USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 44
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
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
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 Ilusband ),*
3. Sex, and whether single, Married, or Widowed,
1. Color,j
5. Age,
Disease or Cause of Death, (Primary and Secondary), 1
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,
1
ung
·
Signature of Undertaker or other person making the Return;
DATED at
18
* 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. ] I'late. Ed. May, 1893 .- 5,000.
Snake
.
Years, .. 3 Months, 3 Days.
Waterin Slicet
Ferra RS2
[ 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 dicd after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the sccondary 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 threc 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 cnough 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 cxcecd- ing fifty dollars.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and age of deceased : Cultor Simon Boston, .. 189 ....
Agen yrs & mos. 27 dys.
Date and place of death: cam 1296 Vonthe Beach
Disease or cause of death : Janition & Heat Exhaustion follow reported Chaleur Incontin
Duration of disease :* Ping weeks
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician. Edward #121
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. till 5 P. M.
UNDERTAKER'S RETURN .- Boston.
Date of death, aug 12
1896
Name, Millón Simón
Maiden name,*
Sex,
Male
Married, single, or widow of wife of.
Color, 20 Age, X years, 4 mos. 27 days. Residence, 92. E. Problemi St-Boston Place of death (street and), Stings It Wenthope wellas- ...
Place of birth, Doctor Mass
Occupation,
Name of father,.
Isaac
Maiden name of mother, Bancha Hilburn
Birthplace of father,
Birthplace of mother, n. M. City
interment, Ohabri Shalom = Exact Boston Mars
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker :
-11 -
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,
Female
4. Color, t
5. Age,
1
Years,
.......
Monthigs
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whom certified,
7. Residence, Melrose mass
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,
Shirley It Ocean spray Kempton Village Of,/ Elmer f, Holmes Hattie Reflumm Nempetin Village V/V 18. Postin Mais Thousandf, It
Signature of Undertaker However making the Return,
Summer Floyd
DATED at Winthrop
, on.
aluguel 16 1846
* 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, speelfy what.
[Be very particular to fill all Blanks.] l'late. Ed. Jan 1895 .- 5,000.
aluguer 16" 1846 Eva Goddard Stolmes
White 2ª
.
[ 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 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 ne. 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 negle 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 unti! 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 agen 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 li 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 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 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 givel 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,*
Rua Goddard Halines
Age, 14 months. 1896,
Date and Place of Death, t -. died at. Winthrop Mass. august 16 Chalula Infantum disease or Cause of Death, - of .. (Primary and Secondary.)} 1 uration of Sickness, - Fin days. I certify that the above is true, to the best of my knowledge and belief. -
1 Jature and Residence of Certifying Physician,
J
Date of Certificate, may 16 1896.
* 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 hat 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 andt belief the fact that such a child died after birth or was born dead. If a physician neg-
If a physician refuses or neglects 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 bothi the primary and the secondary or immediate cause of death as nearly as he can state the same. 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 cnough 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, agert 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 registrationmny 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.
1
e
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,
4. Color, t
Years, E.
Months,. ) 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,
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker wwother person making the Return, .
-
DATED at , on
1
18
* 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. 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 aud belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and trausmit 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 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.
Pillar Herald 1 dias
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
1
Date and Place of Death, t -
died at &t Vivicp 130 20151345
1894 ,
1
Disease or Cause of Death, - of
(Primary and Secondary.) } Duration of Sickness,
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, Price Sollte e
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.
Age, / Zult, K.
[ Public Statutcs, 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, 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 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 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 scction 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 cxaminer 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.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
·
(Maiden Name), ·
Cleveland
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age,
Years,
Months,
9 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, (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker -or other person making the Return, . -
DATED at 11:
, On
10, 24" 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. ] Plate. Ed. Jan. 1895 .- 5,000.
2
L
Skry
02 Chaus ......
.......
r
1
Clugast 23"1896
.......
Droit
[ 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 died, the duration of his last sickness, and tlic 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 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 1 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 bo the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglect: to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides. SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of healthi 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 and 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 physicis cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or al physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate ax required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the sar When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall for 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 finc not exced ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
L
Yame and Age of Deceased,* 1 Date and Place of Death, t - 1
Overbert B. Cleveland
5-8-9 Age,
died at.
Winthrop (atlantic &1) ang 23" 1896, gastroenteritis, Cerchi Were cortes Six days
T
Disease or Cause of Death, - (Primary and Secondary.)}
of
Duration of Sickness,
I certify that the above is true, to the best of my knowledge and belief.
nature and Residence of Certifying Physician,
€
Date of Certificate, Und 25 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.]
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.