USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 38
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PL
ró pago Hardour
PHYSICIAN'S CERTIFICATE.
Charles Halter James
Aje, 4/ 1 po .. Vame and Age of Deceased,* 1899. Date and Place of Death, t - died at 18 Loque> stud aluguer 17".
Disease or Cause of Death, - of Epitelioma of Tongue. -
(Primary and Secondary.)}
Duration of Sickness, -
- 3 yrs I certify that the above is true, to the best of my knowledge and belief. 1
69/thetears mit- 52 umshop st unthrop hun
Signature and Residence of Certifying Physician,
Date of Certificate, Ing 18.
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 ISS8, 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 belief, the name of the deceased, his age, the discase 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 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 lie lias received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or towu, 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, ageut or clerk, make such certificate as is required of the attending physiciau; 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 deatlı, as the clerk or registrar may require. Any persou 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.
Deketen/ 8"1
1. Date of Death, .
2. Name,
(Maiden Name), (Name of Husband) ,
3. Sex, and whether single,
Married, or Widowed,
4. Color, t
5. Age, Year, Months, 15 Days.
Disease or Cause of Death, (Primary and Secondary), #
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, ·
11. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making
the Return, . ·
Summer Floyd
DATED at Winthrop
Lepot 9
.99
* If a Married Woman or Widow. ff 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., 1596 .- 5,000.
319razli0
...
SICH 010
[ 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, forthiwith 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 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, 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 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 linman body until } 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 c' or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned & recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending phys cannot be obtained, for good and sufficient reasons, early enough for the purpose, the chairman of the board of health o physician employed by a city or town for the purpose shall, upon request of said board, agent or clerk, make such certifleat required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the When such satisfactory statement and certificate are delivered to the board of healthi or to its agent, the board or agent shall. 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 t! 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,%
Donald Of Douvan Age, Self
ly 15d 1899,
Date and Place of Death, t - died at
Marasmus
Disease or Cause of Death, - of
(Primary and Secondary.) } Duration of Sickness, - -
I certify that the above is true, to the best of my knowledge and Delief.
thusou nig
Mure and Residence of Certifying Physician,
Date of Certificate, ...
Sehr 8 10 189 9.
* 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 Arts of ISS8, Chapter 300; Arts of 1983, Chapter 224; Acts of 1893, Chapter 263.]
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 deecased, his age, the disease of which he died, the duration of his last sickness, and the date of his deccase; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, 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 inakes 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 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 sneli 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 seetion thirce 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 certifleate 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.
- Boston, .. Seff. 8th 1899
Name and age of deceased: Edward Fr. Collirio.
Age 47 yrs - mos. dys.
Date and place of death: Sift. 8Th 1899. Cross St, near Almont St.
Disease or cause of death : Bright Disease & the Kidney
. . . . . . ...
Duration of disease: *
Probably some 4 or 5 years
I certify that the above is true, to the best of my knowledge and belief.
Name and residence of physician. Albert- B. Dorian 56 Wenthiof St., Winthrop, mars.
M.D.
* 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 September, when the office will be closed on Saturdays at 12 M. ; Sundays, 10 A.M. till 12 M. ; Holidays, from 10 A.M. till 12 M .; other days, from 9 A.M. till 5 P.M.
UNDERTAKER'S RETURN. Boston.
Date of death, th, Sehr 8 Th, 1899 Name, Edward H. Colline To 1899 Name,.
Maiden name,* -
Sex, Male
Married, single, or widow of
Color Wh Age, 47 years, - years, -- mos., - days. Residence,.
wife of Cross & Almond Sho
Place of death (street and) number Can brass & Almond Ste Ward Asus M Ward
Place of birth, Fair Haven Mass Occupation,. Dawayer
Name of father, Joseph W
Maiden name of mother, Subre Hennes on Birthplace of fathe Gastham Mar Birthplace of mother, Unknown
Place of interment, f
Haly Brose Malden
* If a married woman or a widow.
t Give the name of the burial-ground.
m. R. Kelly
Undertaker.
-
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Seht 189.9.
Name and age of deceased: Dover it Vr. Blanchard Age 4/ 5 yrs.
mos. dys. Date and place of death :. Sept 9
Disease or cause of death :
General pares
Winthrop Beach Slight Paralysis)
. . . . ... ... ...
Duration of disease : *
Probably Some years.
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
Y.B. Somman M.D.
of physician.
56 Withid Str .. Mulher, Juan
* 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 September, when the office will be closed on Saturdays at 12 M. ; Sundays, 10 A. M. till 12 M. ; Holidays, from 10 A. M. till 12 M .; other days, from 9 A.M. till 5 P.M.
را
UNDERTAKER'S RETURN .- Boston,
Date of death,. ..
Sejah 9
189.7. Name,.
David W Blanchard Sex, 200
Maiden name, *. ..
Married, single, or widow of.
wife of.
Residence, 309 Columbus an
Color, " Age, XS years, .. .... mos.,. days. Hotel
Place of death (street and) number Young
Ward
Place of birth,
Name of father, War H.
Occupation, Maiden name of mother, Many Haley
Birtliplace of father,
Place of interment, t
Birthplace of mother, Forest Hill
Clark
* If a married woman or a widow. t Give the name of the burialground.
2. Tinkleam
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Left: 13 8
9 ...
