Town of Winthrop : Record of Deaths 1893-1896, Part 41

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 41

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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 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.

Thomas Or. Morgan

Name and Age of Deceased,*

Date and Place of Death,t - , died at

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

Age, 6-3-19 Vinitrop (Read Street) May 26" 1896, with theria Fourteen days

I certify that the above is true, to the best of my knowledge and belief. Albert 13. Roman, MUS

Signature and Residence of Certifying Physician,

Date of Certificate, June May 29to 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 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 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 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 therc 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 seetion 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 27"1896 Thomas

Thélater

(Maiden Name),*

(Name of Husband),*

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

Married Fibile

4. Color,t

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

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

7. Residence,

8. Occupation, .

9. Place of Death, .

10. Place of Birth, .

11. Name of Father,

12. Name of Mother, (Maiden Name).

13. Birthplace of Father,

1.1. Birthplace of Mother, .

15. Place of Interment,

Signature of Undertaker Sacher person making the Return, .

DATED at 9/ml

, Oll ... May 27

189.6 A

* 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. 1905 .- 5,000.

33 Years,. Months, .. Days.

An Ht 2 Loule

Labrei

Englande

Englands

110% Cemetery

[ 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 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 orto 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,* Thomas It. Whitaker

Date and Place of Death,t - died at

Age, 33 years Winthrop (Mintrop, &I) May 2] 1896, Cerebral Uppodlexy

Disease or Cause of Death, - 1 of (Primary und Secondary.)} Duration of Sickness,

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

ilrace.

25 acele 11. 5 1 Mulherop Maz

Signature and Residence of Certifying Physician,

Date of Certificate,

189 6 .

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

t 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 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.

PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.

May 31 189 ....

Name and age of deceased : ( Mary Connelly

Age ... yrs. ...... ... mos. dys.

Date and place of death :

Asthenia HEuxt Secure, Orden

Disease or cause of death :

of lungs.

Duration of disease :*

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

Name and residence

of physician. Tout Stilling

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 A. M. till 12 M .; other days, from 9 A. M +;11 5 P. M.

UNDERTAKER'S RETURN .- BOSTON.

Date of death,

896 Name, Mary Connelly

Maiden name,*

Married, single, or widow of

Patrick

wife of.

Corof War Hay Que + Shirley St.

Color, W. Age,60 years, ~ mos., ....... days. Residence, cor. of Place of death (street and number Wave Day aus + Shirley St Occupation,

wardą

Place of birth, Ireland

ar house

Name of father,

Maiden name of mother,

Birthplace of father, Grelaud.

Birthplace of mother, Dieland

Place of interment,f

halvard

* If a married woman or a widow.

+ Give the name of the burial ground.

Signature of Undertaker :

Sex, 1)

吉海养

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

1. Date of Death, .

Sn. Jour

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, 1

11. Birthplace of Mother, .

15. Place of Interment,

Signature of Undertaker -other person making the Return, .

DATED at

1876

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.] Plate Ed. Jan. 1895 - 5,000.

LA ?- 253

200

. Years,

Months, Days.

Build

[ 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 aud 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 dyj- immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a eertific: 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 leets 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 ease 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 eause of death as nearly as he ean state the same. If a physician refuses or negle to make such certificate he shall forfeit to the treasurer the 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 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 elerk, as the ease may be, a satisfactory written statement containing the faets required by this chapter to be returned an recorded, together with the certificate of the attending physician, if any, as required by seetion 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 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, ageut 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 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 auy other information as to the deceased or to the manner and eause of the death, as the elerk 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.

PHYSICIAN'S CERTIFICATE.

ème and Age of Deceased,* Veres

reg W, Hayden Winthrop June 2

Age,

4-9-1-8

Date and Place of Death, t - died at

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

189 6, Suicide de vital via-

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.

t If child diedl 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 belicf the faet 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 sueli certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides. SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town elerk. No such 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 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 seetion shall be punished by a fine not exceed- ing fifty dollars.

TO THE BOARD OF HEALTH.

[Fill out with ink.]

Date of Death,

Name,

nellie

12 1896. Round Hampe Jullie a. Ranel.

Maiden Name, { If a married woman ) or widow.

If Married Woman, ( Husband's

Name.

Sex, and whether Single, Married or Widowed,

Color, Age, 23 Years,

Months,

Days.

Residence (St. and No.), Shirley

Occupation, Heimatwifi. Birthplace, 0 Elevens. Name of Father, adward S Rand.

Name of Mother,. Emily Heill.

Birthplace of Father, " Mother

Place of Interment,

Oforest Hills bem.

Signature of Undertaker or other person making the return. C.26.00 Undertaker Chelsea, Mass, Jaune 12 1896

PHYSICIAN'S CERTIFICATE.

Name of Deceased,

Nellie Romel decapar.

Date and Place of Death,

: 12th 1896 Winthrop

Disease or Cause of Death, Ahthisu acute

Duration of Sickness, three months

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

Jeong, Queciles

Date of Certificate,

Succce 12

189 6

Physician

UNDERTAKER'S RETURN .- Boston.

PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.

July 6th

189.60

Name and age of deceased : Gathering a & Dad

Age 18

.. yrs. 5 mos . mos. dys.

Date and place of death : Sea Frans are Juan

Wintherals

Discase or cause of death : Bu ghts Disease

& Shadneys

Duration of disease :*

3 Months

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

Name and residence of physician.

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. till 12 M .; other days, from 9 A. M. till 5 P. M.

Sametill wars )

Boston,. .

PHYSICIAN'S CERTIFICATE.

Name and Age of Deceased,*

George Brown Worthof Beach aclass 7/8 1896,

Age, 64 gmx

Date and Place of Death,t - , died at.

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

Duration of Sickness,

of Central

Varmon haga (perplexy) Thirty - six hroma

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

Signature and Residence of Certifying Physician,

Date of Certificate,

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 ametled 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 clied, the duration of his last sickness, and the de' of E.s 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 furnisli for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not execeding fifty dollars. In case the 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 neglcets 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.

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Town of Winthrop : Record of Deaths 1893-1896, Part 41

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

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