USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1897-1899 > Part 40
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SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in such city or town, from the city or town clerk. No such permit shall be issued until there has been delivered to such board, or agent or clerk, as the case may be, a satisfactory written statement containing the facts required by this chapter to be returned and recorded, together with the certificate of the attending physician, if any, as required by section three of this chapter, or in lien thereof a certificate as hereinafter provided. If there is no attending physician, or if the certificate of the attending physici:11 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 attendiug 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- lug fifty dollars.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Que. 16' 189
Name and age of deceased 3
Boston .......
9.
mos.
dus
Date and place of death: Ow. 16'99 - #10 Junmint Que. Huseturp Carcinoma
Disease or cause of death: -
Duration of disease : *
/
I certify that the above is true, to the best of my knowledge and belief.
Name and residence of physician.
Ir.But Michael
Can Banlow 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,
Www. 16
189 9. Namg,
Elizabete A. Granberg. Oritetley Sex, OH.
Maiden name,*
Married, single, or widow of
wife of
Color, . Age, 14 years,
inos., days. Residence,
0
Summit Avz. Ward
Place of death ( street and) number Lunicy Mars Occupation, Place of birth,
Name of father George
Maiden name of mother,
Mary CAT.
Birthplace of father,
Place of interment, t
Birthplace of mother, Winthrop
Osmé.
* If a married woman or a widow.
t Give the name of the burial-ground.
& Brown
Undertaker.
England
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death, .
Dorte 19 " 15 4
2. Name, (Maiden Name), .
(Name of Husband),
3. Sex, and whether single, Married, or Widowed,
9
4. Color, t
5. Age,
43
.Years,
2
Months,
14 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, . ·
DATED at ... . Minthogy
, on
Der 20
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, specify what.
[Be very particular to fill all Blanks.] Plate. Ed. May, 1893. - 5,000.
1353421
4
[ Public Statutes, Chapter 32. as amended by Acts of 1888, Chapter 306 ; Licts 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, tlie name of the deceased, his age, the disease of which he died, the duration of his last sickness, and the date of his decease; and a physician who has attended at a birth of a child dying immediately thereafter, or at the birth of a stillborn child, shall, when requested, fortliwith furnish for registration a certificate, stating to the best of his knowledge and belief the fact that such a child died after birth or was born dead. If a physician neg- lects or refuses to make a certificate as aforesaid, or 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 tlie primary and the secondary or immediate cause of death as nearly as lie can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sun of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a human body until he has received a permit so to do from the board of health or its duly appointed agent, or, if there is no board of health in 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 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, inake such certificate as is required of the attending physician ; and iu 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 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.
Och, 19 45
.1899
Boston,
Terre
Name and age of deceased Norman
.. yrs ... 5
mos .. 14 days.
Date and place of death: Cech. 19.50
135 Shirley St. Wwillerof
Disease or cause of death:
Gunshop women of chett.
Probable
accidental
. . .
Duration of disease : *
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician.
Gracias Astaziis M.D. Med. Spanien
* 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,
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Q-28
Boston, .
1899
Name and age of deceased: arthur & nunes
. Age 8 yrs. 2 .mos.
. 27 dys.
Date and place of death:
October 29041899-Park avenue Hintenof
Disease or cause of death :.. Sosial Meningitis.
Duration of discase : * Than weeks
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician. 26 mais & Same M.D. Werther Mass
* It is very desirable to be informed of the duration of the disease. When more than one eause 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. Fonttrop
Date of death, Oct. 29
Name further I Nunes Sex, M
Maiden name,*
Married, single, or widow Of
wife of.
Color, W Age, 8 years, 2 mos. 27 days. Residence, Winthrop
Place of death (5 number ) Park Que Winthrop Ward Place of birth, 13 os tow
Occupation, ...
Name of father,
Ection2
Maiden name of mother, Mary ". Nachico
Birthplace of father isbon Ye larga Birthplace of mother Of George Western Islay
Place of interment, t.
Malden
* If a married woman or a widow.
t Give the name of the burial-ground.
Undertaker.
[Public Statutes, Chapter 32, as amended by Acts of ISSS, Chapter 306; 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, 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 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, forthiwith 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 towns 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.
membran 5
84
me and Age of Deceased, t ice and Date of Death, # sease or Cause of Death, §
died at
Ages M. D. Pleasant St womshrof man. Antenas 5 old age. Cardiac facture, Strangulalad eternia
iration of sickness,
2 months
I certify that the above is true to the best of my knowledge and belief.
