shall forth- with eountersign 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 seetion shall be punislied by a fine not exeerd- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Date and Place of Death,t - , died at
Age, . 1896 :
Disease or Cause of Death, - of
(Primary and Secondary.)} Duration of Sickness, -
Рантыла. the days I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
4 .
Date of Certificate,
may 11 1896 .
· Ur Sex of Infant (not named). If stulborn 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 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, fortliwith 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 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 thercfrom 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 scetion 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 sutlicient 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.
n
UNDERTAKER'S RETURN .- Boston. PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
9€ 189
6
Name and age of deceased :
Age . .... .. yrs ........... mos. . d.ys.
Date and place of death :
Disease or cause of death :
Duration of disease :* I certify that the abore is true, tosthe best of my knowledge and, belief.
Name and residence
of physician.
2 M D
* It is very desirable to be informed of the duration of the disease.
The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A. M. till 2 P. M .: Sundays. 10 A. M. till 12 M .; Holidays, from_ 10_1, M., til 19 M .. other davs. from 9 .1, M. till 5 P. M.
più
.. 0.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
(Maiden Name),*
(Name of IIusband) ,
3. Sex, and whether single, Married, or Widowed,
1. Color, t
5. Age, Disease or Cause of Death, (Primary and Secondary ), #
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Deatlı, .
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 -
the Return, .
DATro at Winthrop
may 12
C
1866
4 If a Married Woman or Widow. # If a Soldier who served in the War of the Rebellion.
tlf other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] Platc. Ed Jan. 1895 - 5,000.
May:11 " 1896 Charlie H, Verkehrry
quale married white
54 Years, Months, 14 Days.
Dr B C. Kelsay Rollhuy Mutluop mart Real Estate Pleasant Rett Winthrop amee Calma E. March Monthof, Chelsea Gloucester Mass Monttrop Comely Summer Floyd
[ 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 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 case the deceased was a soldier or a sailor wlio 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 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 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 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 ease of death by violenee the medical examiner shall, if requested, make" the same. When such satisfactory statement and certifieate are delivered to the board of health or to its agent, the board or agent shall forth- with eountersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and eause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
2080 of an laske
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, J Date and Place of Death, t .
Charles Or Tewksbury
Age, 54 Winthrop (Pleasant SV) May 11 1896, died at .. intestinal ulceration of
Disease or Cause of Death, - B (Primary and Secondary.)} Duration of Sickness, - -
I certify that the above is true, to the best of my knowledge and belief.
B.le Kelsay 221, 2. 79 Harren 22
Signature and Residence of Certifying Physician, Roxbury Mass
Date of Certificate, May 13th 189
·
* 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 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 inakes 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 sueli eity 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 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 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.
NO.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
(Maiden Name),*
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
1. Color, t
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,
Signature of Undertaker or other person making the Return. .
Summer Floyd
DATED at Printtrop , 011
may 19, 1896
1896
may 1800 Jeannette M. Davis
Wallace
Davis
George Jecuale word
"
While
63 Years,
Months, ...
[ .... Days.
3 weeks
" unknown
8. Itorigin un.
Boston
Winthrop New Bedford John D. F. Wallace Jeannette m. Morse Scotland 300 Row
* 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. 1895. - 5,000.
[ 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 botlı 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 lie shall forfeit to the treasurer the sun 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 lias 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 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 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.
Name and Age of Deceased,*
Jeannette W. Davis Winthrop May 15th 1896,
Age, 63-9-19
Date and Place of Death, t - died at.
Disease or Cause of Death, - (Primary und Secondary.) } Duration of Sickness, -
of ..
gripp and Heart Disease 3 weeks "
" unknown
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, ....
S. Nogice, 175 Newbury Ar Boston Date of Certificate, .. May 19 th 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 pas 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 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- 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 cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certifieate 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 sueli city or town, from the city or town clerk. No sueh 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 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 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 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 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, .
2. Name,
May 26 +1896 Santos H, Morga
(Maiden Name),
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
Sale
4. Color,t
5. Agc,
6
Years,.
3
Months, ....
19 Days.
Disease or Cause of Death, (Primary and Seeondary), #
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 otherperson making
1
the Return, ;
DATED at
, on
18/
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
tlf 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.
Diphtheria
.. Front Slivet
Road 21:001
Sach Baston
mary Jane Dringhee
10
[ 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 faet that sueh 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 exeeeding 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 sueh 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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