USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 30
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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
Signature and Residence of Certifying Physician,
Hong. Parler.
Minsterate
is
Date of Certificate, Dec.zych 1898.
* Or Sex of Infant (not named). If stillborn so state.
t If child died immediately after birth so state. Plate. E.I. December, 1896. - 5,000.
# If a soldier or sailor who served in the War of the Rebellion.
[ Public Statutes, Chapter 32, as amended, by Acts of 1988, Chapter 300 ; Arts 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 aud belief, the name of the deceased, his age, the disease of which he (led, 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 boru 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 death as nearly as he can state the same. If a physician refuses or negleets to make sueli 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 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 uutil there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement coutainiug 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 statemeut 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 registratiou. 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.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death,
.
Walter R. Holle
2. Name,
(Maiden Name),*
(Name of Husband),*
11 au!
3. Sex, and whether single, Married, or Widowed,
4. Color, i
5. Age,
16
Years,
4
Months,
Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . (By whom certified, ·
7. Residence, Clerk
8. Occupation, .
9. Place of Death, .
:35 Lenursel
Each 1
10. Place of Birthi, .
11. Name of Father,
12. Name of Mother, . (Maiden Name),
13. Birthplace of Father, . 130.11. 7
14. Birthplace of Mother, .
15. Place of Interment. .............. ........
Signature of Undertaker or other person making the Return,.
Floyd
DATED at -
, Oll
189.6
* 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., 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 ecrtificate 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 siekness, and the date of his deccase; and a physician who has attended at a birth of a chilld 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 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 deccased was a soldier or a sailor who served In the war of the rebellion, the physician shall give both the primary and the secondary or Immediate eause 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 i ury 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 an physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate as . required of the attending physician; and in case of death by violence the incdical 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 eountersign 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 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 ilne not exceed- ing fifty dollars.
P
0007112
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Halter Di Hoble
16 yrs Age,
Date and Place of Death,t - died at. Winthrop Dee 28." 1598 of Tuberculosisg 16 Lungs. Pneumonia. , Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness, - Afew months. Fenal Acelevens three days. I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, Albert B. Downon, Mo.
Date of Certificate,
1898
* Or Sex of Infant (not uamed). If stillborn so state.
{ If child died immediately after birth so state. Plate. Ed. December, 1896. - 5,000.
# If a soldier or sailor who served in the War of the Rebellion.
L'ubuc Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300; Acts of 1889, Chapter 224 ; Arts 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, wher 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 staterrent 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 death as nearly as he can state the sanic. 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 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.
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, j
5. Age, 94 Years, .Months, Days
Disease or Cause of Death, (Primary and Secondary ), ;
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
1
10. Place of Birth, .
11. Name of Father,
f
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
1.
1
15. Place of Interment,
Signature of Undertaker or other person making the Return, .
DATED at Winthrop 0
10
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., 1806. - 5,000
9
1 15.
Frid
[Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 300 ; Acts of 1889, Chapter 224 ; Arts of 1993, Chapter 263
SECTION 3. A physician who has attended a person during his last illness shall, when requested, foul with furnish for regl tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his ag disease of which I: th of a child dyin tration a certificat If a physician nez a fine not exceedin :ian shall give bot refuses or neglect he resides. lied, the duration of his last sickness, and the date of his decease; and a physician who has attended a immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furuish for stating to the best of his knowledge and belief the fact that such a child died after birth or was born de lects or refuses to make a certificate as aforesaid, or makes a false statement therein, ne sha.l be punished fifty dollars. In case the deccased was a soldier or a sailor who served in the war of the rebellion, the ph the primary and the secondary or immediate cause of death as nearly as he can state the sam(. If a physien to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in w SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom amman body until h
has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board behealth in such cit or town, from the city or town clerk. No such permit shall be issued until there has been delivered to 'such board, or agent o clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned an recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in he. thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physicia cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or p physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certificate ? required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the s& When such satisfactory statement and certifieate 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 gi. shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as th clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed ing fifty dollars.
1
PHYSICIAN'S CERTIFICATE.
Tame and Age of Deceased,*
May C. Charles
Age, Perfect Av. Werichich, Mars. Jan. 9th 1899 ,
Date and Place of Death, t - died at ..
Disease or Cause of Death, - (Primary and Secondary.)} uration of Sickness, -
of
Old age
Final rechnen two weeks.
I certify that the above is true, to the best of my knowledge and belief.
twee and Residence of Certifying Physician, .... Albal 13. woman, Mal,
Date of Certificate,
Jan. 1315
1807 ·
Or Sex of Intant (not named). If'stillborn so state. If chill died immediately after birth so state. Plate. Ed. December, 1896. - 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 300; Arts of 1889, Chapter 224; Acts of 1833, 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 deeease; and a physician who has attended at a birth of a chilld 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 antl belief the fact that such a child died after birth or was born dead. If a physiclan 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 ean state the same. If a physician refuses or negleets to make sueh 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 eity or town or remove therefrom a human body until lie 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 elerk. No sueh 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 eertifieate of the attending physician, if any, as required by seetion 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 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 eountersign 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 deecased 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.
Vommyfontwealth of an. Enchusetts.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death, .
January 17 1849 Stillthen Onfanno
2. Name,
(Maiden Name),*
(Name of Husband),*
3. Sex, and whether single, Female
Married, or Widowed,
4. Color, i
5. Age,
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . (By whom certified, · sea fran Che, 2and house from Schuler
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
Lea From an Zece Fran chie Herbet W. Baxter Persie @ Wille
12. Name of Mother, . (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment, .
Signature of Undertaker 1
other peram making the Return, .
Summer Floyd
DATED at
Jan 17 + 18 9.8
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
t lf 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.
Monthof Quely
[ 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- lects or refuses to make a certificate as aforesaid, or makes a false statement therein, he shall be punished by a ilne 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 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 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 dellvered to the board of health 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 -hall 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,*
( Female) Baxter Age,
Date and Place of Death, i - ! died at
Disease or Cause of Death, - (Primary and Secondary.) } Duration of Sickness, -
of .
ring "> 1899, Sito Bom
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, ........... ......
Date of Certificate, ...
Detin 3
1899.
* Or Sex of Infant (not named). If stillborn so state.
If chill died immediately after birth so state. Plate. Ed. December, 1896. - 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; 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 died, the duration of his last siekness, and the date of his dcccase; 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 ecrtilcate, 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 can state the same. If a physician refuses or neglects to make sneh 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 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 eity 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 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 ecrtifieate as is required of the attending physician ; and in case of death by violence the incdical 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 deccased 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.
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