USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 11
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Somos 5 Penalty for violation not exceeding fifty dollars.
F
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK.( ALL NAMES TO BE IN FULL.)
Name,
Nancy a. Wilson
Sex,
Color,
Date of Death,
May 30
.190 %; Age, 66 Years, (
2
Months,
Days.
Maiden Name, { I
widowed }
Nancy a, anderson
Husband's Name,
Patrick Wilson
Single, Married, Widowed or Divorced, .. Occupation,
*Residence, also state fully.
§ If out of town, {
Winthrop, Mass
Place of Birth, Oreland
*Place of Death,
11, Cottage avenue Collage Stile
Name and Birthplace of Father,
Ir Elliane anderson (Unknown
Maiden Name and Birthplace of Mother,
Place of Interment, (Give name of Cemetery),
Oakwood Cemetery (Troy ny.
Dated at
Winthrop
Summer Floyd
on
May 31
190 /
Signature and
place of business
of Undertaker.
Minutos Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Nancy a. Wilson Age, 66 Y.M. D.
Place and Date of Death,
died at.
Disease or Cause of Death, # Secondary,
Primary,
May 30. 190/ .
General Tuberculosis Duration, Uncertain
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
S
Certifying Physician.
M. D. .
Winthrop Mass
Date of Certificate,
May 31st
190/.
* Give also street and number, if any. t Give sex of Infant not named. If still- born, so state.
{ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health. may 31
T
or divorced.
No. 27
RETURN OF THE DEATH
OF
Nancy a. Wilson Or Stillede
11 Cottage avenue at
Date, May 30 .. 190/ -.
Filed, may 31 190 ____.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION S. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
Dasalte for vinlation not exceeding fifty dollars.
-
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Hannah Belcher
Sex,
Color,
Date of Death,
June 25'
190 / ; Age,.
88 Years,
5
Months, 20 Days.
Maiden Name, { If married, widowed )
or divorced.
Hannah Floyd
Husband's Name,.
David Belcher
Single, Married, Widowed or Divorced, Occupation,
*Residence, ¿ also state fully. §
{ If out of town, {
Winthrop Mass
Place of Birth,
Winthrop Mass
*Place of Death,
99 Winthrop Street
Name and Birthplace of Father,
David Floyd
Maiden Name and Birthplace of Mother, Hannah Tewksbury
Place of Interment, (Give name of Cemetery),
Winthrop Cemetery
Dated at.
Winthrop
Signature and
Summer Efloyd
on
June 25''
190 /
place of business
of Undertaker.
Winthrop Dass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Hannah Belcher Age, 88 Y. 5 M. 2OD.
Place and Date of Death,
died at
Thinking Mass
June 25 190/.
Disease or Cause - Primary,
of Death, ţ Secondary,
Cerebral apoplevy
Duration, immediate-
Duration,
F
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence § of Certifying Physician.
M. D.
Date of Certificate, June 26 190/ .
* Give also street and number, if any. t Give sex of infant not named. If still-born, so state.
# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health. ne 25
1
No. 28
RETURN OF THE DEATH
OF
Hannah Welcher 99 Winthrop Street at
Date, une 25" 1901
Filed, June 26 190 __ .......
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred. -
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
Penalty for violation not exceeding fifty dollars.
-
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK, ALL NAMES TO BE IN FULL.)
Name,
bare Metal Chrman
Sex,
.Color,
Date of Death,
June 24
190 /; Age, / Yeary, 4 Months,
19 Days.
Maiden Name, { If married, widowed )
or divorced.
سم
Husband's Name,
Single, Married, Widowed or Divorced, Occupation,
*Residence, { If out of town, )
? also state fully.
Winthrop
mask
Place of Birth,
Winthrop Masa
*Place of Death,
Orlando are off Bartlett Road
Name and Birthplace of Father,
Charles 6. Chiman . Patterson Pa
Maiden Name and Birthplace of Mother, Ethel Steel Meteals -
Place of Interment, (Give name of Cemetery), Winthrop Cemetery
Dated at
Winthrop
Summer Floyd
on
June 28'
.. 190 /
Signature, and place of business of Undertaker. Winthrop mase
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Carl Instead dervon Age, / Y. 4 M. /D.
Place and Date of Death,
died at
June 27. 190 /.
Disease or Cause
of Death, ;
Secondary,
Primary,
Infantile Commolina Duration, 5 hours
Duration,
I certify that the above is true to the best of my knowledge and belief.
signature and Residence S
of
M. D.
Certifying Physician.
Das am
Date , of Certificate, June 29 .190 .
* Give also street and number, if any. t Give sex of infant not named. If still-born, so state.
# If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town. :
Agent of Board of Health.
27
No. 29
RETURN OF THE DEATH
OF Carl Metcalf Chrman Orlando avenue at
Date, June 2m
190 ___
Filed, June 28 1901
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death oecurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death oceurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after sueli death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forthi the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to . the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
Penalty for violation not exceeding fifty dollars.
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Ofrederick Munday
Sex,
200
Color,
W.
Date of Death,
June 30
190 / ; Age, 2 Years,
Months,
~Days.
Maiden Name,
{ If married, widowed {
or divorced.
Husband's Name,
Single, Married, Widowed or Divorced,
Occupation,
Plumber
*Residence, { If out of town, )
¿ also state fully.
Shirley Steel Winthrop
Place of Birth,
England
*Place of Death,
Minitrop mass
Name and Birthplace of Father,
Unknown
Maiden Name and Birthplace of Mother,
Winitrop Cemetery
Place of Interment, (Give name of Cemetery),
Dated
Winthrop
Bummer Floyd
on
June 30
190 /
Signature and place of business of Undertaker.
