USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 12
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
0 Jernale Married
4. Color, t
5. Age, 30 Years, 9
Months, .3 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. .
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker brother person making the Return, .
1 ١
DATED at -
. on
18
** If a Married Woman or Widow. # If a Soldier who served in the Waf 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., 1896. - 5,000.
H2015 3.1
ice . (Maiden Name),
× Sinodia
9
/
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he (lied, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, 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 uudertaker, 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, carly 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 comtersign 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.
Lura Nelson Sage
Name and Age of Deceased,*
Date and Place of Death, t - died at
Disease or Cause of Death, - (Primary and Secondary.)}
of
Duration of Sickness, -
3 cups
I certify that the above is true, to the best of my knowledge and beliefs
Signature and Residence of Certifying Physician,
Date of Certificate,
Olay 18 189
* Or Sex of Infant (not named). Jf stillborn so state.
t If child died immediately after birth so state. Plate. Ed. December. 1996 .- 5,000.
# If a soldier or sailor who served in the War of the Rebellion.
Age, JOye- 9m-3de Winthrop, (oreet Chenue) (lng. 16" 1891), Septicemia + acute valuta
[ Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300 ; Arts of 1889, Chapter 224; Arts of 1898, 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 statiug, to the best of his knowledge and belief, the name of thic 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 elilld 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- leets or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he ean 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 lic lias received a permit so to do from the board of. licalth 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 issned until there has been delivered to sneh 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 iu lieu thereof a ecrtificate 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 statemeut 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 deceased or to the manner and cause 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 ilfty dollars.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and age of deceased : Rosa Mc Shane Boston,
Aug-17Th Age 10 yrs. mnos.
189
7 dys
Date and place of death :
Disease or cause of death :
withtheria
Duration of disease :*
bix day
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician.
Albar 19. Doman
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. 17
Maiden name, *..
1897 Name, Base" Mr. Shave Sex,
Married, single, er widow of
wife of -
Color, W Age,/ 0 years, mos.,
days. Residence, Gerald R&
Place of death ( street and
number
Gerald st Wuittich ward
Place of birth, Winthrop Maks Occupation,
Name of father, Bernard
Maiden name of mother, Que Rogers
Birthplace of father, Geland Birthplace of mother. Treland
Place of interment, t
"Holy Cross" Malden
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker :
Vhas. J. Have
-
£
No.
Commonochity of Sulassistanscus.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Deathı, .
2. Name, (Maiden Name), (Name of Husband),*
3. Sex, and whether single,
Married, or Widowed,
4. Color, i
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 Birthi,
11. Name of Father,
12. Name of Mother, (Malden Name),
13. Birthplace of Father. .
14. Birthplace of Mother. .
15. Place of Interment,
Winthrop (Fam liar Que) Dorchester Henry I Burdick Leona Miller Moira nef. Fort ann Winthrop Comeley
Signature of Undertaker weather rss-making
1 Summer Floyd)
the Return, .
DATED at
August 29 1× 9.7
* 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., 1596. - 5,000.
1897 Edwards Miller Burdick
male.
White
Years,
Months, - Days.
10 days De a 13 Toman. Winthrop
Campers22 Pro Plusk + Box
Manage
[ 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, hls age, the disease of which lie died, the duration of his last siekness, and the date of his decease; and a physician who has attended at a birth of a ehild dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a eertifleate, stating to the best of his knowledge and belief the faet that such a child died after birth or was born dead. If a physleian neg- leets or refuses to make a certifleate as aforesaid, or makes a false statement therein, he shall be punished by a fine not execeding 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 ecrtifieate 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 reecived a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health In such city or town, from the city or town clerk. No such permit shall be Issued until there has been delivered to such board, or agent or clerk, as the ease may be, a satisfactory written statement containing the faets required by this chapter to be returned and recorded, together with the eertifieate of the attending physician, if any, as required by seetion three of this chapter, or In lien thereof a certifieate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a eity or town for the purpose shall, upon request of said board, agent or elerk, make such certifieate as is required of the attending physician ; and in case of death by violence the medical examiner shall, If requested, make the same. When such satisfactory statement and certifieate are delivered to the board of health or to its agent, the board or agent shall fortli- with countersign and transmit the same to the elerk or registrar for registration. The person to whom the permit is so given -hall thereafter furnish for registration any other information as to the deceased or to the manner and eause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Edward In Burdick
Date and Place of Death,t - died at
Disease or Cause of Death, - of (Primary and Secondary.) } Duration of Sickness, 1
Age, 1 year Hintrop (Fam Baan) augstu189, Inflammatory Diarrhoea Jen day I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, ......
