USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 2
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Date of death, 2019
189 ....
Name,
Ale nella
Maiden name,* nella Sturdy
Sex,
Married, single, or widow of Wife of Lox af lora
Color,
r, MA Age, 4 yea
Age, years, - mos., days. Residence bude tell If the Photo
Place of death ( street and a) Under five of you think
ward
number
Place of birth,
Atale tel. 11
Occupation, Un.
Name of father der and find Maiden name of mother, & are
Madden
Birthplace of father,
Birthplace of mother, Ber eter
Antalden
Place of interment,t
* If a married woman or a widow. t Give the name of the burial ground.
Signature of Undertaker :
Para flottage
1.
C. C
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,t
5. Age,
Years, - Months, Days.
Disease or Cause of Death, (Primary and Secondary), #
Fra 19 harman
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,
Starting Cemetery
Signature of Undertaker or other person making the Return, .
Jums 2
DATED at
, on
lan
23
* 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. Dee., 1895 .- 5,000.
Fair Par av.
11. 11 Charles H. Whitney Hamel a, Booth. Bestin Mass
England
18-9.
22"1897
Female
[ Public Statutes, Chapter 32, as amended by Acts of 188S, 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 discase 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 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 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 issned 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 hercinafter 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 countersign and transmit the sainc 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.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,
Whitney
Age, 1 hour
Date and Place of Death,t - died at Wusthof Jan. 22℃
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness,
of Primative
1897,
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, Albat B. woman, Ma.
Date of Certificate, ..
Jan. 22, 1897
* 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 ISSS, Chapter 300 ; Acts of ISS9, Chapter 224; Acts of 1893, Chapter 263.]
SECTION 3. A physiclan 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 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 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 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 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 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.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death, .
telweg 4"1897
2. Name,
*, Becher
(Maiden Name), ·
Spooner
(Name of Husband),*
Feriale
3. Sex, and whether single, Married, or Widowed,
Shared
4. Color,t
5. Age,
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Siekness, . (By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment, ·
Thuthey Only Surmer Flação
DATED at , on folia 41
* 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.] l'late. Ed. Dec., 1895. - 5,000.
..
England
Singland
Estalado Freaplica
Signature of Undertaker or other person making the Return, .
201 White
39 Years, O
Months
~Days.
Itiraz &
Ortilthen Olces
[ 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 hc died, the duration of his last sickness, and the date of his decease; and a physician who has attendedl 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 physiciau 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 Inman 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 auy, as required by sectiou three of this chapter, or in lieu thercof a certificate as hereinafter provided. If there is no atteuding 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 exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
=
Name and Age of Deceased,*
Date and Place of Death, t - died at Winthrop 2
189 7 ,
Disease or Cause of Death, - (Primary and Secondary.) }
of
Septic Veronica Y lava
- Duration of Sickness, -
I certify that the above is true, to the best of my knowledge and belief.
... Signature and Residence of Certifying Physician, Price
Free or 1897 .
Date of Certificate,
* Or Sex of Infant (not named). If stillborn so state.
t If child died immediately after birth so state. Plate. Ed. October, 1895. - 5,000.
# If a soldier or sailor who served in the War of the Rebellion.
Age, .
[ Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 306 ; Arts 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 kuowledge 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 sokher 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 hi such city or town, from the city or town clerk. No such permit shall be issned 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 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 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 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 City or Town in which the Death occurred.
1. Date of Death, .
2. Name,
, Delay 7" 1897 Cathare Floyd
11 Connelly
(Name of Husband),*
Josiah Floyd Female 1
3. Sex, and whether single, Married, or Widowed,
Ddrmed
Mité
4. Color,t
5. Agc,
79 Years, of Months, - Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Siekness, . By whom ecrtified,
Winthrop mass
7. Residence, .
8. Oeeupation, .
9. Place of Death, .
10. Place of Birth, .
Ireland
11. Name of Father,
12. Name of Mother, (Maiden Name), Greland
13. Birthplace of Father, . .
Ireland
14. Birthplace of Mother, .
15. Plaec of Interment,
Signature of Undertaker or other person making the Return, .
DATED at Minilujo , on Februar 8"
189.7
* 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., 1895 .- 5,000.
De Johnson
2
Casa Street
Holy Cross Cemetery
1
(Maiden Name), ·
85
[ 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- Iccts 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 bot !: 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 thicreof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attenuing 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 thie clerk or registrar may require. Any person violating any of the provisions of this section shall be punishicd by a fine not exceed- ing fifty dollars.
1
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Date and Place of Death, t - died at
Catherine Floyd Age, Winthrop (Crash) Ferry." Temilié (Old age)
1897,
Disease or Cause of Death, - of . (Primary and Secondary.)} Duration of Sickness, J
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician,
C
189
Date of Certificate,
{ If a soldier or sailor who served in the War of the Rebellion.
* Or Sex of Infant (not named). If stillborn so state.
t If child died immediately after birth so state. Plate. Ed. October, 1895 .- 5,000.
£
[ 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 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 died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, fortliwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or inakes a false statement thierein, he shall be punished by a fine not exceeding 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 nearly as he can state the same. If a physician refuses or neglects to make such certificate lie 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 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 flue not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
7/11tturab 1911. 46 81897
Name of Deceased, 2. Augusta
Medford, Berg
Age, 53 Yrs., 5 Mos., J Days.
Place and Date of Death : Died at. 175 Shelly St Pricecap .Medford, 1897
Disease or cause of Death :
Primary. Hermiplegia
If a soldier who served in the War of the Rebellion, both ) *
( the primary and secondary causes of death must be given, . Secondary,
Duration of Disease, t Eight
I certify that the above is true, to the best of my knowledge and belief,
Signature of Physician,
Eftersans M.D.
Residence,
(No.)
(Strect.)
(Town or City.)
* Acts of 1889, Chap. 224. t It is very desirable to be informed of the duration of the disease.
75
V
1
UNDERTAKER'S RETURN.
Musterap
MEDFORD, MASS.
Date of Death,
" Name
Name of } Husband. )
-ccola
Maiden Name,*
Sex, nek Color,+
Single, Marriedyor Widowed,
3
Age, SJ Yrs., S Mos., Days. Resistence,.
mace
(No.)
(Town or City and State.)
Place of Death,
Street and Number.
mlerMedford. Ward
Weston Muss
Occupation, .. "Tame of Father,
Place of Birth. Maiden Name { of Mother, 1 Birthplace Boston
Birthplace } Tu of Mother,
Place of interment,
Call Grovt
9
InEnforce hass (Town or City and State.)
* If a married woman or a widow. tlf other than white, (A) African, ()I) Mulatto, (I) Indian; if of other races, specify what.
Signature of Undertaker.
Residence, 26 (No.)
(Street:)
(Town or City.)
(Cemetery.)
of Father,
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
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