USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1893-1896 > Part 9
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JRN OF A DEATH.
To me Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
(Maiden Name),* (Name of Husband),
10"/803 See
X Taylor Snoche
3. Sex, and whether single, Married, or Widowed,
4. Color, i
5. Age,
Years,
Months,
.. Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . By whom certified,
7. Residence, .
S. Occupation, .
9. Place of Death, .
10. Place of Birth, . Dublin Ireland
11. Name of Father, .
12. Name of Mother, (Maiden Name),
13. Birthplace of Father,
11. Birthplace of Mother,
15. Place of Interment,
Sacland Ireland Greenwood Cemeter
Brother sig
Signature of Undertaker bugtheperson making the Return, .
SummerFloyd 1
DAATED at
., (11
Cette 10- 1893
' If a Married Woman or Widow. f Ha Soldier who served in the War of the Rebellion,
f 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.
[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 tlie 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 reside. 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 ( " physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certifica" required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Vame and Age of Deceased,*
Mary Rea
Age,
68 years.
Date and Place of Death, t - died at
Underhill Street) Och10,893.
isease of Cause of Death, - (Primary and Secondary.)} Duration of Sickness, -
of
Cancer of Stomach
I certify that the above is true, to the best of my knowledge and belief.
Ind Residence of Cerlifying Physician, M. S Soncino Winthrop Mah
RETI
Date of Certificate, Det 11"
1893
alit (not named). If stillborn so state. ¡ If child died immediately after birth so state. Plate. Ed. May, 1893. - 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 deccase; 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 canse 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.
.
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Oct26 - 1893. Charles Thiston Johnson
2. Name,
.
( Maiden Name),* .
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
male Banned
4. Color,1
5. Age, 55 Years, -Montlis,. [ Q.Days.
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 de other person making the Return, y
DATED at Winthrop
Celoter 26 is 93
T
* Ha Married Woman or Widow. { fla Soldier who served in the War of the Rebellion. f If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] Plate. Ed. May, 1893 .- 5,000.
Clergyun 1 Minutterof Hands
Natanz
mass
Welcome HV. Johnson Lucy the empres.
Sterling mass
Nahans
1 1 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 reg 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 dyi immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certifica stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician n lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceedi fifty dollars. In case the deceased was a soldier or a sailor who served iu the war of the rebellion, the physician shall give be 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 until has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such or towu, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physi cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate required of tlie attending physician ; and in case of death by violence the medical examiner shall, if requested, make the sa When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall fo with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so g 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 persou violating any of the provisions of this section shall be punished by a fine not exc ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
ime and Age of Deceased,*
Charles Thurston foh usou
Age, Fc 55)
ute and Place of Death,t
died at. Winthrop-Clef-26
189 2.
ease or Cause of Death, - (Primary and Secondary.)} ration of Sickness,
of Luluculosis disserundta.
I certify that the above is true, to the best of my knowledge and belief.
ature and Residence of Certifying Physician,
Heures Qi Marcel 221/2.
100 Courezzozeercolthale. Birlou
Date of Certificate, Del 26. OH
189 2.
Sex of Infant (not named). If stillborn so state.
1 If child died immediately after birth so state. Plate. Ed. May, 1893. - 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 chied, the duration of his last sickness, and the date of hits deccase ; 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 such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certifieate 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 eity or town or remove therefrom a human body until hc 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 faets required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall. upon request of said board, agent or elerk, 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 certifieate 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 deccased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this seetion 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),
(Name of Husband),*
Stemra Oultai Sehral
3. Sex, and whether single, Married, or Widowed,
4. 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),
Kircherter
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, ·
Signature of Undertaker wiother person making the Return, .
-
, on
nor
IF 1893
* 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. May, 1893. - 5,000.
Jane 3/93
7.5
Years,
9
Months,
2,
Days.
Lin
Month
maz
ford-Cheie
DAATED at
20 1893 Hannah Venteduy Italie
Chance
3-2 0 1 :475.00 4.00
[ 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 mis chawledge and belief, the name of the deccased, his age, the disease of which he died, the duration of his last sickness, ant to date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of astillborn child, shall, when requested, forthwith furnish for registration a certificate stating to the best of his knowledge and beef 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 bnry in a city orftown or remove therefrom a linman 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 healthi or to its agent, the board or agent shiall forth with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so giver 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.
Vame a ' Age of Deceased,*
Date and Place of Death, t -
died at. Minitrop Pleasant St.
For '30 180 3.
Disease or Cause of Death, - V (Primary and Secondary.) } Duration of Sickness, -
of
Cancer
-
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
M. a. Morrison,
80 Princeton St. S. Botw
Oct. 31 1893.
Date of Certificate,
Or Sex of Infant (not named). If stillborn so state. [ If child died immediately after birth so state. Plate. Ed. May, 1893. - 5,000.
{ If a soldier or sailor who served in the War of the Rebellion .
Stanuali Tewksbury.
Age, . 75 gr /mos 27d.
i Public Statutes, Chapter 32, as amended by Acts of ISSS, 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 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 refuscs 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 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 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 elerk, 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 cxeced- ing fifty dollars.
-VO.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
2. Name,
11893 Frances Routine Mincho
(Maiden Name),* ·
(Name of Husband),
3. Sex, and whether single, Married, or Widowed,
teniale
4. Color, ¡
5. Age, 1 Years, Honthis, 11 .Days.
Disease or Cause of Death, (Primary and Secondary), #
6. (Duration of Sickness, . By whom certified, .
7. Residence, .
8. Occupation, .
Putrane Rivel
9. Place of Death, .
10. Place of Birth, . .
Michael 8
11. Name of Father, .
Julia 6 0
12. Name of Mother, · (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
galde Alle Gra Ceniet
Signature of Undertaker wpotter pero making the Return, .
Summer Florid
DATED at Want , on Nor10.
1893
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion. ¡ li other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify whal. [Be very particular to fill all Blanks.] Plate. Ed. May, 1898. - 5,000.
.
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 300; 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 deccase; 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 aforcsaid, 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.
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