1218 mel cats
M. D.
Signature and Residence of Certifying Physician.
52 umshop st.
1
Date of Certificate,
189 9.
Give also street and number, if any.
Or sex of infant not named. If still-born, so state.
# If child died immediately after birth, so state.
f a Soldler or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
R
...
at
Date,
Filed,
The provisions of chapter 444 of the oldest person next of kin present at the time which a death oceurs, shall, within five days the clerk of the city or town in which the d The commanding officer of a vessel sh or to the clerk of the city or town within th Penalty for negleet to comply with the A physician who has attended a pers request, furnish for registration a certificate Penalty for refusal or neglect, ten dol Any person having charge of the fumer certificate made in accordance with section
ILLLUTIT
RT DLAIII.
To the Clerk of the 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,
1. Color, t
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,
Signature of Undertaker
wwwprat making the Return,.
nov. 24th Les masters
-199
male + married
33 Years,. Months, Days.
165 Shirley St. Withro Ship's steward mass: winthrop mass:
L'pool! Eng: Ebeneezer masters
warringlow Eng. counthrop. Zuass.
Summer Floyd
DATED at Anthropo , On 3 25 18 99
* 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. May, 1893 .- 5,000.
[ Public Statutes, Chapter 32, as amended by Acts of 18SS, Chapter 306 ; Acts of 1889, Chapter 224; Acts of 1893, Chapter 263.]
SECTION 3. A physiciau 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 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 therein, he shall be punished by a fine not exceeding fifty dollars. In case the deceased was a soldier or a sailor who served in the war of the rebellion, the physiciau shall give both the primary and the secondary or immediate cause of death as nearly as he can state the same. If a physician refuses or neglects to make such certificate he shall forfeit to the treasurer the sum of ten dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sexton or other person shall bury in a city or town or remove therefrom a 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 pliysiciau 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 towu for the purpose shall, upon request of said board, agent or clerk, make such certificate as is required of the attending physician; aud in case of death by violence the medical examiner shall, if requested, make the same. Wheu 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 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,
terra
4. Color, i
Write
Years,
2/2Months,
Days.
5. Age, Disease or Cause of Death, (Primary and Secondary), ;
6. Duration of Sickness, . By whom certified,
Prutt. 6 4wars
7. Residence,
8. Occupation,
9. Place of Death, .
10. Place of Birth, .
.
Frank & Freer Torcer Edrich Branche Carne
12. Name of Mother, (Maiden Name),
13. Birthplace of Father,
11. Birthplace of Mother, .
15. Place of Interment,
Tempoy Deposit Ree Pont
n
Signature of Undertaker or other person making the Return, .
DATED at
Dee 1"
189.9
+ If a Married Woman or Widow. fIra Soldier who served in the War of the Rebelhou.
f 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.
December 1" 1049 Medien Helen Vander
220 thrity RL
11. Name of Father,
[Public Statutes, Chapter 32, as amended by Acts of 1888, Chapter 306; 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 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 exeeeding 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 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 eity 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 snch 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 perinit is so given shall thereafter furnish for registration any other information as to the deceased or to the manner and cause of the deathi, 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.
ime and Age of Deceased,*
Mildred Helen Fowlin
ute and Place of Death, \ - , died at.
Hinthof, Dec. 12h
Age, 2 1/2. mad. 1899,
of . anumara
isease or Cause of Death, - (Primary and Secondary.)} uration of Sickness, nine days.
I certify that the above is true, to the best of my knowledge and belief.
nature and Residence of Certifying Physician, A.J. Porter, Punctual.
Date of Certificate, Dec. 12h
1899.
r Sex of Infant (not named). Ifstillborn 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 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 siekness, aud the date of his deeease; and a physician who has attended at a birth of a ehlld dying immediately thereafter, or at the birtli of a stillborn child, shall, when requested, forthwith furnish for registration a certificate, stating to the best of his kuowledge 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 ease the deceased was a soldier or a sailor who served in the war of the rebellion, the physieiau 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 sum of teu dollars for the use of the town in which he resides.
SECTION 5. No undertaker, sextou 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 eity or town elerk. No such permit shall be issued uutil there has been delivered to sueh 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 three of this chapter, or in lien 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 snch eertifleate as is required of the attending physician ; and in case of death by violence the medical examiner shall, if requested, make the sante. 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.
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