USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 34
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PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,*
Susannah & Richardson Hinter Marie 2 "
Date and Place of Death, t - , died at
Age, m2 yrs-2-13 1899,
Disease or Cause of Death, - (Primary and Secondary.) }
of Nephritis, Uralma
uration of Sickness, - (Immediate 48 horas) chrmic.
I certify that the above is true, to the best of my knowledge and belief.
B. H. metcalf no vostropet winthrop
Signature and Residence of Certifying Physician,
Date of Certificate,
)
1899 1
* 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 Acts of ISSS, 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 and belicf, the name of the deccased, liis 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 dicd 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 punislicd by a fine notexceeding fifty dollars. In case the deccased 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 this 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 arc 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 thercafter furnish for registration any other information as to the deccased 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 Town in which the Death occurred.
1. Date of Death, .
april 191809
2. Name,
malerin Sean Dana's
(Maiden Name), * .
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t
5. Age,
Years,
8 Months
Months,
12
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
11. Name of Father,
David &Harald
Floraa
12. Name of Mother, . (Maiden Name),
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker orother person making the Return, .
Summer Floyd
DATED at
Nanthropo
, on
Merie 20
189.9
* If a Married Woman or Widow. { If a Soldier who served in the War of the Itebellion.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what. (Be very particular to fill all Blanks.] Plate. Ed. May, 1893. - 5,000.
Nontrop, Mais
Court Road
0 1.27
[ Public Statutes, Chapter 32. as amended by Acts of ISSS, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 20%
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for reg tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which 1. died, the duration of his last sickness, and the date of hls decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at thic 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 thic 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 beendelivered 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.
PHYSICIAN'S CERTIFICATE.
Malcom Seare Donald
Age, 8 mos 12ds
Date and Place of Death,t - diedat
Mantrop (Court Road) Oyente 19" 189, Vinicius usa about 2 months . sem anaemia
Disease or Cause of Death, -
of
(Primary and Secondary.) } Duration of Sickness, -
-
1
I certify that the above is true, to the best of my knowledge and belief?
O & Johnson. MA. apr 22.1899 .
10days
Signature and Residence of Certifying Physician,
Date of Certificate,
à 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.
Fame and Age of Deceased,*
[Public Statutes, Chapter 32, as amended by Arts of 1888, Chapter 300; Arts 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 clied after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement thercin, 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 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 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 healthi 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 Town in which the Death occurred.
1. Date of Death,
alene 23" 1899
2. Name,
Gouverneur Ment
(Maiden Name),*
(Name of Husband),*
Sale
3. Sex, and whether single, Married, or Widowed,
maned
1. Color,i
5. Age,
54 Years, ....... 6 Months, Y ..... Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. {Duration of Sickness, . By whom certified,
7. Residence,
Pleasel Rl-Cut Rale.
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
Richard Kem
11. Name of Father, .
12. Name of Mother, .
. (Maiden Name),
mann,
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment,
greenland 119th
Signature of Undertaker or other person making the Return, .
DAATED at
.... , on Тремя 24 189.9
* If a Married Woman or Widow. { If a Soldier who served in the War of the Rebellion.
tlf other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.] Plate. Ed. May. 1895 .- 5,000.
White
1098 6월4
Oren Orleans
Hank Lithium
Shumway
Commetuel
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 300 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263;
SECTION 3. A physician who has attended a person during his last illness shall, when requested, forthwith furnish for regis. tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, 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 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 sneh permit shall be issued until there has been delivered to such board, or agent or elerk, 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 givenl 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.
Vame and Age of Deceased,*
Gouverneur
Rent Age, Winthrop (Pleasant St) april 23",89. Chronic Interstitial Rephritis
54 ya -6m-
Date and Place of Death,t - died at
Disease or Cause of Death, - (Primary and Secondary.)} Duration of Sickness, -
of. 3 yearst
I certify that the thove is true, to the best of, my knowledge and belief.
Signature and Residence of Certifying Physician,
Date of Certificate,
Bethutcalf M.M. 52 withrop st. Winthrop april 23 d; 189 9 .
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 30G ; 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, forthwithi 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 lie clied, 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 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 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 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 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.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
May loth 9 189
Boston,
Name and age of deceased: Williams Mulloy
Date and place of death: may Sek 1891 facility Disease or cause of death :
47 Pleasantth Mulherof Maco
. ......... .
Duration of disease : *
about 2 months
I certify that the above is true tofthe best of my knowledge und better.
Name and residence
of physician.
M.D.
98 tricolor
* It is very desirable to be informed of the duration of the disease. When more than one cause of death is mentioned state the duration of each.
The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A. M. till I P.M., except during the months of June, July, August and Seotember, when the office will be closed on Saturdays at 12 M. ; Sundays, 10 A. M. till 12 M. ; Holidays, from 10 A.M.
Age 76 yrs. ~ mos. dys.
--
UNDERTAKER'S RETURN .- Boston.
Date of death, may 5 th
189 9 Name,.
William.
Zul
Maiden name,*
.Sex,
Married, single, or widow of wife of
Color, Mit Age, 76 years, - mos ..
days. Residence, 47 La.
Place of death (s number ad), 47 Pleasant St Winthrop Ward
........
Place of birth, Ireland Occupation, Cooper
Name of father, Unknown) Mulloy Maiden name of mother, Untentime
Birthplace of father, Ireland Birthplace of mother, Ireland
Place of interment,t
* If a married woman or a widow. t Give the name of the burialground.
Undertaker.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),*
(Name of Ilusband),
3. 'Sex, and whether single, Married, or Widowed,
medard
4. Color, 1
5. Age,
35 .Years, .... ~ Months, Days.
Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . (By whom certified,
7. Residence,
8. Occupation,
Frontal 21-
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, (Maiden Name),
9%
13. Birthplace of Father,
11. Birthplace of Mother, .
15. Place of Interment,
Italy torres
Signature of Undertaker as other perman making the Return, .
may 7
hittares
DATED at
, (11
may 70
18 22
+ If a Married Woman or Widow. { If a Soldier who served in the War of the licbelliou. f If other than White. (M.) Mulatto. (T.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.} Plate. Ed. May, 1893 .- 5,000.
[Public Statutes, Chapter 32, as amended by Acts of ISS8, Chapter 306 ; AActs 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, fortliwith 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 elilld 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 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 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 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 lie has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or elerk, 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 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 eause of the death, as the clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exceed- ing fifty dollars.
PHYSICIAN'S CERTIFICATE.
ame and Age of Deceased,*
ate and Place of Death, t - died at
Catharine Whillaren Huntrop May ("
Age,
35 Years 1899,
isease or Cause of Death, - (Primary and Secondary.)} uration of Sickness, -
of Burne
- Ten days
I certify that the above is true, to the best of my knowledge and belief.
nature and Residence of Certifying Physician, ...
Horace J. Soua M J
₹
Date of Certificate,
May 5
1899
Dr Sex of Infant (not named). if stillborn so state.
If chil I 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.
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