USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 31
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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,
January 18h- 1899 Lillian Lucilla Nofer
2. Name,
(Maiden Name), (Name of Husband),
3. Sex, and whether single, Married, or Widowed,
4. Color, j ( White)
5. Age, 15 Years, 2 Months, 19 Days. Disease or Cause of Death Tolar Merwoman 1 (Primary and Secondary), # 6. Duration of Sickness. . By whom certified,
. 7. Residence, Winthrop Highlands.
8. Occupation, .
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,
9. Place of Deathi, . Winthrop Highlands Malden Ahrend C. J. Sole Amanda le. School Newyork City Allevitocon, Ja. Winthrop Cemetery Summer Floyd Signature of Undertaker weather persms making the Return, . Jan 19
DATED at
1. 9.9
* If a Married Woman or Widow. # If a Soldier who served in the War of the Rebellion. f If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] Plate. Ed. Dec., 1596. - 5,000.
[ Public Statutes, Chapter 32, as amended by Acts of 1988, 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, forthwitli 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 whileli 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 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 sneh 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 ease 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 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 clerk, inake 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 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 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.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
dellean Lucilla Pape
Age, IS ard
Date and Place of Death,t - died at
Werethepe, Jan. 18th
1899,
Duration of Sickness,
Disease or Cause of Death, - (Primary and Secondary.)} Eight days ( ?!
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, My Porter, Pinchaha.
Date of Certificate, f.c. v. 19CZ 1899
·Or Sex of Infant (not named). 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
[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 siekness, and the date of his deeease; 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, ne shall be punished by a fine not exceeding fifty dollars. In ease 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 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 bury in a eity or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the eity or town elerk. No such permit shall be issued until there has been delivered to sueh board, or agent or clerk, as the ease 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 seetion three of this chapter, or in licu 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 eity or town for the purpose shall, upon request of said board, agent or elerk, make such certificate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same. When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth- with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and 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.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the Death occurred.
1. Date of Death, .
January 19" 1899 Winifred Gibbons
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,
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,
nulford Muss
Signature of Undertaker on making
. the Return, .
DATED at
Summer Floyd January 20 19.9 , 011
--
* 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.
termale 1111
white
4
Years,
Months,
28
Days.
84 Fleasand Steel
84 Pleasant Street
Homelibrille CHY. Bernard Q El anna do Brebber Sillad Mark
3-6'
[ 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 persou 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 faet 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 nogleets 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 healthi in sueli 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 liel thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physiei cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health or ar physician employed by a city or town for the purpose shall, upon request of said board, agent or elerk, make such certifieate as required of the attending physician; and in case of death by violence the medical examiner shall, if requested, make the salut When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall fort with countersign and transmit the same to the clerk or registrar for registration. The person to whom the permit is so giver shall thereafter furnish for registration any other information as to the deceased or to the manner and ease of the deatlı, as the elerk 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,* Ninnafred Sebbour Date and Place of Death, t - died at SH Plearau St., Mentheo, Hans Jan 19-
Age, 4 jrs 4 mes .. ], 0
Disease or Cause of Death, - (Primary and Secondary.) } ration of Sickness,
of Convulsions 24 hours
I certify that the above is true, to the best of my knowledge and belief.
„nature and Residence of Certifying Physician, Albert 10 woman,
Date of Certificate, 1-21- 1899
* Or Sex of Infant (not named). If stillborn so state.
t 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.
[Public Statutes, Chapter 32, as amended by Arts of 1888, Chapter 306; Acts of 1889, Chapter 224 ; Acts of 1893, Chapter 203.]
SECTION 3. A physician who has attcuded a person during his last illuess 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 thereiu, he shall be punished by a fine notexceeding 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 of 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 stateruent 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 scetion shall be punished by a fine not exceed- ing fifty dollars.
No.
Commonwealth of atlassachuseils.
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. Ago,
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, ·
Signature of Undertaker 1 1
orother person making the Return, .
Colonia
Ca20 1899 رجال
Years,
Months, Days
Anlar
21.50
-
DATED at
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 ISSS, Chapter 300 ; Acts of 1889, Chapter 221 ; Acts of 1893, Chapter 263.]
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regi -- tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he tied, 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 lils 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, 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 lie can state the same, If a physician refuses or negleets 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 therefron 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 eoutaining 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, ageut 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 ageut shall fortli- with countersign and transmit the same to the elerk 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.
Frango
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,* Date and Place of Death,t - died at. Jane Damit
77-17 Age,
1899,
of
Disease or Cause of Death, - (Primary and Secondary.)} 1 Duration of Sickness, - -
I certify that the above is true, to the best of my knowledge and belief.
Signature and Residence of Certifying Physician, Horace de Jinde
.
Date of Certificate,
1890
1 ·
* Or Sex of Infant (not named). 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.
[ Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 300 ; Acts of 1889, Chapter 221 ; 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 aud belief, the name of the deceased, his age, the disease of which he died, the duration of his last sickuess, 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, 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 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 physiciau, 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 couutersign aud 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, .
January 31"1899
2. Name,
(Maiden Name),*
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age,
mare 1 Manuel While?
83 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, .
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,
Signature of Undertaker or other person making the Return, .
1
Summer Floyd
DATED at Nittio , 011 Fit In
189.9
* 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, speelfy what.
| Be very particular to fill all Blanks.
Plate. Ed. Dec., 1896 .- 5,000
Honthion Suas, Toutes D'argent Slet
Jane routage England England
----
Bort Boy . -
[Public Statutes, Chapter 32, as amended by Acts of ISSS, 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 (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, 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 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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