USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 48
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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 lie 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 furuish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and age of deceased :
William
Boston,
Brown
Nuithoy, Mais. Nos. 11th.
189G ..
Age . 84 yrs - .. mos .. dys.
Date and place of death: Mv. 11th 38 Nuitho
Sp. Wer Thon, 12laar.
Disease or cause of death :
Chronic Cestitis-Age
Duration of disease :*
Some months
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ) of physician. Albert B. Dichiar Winthrop Mass.
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,
rr. 11th
1896
Name, Hillin
2202021/
Maiden name,“
Sex, Male
Married, single, er widow Soft wife of.
Color, MutAge, 84 years, Xmos., X days. Residence,
11 Nabullah M Bolos0
Place of death street and) 38 Ninthroh S. WinthropMass ward.
number
Place of birth,
Occupation, Marhentes
Name of father, Forme
Maiden name of mother Marcella Meklewald
Birthplace of father, marcel drase logre Birthplace of mother,
1 cotland
Place of interment,t
forest Hills
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker :
C/
To the Clerk of the City or Town in which the Death boomres.
1. Date of Death, .
Donnez Kom/12: 0.11
2. Name,
(Maiden Name),* (Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age, .
( Years, 1
Months,
5
Days.
Disease or Cause of Death, (Primary and Secondary); }
Dr Forma
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 + other person making the Return, .
S
DATED at
....
, on
187.
* 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. Dec., 1895 .- 5,000.
11
P. le d'Ranol
DE Volano
l
/ Flujo
-
[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 regi tration, a certificate stating, to the best of his knowledge and belief, the uame 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 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 ne lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fiue uot exceedin fifty dollars. In case 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 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 h 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 cit or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent o clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned an recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lie thercof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physicia cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or an physician employed by a city or town for the purpose shall, upon request of said board, ageut 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 sliall forth with couutersign 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 cxcccd ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Vue and Age of Deceased,*
James Roy We Touchlin
Age,
'e and Place of Death, t
died at.
Winthrop(Odermon@tel) for 14" 1896,
.....
ease or Cause of Death, - \ of (Primary and Secondary.)} ration of Sickness, -
Diphtheria five days
I certify that the above is true, to the best of my knowledge and belief. Albert /3. Dorman
nature and Residence of Certifying Physician,
Date of Certificate,
vov. 14th
1894.
Or Sex of Infant (not named). If stillborn so state.
{ If child died immediately after birth so state. Plate. Ed. October, 1595. - 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 203.
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which lu 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 thereiu, 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 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 canse of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Revere Nw. 20th
Dootori, 189. 6
Name and age of deceased : .. Joshua J-Haces
Age 75 yrs 8
..... mos. dys.
Date and place of death : Nov 20th 1896, 19 Charles LA
Disease or cause of death : apoplexy (cerebral hemarhage)
Duration of disease
:*
Death Probably instantaneous
I certify that the ubore is true, to the best of my knowledge and belief.
Name and residence )
Brainallendrews M. D. of physician. Wirthole ave. Revere.
* 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.
26 V
Winthrop
UNDERTAKER'S RETURN .- Best
Date of death,
(Nov 20-1896 Name, Joshua M. Lange
Maiden name,*
Sex,
„Onak
Married, single, or widow of
wife of
Color, WY Age, 75years, & mos.,
days. Residence, 13.
Charles 81
Place of death (street and number ), 13 Charles Aft
ward
Place of birth,
Occupation,
Averchant
Name of father, Jessie
Maiden name of mother,
Berther
Birthplace of father, ) Vely tet
Birthplace of mother,
Place of interment, i
Nelikkell
* If a married woman or a widow. + Give the name of the burial ground.
Signature of Undertaker :
of H Carter
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred. 10 1. Date of Death, . Yneneu 22"1896 Chillies Payson Floyd
2. Name,
(Maiden Name),* ·
(Name of Husband),
Male
3. Sex, and whether single, Married, or Widowed,
Medonner
white
4. Color,t
5. Age, .
81
Ycars, ......
8
Monthıs, ...
3
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whoin certified, ·
In D. Millard Coy
7. Residence, .
8. Occupation, .
9. Place of Death, . .
Oferman Sted Winthrop Chelsea
11. Name of Father, .
Land
12. Name of Mother, (Maiden Name),
Chelsea
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker wwwwww making the Return, .
Summer Floyd
DATED at
, on
Chiember 23.1896
* If a Married Woman or Widow. If a Soldier who served in the War of the Rebellion.
t If other than White. (Mf.) Mulatto. (I.) Indian. If of other Races, spceify what.
[Be very particular to fill all Blanks.] Plate. Ed. Dee., 1895. - 5,000.
...
Minitusto mars
Farmer
10. Place of Birth, . .
Normal , Jewelry
Chelsea
Minihol Cemeter
[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 deccased, 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 ncg 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 thercof 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 sliall, 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 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 dcatlı, 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,*
Phillip Caynow Floyd
Winthrop mars 1896
Thor 22 Age, 0 Date and Place of Death, t - died at.
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness, - -
of Cerchia softening; Urania. about three years. I certify that the above is true, to the best of my knowledge and belief. Willand cry, Cast Boston.
Signature and Residence of Certifying Physician,
Date of Certificate,
* 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 dicd after birth or was born dcad. 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 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 towu, 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 physiciau 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 couutersign 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 aud 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 City or Town in which the Death occurred.
1. Date of Death, .
OKnumber 23" 1896 Millie Q, Daggett
2. Name, (Maiden Name),*
(Name of Husband),*
male &
3. Sex, and whether single, Married, or Widowed,
4. Color,t
While
3 Hours
Fears, Months,
Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Siekness, . By whom certified,
16 Sargent St Winthrop
7. Residence,
8. Occupation, . .
9. Place of Death, . .
10. Place of Birth, . .
11. Name of Father,
5 Frederick I Daggett 11
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker whowwwwww making the Return, .
Summer floyd
DATED at
, Ou.
avvanta 25° 1896
" If a Married Woman or Widow. fOf 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. Dec., 1895 .- 5,000.
5. Age,
In Daman
11 +1.
Bezzie SV. Simmons Anth Hayne me Hamouche Or. S. Altintop Cemeler
[ 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 furuish 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 deccased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides. SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent o clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned an recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lie thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physicia cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or an physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as 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 giv shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as t clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exced ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
'ame and Age of Deceased,*
Date and Place of Death, t - died at
Willie Ot. Daggett Winthrop, Frember 23" Premature
Age, 30 Hours
1896,
Disease or Cause of Death, of
Primary und Se undary.) } Duration of Sickness,
I certify that the above is true, to the best of my knowledge and belief. Albert 18. honnan M.G.
Signature and Residence of Certifying Physician,
Date of Certificate, - Jhv. 23, 189%.
Or Sex of Infant (not named). If stillborn so state.
t If child died immediately after hirth so state. Plate. I.d. 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 deeeasc; 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 solthier 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.
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