189 /
Name and age of deceased :
Boston,
Duncan
Age ..
.yrs.
mos ..
Date and place of- death.
September 13 the at a time. Aug. Withroh Mann.
Disease or cause of death:
Marasmus
Leven
Duration of disease : *
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician.
M. D
* It is very desirable to be informed of the duration of the disease.
The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A. M. till 2 P.M .. , except during the months of June, July, August and September, when the office will be closed on Saturdays at 12 M .; Sundays, 10 A.M. till 12 M .; Holidays, from 10 A. M. till 12 M .; other days, from 9 A.M. till 5 P.M.
1
UNDERTAKER'S RETURN .- Boston.
Date of death WEJw: 13'
189.9.
Name, .. Alici Duncan
Maiden name,*
Sex.
Married, single, or widow of wife of ...
St. Germainist.
3+1
Color, Age, years, 8
mos., 9 days.
Residence Boston
Place of death ( street and) number
ward
Place of birth, Boston
(Occupation, Hartic)
Name of father,.
Maiden name of mother, Jadie E. Lugar
Birthplace of father,. Cart Jester Birthplace of mother,
Dorchester man.
Place of interment, t
Cancer
* If a married woman or a widow.
t Give the name of the burial ground.
Undertaker.
.
,
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased,* Luke Querns
Age, 36
Date and Place of Death,t - died at Berlín Harbor
Jeph. 14th 1899,
Disease or Cause of Death, - (Primary und Sccondary.)} Duration of Sickness,
of Accidental drowning
I certify that the above is true, to the best of my knowledge and belief. Francis AStaris Med. Locui
Signature and Residence of Certifying Physician,
Date of Certificate, Jeph. 250 .. 1899:
* ()r 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 1888, Chapter 306 ; 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, 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 ehild 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 bot) the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglect 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 has received a permit so to do from the board of healthi or its duly appointed agent, or, if there is no board of health in sueli c or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned al recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lic 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 required of the attending physician ; and in ease of death by violence the medical examiner shall, if requested, make the sar When sueh satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall for with countersign and transmit the same to the clerk or registrar for registration. The person to whoin the permit is so gh shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the death, as clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not exer ing fifty dollars.
UNDERTAKER'S RETURN .- Boston.
Date of death,
September 14
1899 Name, Lure Onens
Maiden name,*
Sex, Male
Married, single, or widow of
wife of
Color, Age, 3 6 years,
inos.,
days. Residence, Boston
Place of death 7
street and Et) Jam Bar, Boston Castor
ward
Place of birth, Occupation,
Name of father, Birthplace of father,
Maiden name of mother,
Birthplace of mother,
" Place of interment, f
Willimantic
* If a married woman or a widow. + Give the name of the burial ground.
Signature of Undertaker : Summer Oflloyd
RETURN OF A DEATH.
To the Clerk of the City or Town in which Death occurred.
1. Date of Death, .
October 6"1818
2. Name, (Maiden Name),*
(Name of Husband),*
3. Sex, and whether single, Married, or Widowed,
1. Color, t
5. Age,
Disease or Cause of Death, (l'rimary and Secondary ), ; 1
6. Duration of Sickness, . By whom certified,
7. Residence,
8. Occupation, .
9. Place of Death, .
Julian
10. Place of Birth, Chalet Q.E.D
11. Name of Father,
12. Name of Mother, (Maiden Name),
13. Birthplace of Father, .
11. Birthplace of Mother, .
15. Place of Interment, ·
Signature of Undertaker or other person making the Return, .
.....
DATED at
. (11
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. 1 Plate. Ed. Dec., 1896 .- 5,000
), uta
55 Yea
1
Months,
23
Days
grinet. . ..
[ 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 bas attended a person during his last illness shall, when requested, forthwith furnish for regfy tration, a certificate stating, to the best of his knowledge and belief, the name of the deceased, his age, the disease of which le (lied, the duration of his last sickness, and the date of his deeease; aud a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his knowledge and belief the faet 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 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 eits or town, from the eity or town elerk. No such permit shall be issued until there has been delivered to sueh board, or agent (nt 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 section three of this chapter, or in livt 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 an; physician employed by a eity or town for the purpose shall, upon request of said board, agent or elerk, make such eertifleate as i. required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the same When such satisfactory statement and certificate are delivered to the board of health or to its agent, the board or agent shall forth with countersign and transmit the same to the elerk 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 eause of the death, as tli clerk or registrar may require. Any person violating any of the provisions of this section shall be punished by a fine not execed ing fifty dollars.
/ Cra
PHYSICIAN'S CERTIFICATE.
ame and Age of Deceased,*
Elizabeth Jane Putnam Winthrop (Putnam Street) Och 6 189. ,
Age, 55-1-23
ate and Place of Death, t - , died at.
Disease or Cause of Death, - (Primary and Secondary.)} uration of Sickness, - - |
of Multiple Sclerosis Nine months.
I certify that the above is true, to the best of my knowledge and belief.
gnature and Residence of Certifying Physician,.
Haraca de Poule M.J.
Date of Certificate, ...
Oct yu
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 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 furulsh 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 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, forthiwith furnish for registration a certificate, stating to the best of his knowledge aud belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or makes a false statement thereiu, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physician shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
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