A. 12 Norman, MO.
Date of Certificate, aug 25th 17 189%.
* Or Sex of Infant (not named). If stillborn so state.
[ If chill died immediately after birth so state. Plate. Ed. December, 1896. - 5,000.
# Ifa 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; Arts 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, forthiwith 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 sun of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until lie las 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 lien 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 snch satisfactory statement and certificate are delivered to the board of healthi or to its agent, the board or ageut 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.
No.
Commonwealth of Massachusetts.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the Death occurred ..
1. Date of Death, .
2. Name,
August 27. 4. 1897 Jerremy Towle
(Maiden Name), · (Name of Husband),*
3. Sex, and whether single, Married, or Widłowert,
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).
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
Hoodlawn Cemetery
Signature of Undertaker or other person making the Return, .
DATED at
Mike
White
..
65 Years, X Months, Intestinal structuri The acute conditions, who
Winthrop Man. Carpenter
4 Read Et Winthrop Man. Cohasett Man. Jeremy Toute Unknown-
JW Spraque 120 Meridian STE Boli 189.7
* 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., 1896 .- 5,000
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 300; Acts of ISS9, Chapter 224 ; Arts of 1993, 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 tlied, the duration of his last sickness, and the date of his deceasc; 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, ne shall be punished by a fine not exceediug fifty dollars. In case the deceased was a solcher 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 uearly as lie can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the suin 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 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 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 excecd- ing fifty dollars.
(Fill out in Ink.)
No.
RETURN OF DEATH TO THE CITY CLERK CITY OF SALEM, MASS.
Date of Death,
Schi- Lizzie B. Gladwin Butman
15- UF 189
7
Name,
Maiden Name,1 /
Sex, Menale; Single, Married, Wie Color2 (if other than white)
Aged
29
years,
months, days
Cause of death,
Residence,3-No.
New york Street.
Place of death, -- No.
Fruithra Center Street.
Occupation,
Birthplace,
Name of Father,
Maiden Name of Mother,
Birthplace of Father,
Birthplace of Mother,
To whom Married,
Attending Physician,
Date of Interment or Removal,
Place of Interment
Ground,
Harmony
Brave Lot, Lot , Salem Mars.
Section,
Range,
Grave,
Undertaker (signature),
Salem Mars. Butman ably le le church New Orleans Salem' Ellis Mr. Gladwin
Burgers
12 H
189
7
C
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Date and Place of Death,t .
Lizzie B. Gladwin died at Minthofle entre
Age, 29 ys Seft- 15 189 7, -
Disease or Cause of Death, . (Primary and Secondary.)} Duration of Sickness,
Route Meningitis of
I certify that the above is true, jo my best knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate,
339 Broadway Paulily 189
* Or Sex of Infant (not named). If stillborn, so state.
+ If child died immediately after birth, so state
# If a soldier or sailor who served in the War of the Rebellion.
[Public Statutes, Chapter 32, as amended by Acts of 1889, 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, forwith furnish for registration, a cer- tificate 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 the 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 physcian neglects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punisiied 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 a 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 sufficent 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 forthwith countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall there- after 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 exceeding fifty dollars.
No.
CumnorwegiTy of ¿ttassachusetts.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),* (Name of Husband) ,
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.