USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 16
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No.
Commonlocalth 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,
13"1897 Oahmad d. miller
(Maiden Name),*
(Name of Husband) .*
3. Sex, and whether single, Married, or Widowed,
4. Color,t
5. Age, Years, - 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, (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker ++other wason making the Return, . .
1
Ir mihup Tras
Paulus Prena 2. 0 Duchert-
Harchile, Ceneley
DATED at
13 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. Dec., 1896. - 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 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 physielan 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 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 faets required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by seetion 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, carly 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 clerk, make sneh eertificate as is required of the attending physician ; and in case of death by violenee the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,* Thomas J. Miller Age, Winthrop (Pauline Sv) Jan 13"1898. Date and Place of Death,t - died at. Intestinal obstruction Disease or Cause of Death, - of (Primary and Secondary.)} Duration of Sickness, - Twelve hour
3 Days
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, A. B. Bonneau
Date of Certificate, ... Jan. 14th
1890
* Or Sex of Infant (not named). If stillborn so state.
I If child died immediately after birth so state. Plate. EJ December, 1890. - 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 kuowledge and belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he lias 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 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 orto its agent, the board or agent shall fortli- 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.
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 300; Acts of 1880, 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 kuowledge 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; aud 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 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 town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physician cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as the clerk or registrar inny require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
UNDERTAKER'S RETURN. Boston.
Date of death, Jan 25% 1898
Name,
George De Young Sex Mele
Maiden name,*
Married, single, or widow of ..... Widower wife of
Color, Age, 7.5 years. 6 mos .. .. days. Residence,
Winthrop mass.
(street and), 74 Bowdoin St Win theap ha war
Place of birth, Thomaston Chomarton Maine Occupation,
Carpenter
Name of father,
.... Maiden name of mother,
mary Myers,
Birthplace of father, .. linkenown.
Birthplace of mother, Unknown
Place of interment, t
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker : ANS paraque
R
INC
OR ATE
WINTHROP
A TOWN
* 18 52
Commonwealth of Massachusetts
CERTIFICATE OF DEATH FROM THE RECORDS OF DEATHS IN THE TOWN OF WINTHROP, MASSACHUSETTS
Date of Death:
January 25, 1898
Name:
George W. Young
(Maiden Name):
Sex, Color and if Single:
Male
Married or Widowed:
Widowed
Color:
White
Age:
75 years, 6 months
Disease or Cause of Death: Apoplexy
Residence:
Winthrop, Massachusetts
Occupation:
Carpenter
Place of Death: 74 Bowdoin Street, Winthrop, Massachusetts
Place of Birth:
Thomaston, Maine
Name of Husband or Wife:
Name of Father: John Young
Maiden Name of Mother:
Mary Byers
Birthplace of Father: Unknown
Birthplace of Mother:
Unknown
Place of Interment:
Date of Record:
June 26, 1898
Registration No .:
4
I, the undersigned, hereby certify that I am clerk of the Town of Winthrop; that as such I have custody of the records of births required by law to be kept in my office.
And I do hereby certify that the forgoing is a true copy from said records.
Witness my hand and seal of said Town of Winthrop on this 6th
day of February
2013
Carla Vitale, Town Clerk
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Bomtent, Jan 26th
189 8.
Name and age of deceased : Kessie H Young
Age 75 6
dyx Date and place of death Jan 25 %. 1898, N. 74 Bowdoin St Winthrop Inass Disease or cause of death :
Lu day 2
Duration of disease : *
·
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician.
M. D Can 251848
* It is very desirable to be informed of the duration of the disease.
€
C
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.
Commonlocalth of Massachusetts.
Y No.
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),*
3. Sex, and whether single, Married, or Widowed,
4. Color,
5. Age,
(Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, . Builder almont Places
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,
(
the Return, . 1
1
00
18
DATED at
* 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.
.
male
Traite" Years, .... Months,
Days.
Signature of Undertaker ) super making
[ 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 belicf, the name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a fine not 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 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 tury 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 eity or town, from the city or town clerk. No such permit shall be issued until there has been delivered to suchi 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 thic board of health or any physician employed by a city or town for the purpose shall, upon request of said board, agent er 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 shall fortli- 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 deatlı, 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.
-1,00€
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
20192 6, Stanley : Privatnoj (le mont &t) Jan 27 "1808
e, 42-7-1 Age,
Date and Place of De.ith, t - died at
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness,
of Ten months
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate, Jan. 30Th
1800
* Or Sex of Infant (not named). If stillborn so state.
t If child died immediately after birth so state. Plate. Ed. December. 1996 .- 5,000.
Į If a soldier or sailor who served in the War of the Rebellion.
[Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300 ; 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 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 flue 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 botli 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 hereiuafter 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, tlic 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 shall forth- with conntersign 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 OF THE CAUSE OF DEATH.
Jan 29th Age. 78 yrs. mos.
189
Name and age of deceased .
dys. Date and place of death: Jan 29th, 1898, Solo Cercle of Winthrop (mass.
Disease or cause of death:
Senility
Duration of disease : *
I certify that the above is true, to the best of my knowledge and Delief.
Name and residence
M. D
of physician.
am 2948
* 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.
Winthrop
Date of death,
death Jan 29th
£
Fanc John Light foply Sex, male
Maiden namely
Widower
Married, single, or widow of wife of
Color W Age, 7. 8years, mos .. days Residence,
mass
Place of death ( street, and . 2010 Center of ( Winthrop mass,ward
Place of birth,
Newyork Ch4)
Occupation,
Ship Carpenter
Name of father James Lightbody
Maiden name of mothe Mary Mc Lean
Birthplace of father, Ireland
Birthplace of mother, London derry
Place of interment, t
East-Berlin Cemetery
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker : DIV Spraque
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Feel 8th
Name and age of deceased :
Edward F. Rollins
Boston,
189
8
Age 69 .. yrs. x. mos. 26 mys.
Date and place of death : Fcb $ 1 T9T Mermaid Ave Withmy llan
Discase or cause of death :. Bronchitis accompanied by Culinary
Edema and Cardiac degeneration. (Alcoholic Hobit)
Duration of disease : * In severe form (five days) preceded by gradual -cuivre for some four months, I certify that the above is true, to the best of my knowledge and belief. Name and residence Page of physician. Edward Je M. D
# 131 Track the Wanting class 0
* 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.
8. 14,
UNDERTAKER'S RETURN .- Boston.
Date of death,
February 6th
189 8.
Name,
Edward + Retling
Maiden name,*
Sex,
Male
Married, single, or widow of wife of
Color, White Age, 69 years, Y mos.
26 days. Residence, Mermaid Que Lernthrop
Place of death ( number
street and Mermaid Que
ward.
Place of birth, Randolph VG.
Occupation, Hotel Proprietor
Name of father, Edward
Maiden name of mother,
Birthplace of father, Birthplace of mother, .
Place of interment, t
Ashburnham
(Old Cemetery )
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker : arthur Janfot
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death, . Achwany 10" 1898. Jessie Thomas Perry
2. Name,
(Maiden Name),
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. C'olor, ¡
5. Age, Years, 2 Months, -
10 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, .
14. Birthplace of Mother, .
15. Place of Interment,
Pauline Street Hinitrop Mars Job Perry Sarah England Cash Ballon
--
England
Winthrop, Queley -
Signature of Undertaker er per+ making the Return, .
Summer Floyd
DATED at Winthrop 1 , (11 Feb 11 1898
* 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. Dec., 1896 .- 5,000
[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 furuish 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 dicd, 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, fortliwith furnisli 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, ne 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 deathi 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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