18 2 termin 21 Hanshop
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Etpodence Munday
Age, 2% r. C. D.
Place and Date of Death,
dicd at
Minttrop (June 30"
190 /.
Disease or Cause of Death, # Secondary,
Primary,
Duration,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
Wed. Sommer
Date of Certificate,
* Give also street and number, if any. t Give sex of infant not named. If still-born, so state. # If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
3J
M. D.
Certifying Physician.
20
190 /.
/
Unknown
No. 30
RETURN OF THE DEATH
OF
Frederick Munday Bilialay Chemate at
Date,
une 30" 1901
Filed, July 1
190_1.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthiwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in thic war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to thic clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS of 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of this cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
Dasely for violation not exceeding fifty dollars.
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH. To the Clerk of the City or Town in which the death occurred.
(FILE OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Martha Shipper
From
Sex,
Color, ..
Date of Death,
190 ) ; Age, 3 0 Years,
6
.. Months,
2 Days.
Maiden Name, (If married, widowed }
or divorced. Martha Shipper Jupeper
Husband's Name,
Ofrederic Brown
Fingle, Married, Widowed or Divorced, ... .Occupation, Otniente
*Residence, { If out of town, )
Hintenopp mask
? also state fully. }
Place of Birth, Beton Mass
*Place of Death,
Derrace avenue Winthrop
Name and Birthplace of Father,
Maiden Name and Birthplace of Mother, Have Roscoe
Place of Interment, (Give name of Cemetery), Winthrop Cemetery
Dated at
Winthrop
on July 2' .190/
Signature and place of business of Undertaker.
Summer Efloyd Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Martha Phileles BrownAge: 58 5. 6 N. 2D.
Place and Date of Death,
died at. Terrace avenue Winthrop July / 1901.
- Primary,
Sivasis Scriasis
Duration,
Duration,
3 hours.
I certify that the above is true to the best of my knowledge and belief.
Horace) Soule
M. D.
Signature and Residence S of Certifying Physician. 2 Date of Certificate,
(Winthrop mass
190.
* Give also street and number, if any. | Give sex of infant not named. If still-born, so state.
{ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
€
Disease or Cause of Death, ¿ Secondary,
No. 31
RETURN OF THE DEATH
OF
Brown
Martha Phifejes L'enrace avenue at
Date, July 1
1901
Filed, July 2 190_ 1. [EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of auy of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7 five dollars.
SECTION 10. A physician who has attended a person during his last illness shall person, upon request, furnish for registration a eertificate setting forth the required faets. SECTION 11. In case the deceased was a soldier who served in the war of the reb the secondary or immediate cause of death as nearly as he can state the same. Penalty f SECTION 12. Any person having charge of the funereal rites preliminary to the iuter the physician's certificate made in accordance with section 10, and return it, together with the board of health or to the clerk of the city or town in which the death ocenrred.
thwith after the death of said
give both the primary and or neglect, ten dollars. a human body shall obtain
acts required by section 1, to
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, uutil a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
tv for violation not exceeding fifty dollars.
[7.'00.37.XX M.]
Permit No.
RETURN OF DEATH. BOSTON.
1901
Year, 1827
Date of death
Month July 21
Birth
Month,
Day
Name in full, Maiden name,.
Male.
Sex Conjugal condition
Single .- Married. Widowed.
Color
Female.
Divorced. Widow of.
Wife of. -
Place of death?
Street, 1.
61 Locust QL
Winthrop
Place of birth,
-
Wieland
Occupation, ..
Laborar Unknown Maiden Name of Mother,
Unknown
Dieland
Birthplace of Father, Ireland Birthplace of Mother, Place of interment, Holy Cross Malden Bernard D. Mc Mackie 61 Bunlar Série @Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, .. July 2
190 ...
Name and age of deceased, Johan Whole
Age, 74 years.
Date and place of death,* (Thrutrop mass July 2 1901
Disease Chief cause,
Contributing causc.
Chief cause, ... 36 horas
Duration Contributing cause, ..
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ? of physician,
M.D.
* If in an institution, state how long an inmate and previous residence.
Chiutrop mass -
The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A.M. till | 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.
Unknown
Age & Months, L Years, 74
Day, John Whalen
Residence,
( Days, Boston White. Black (Negro or mixed). Indian Chinese. Japanese ....
Number,
Name of Father,
Senility
Year,
Died July 2"1901 61 Loque Street Filed July 3, 1901
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
John Whitman Detrambula, Sex, ale Color,
White
Date of Death,
July 5 th
.190/ ; Age, 6 hours
Years,
Months,
Days.
NN
Husband's Name
Single, Married, Widowed or Divorced, Occupation,
*Residence, { If out of town, ) ¿ also state fully. § -1 Ocean ave. Winthings, Jeack, Winthrop Place of Birth,
*Place of Death,
, Ocean Ove Winthrop
each Monthof
Name and Birthplace of Father Hortonvy Sehambulan Jamaica, lai Man
Maiden Name and Birthplace of Mother, Thatall Golching, St. John N.B.
Place of Interment, (Give name of Cemetery), ..
trest Fille Comoley
Dated at
Minituop
Summer Floyd
on
1 190 /
Signature and place of business of Undertaker.
Stinttrop Evase
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
died at
Christine Grith
Duration,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
Certifying Physician.
28 Latin H-EV3
Date of Certificate, 6 190/.
* Give also street and number, if any. t Give sex of infant not named. If still-born, so state.
{ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of , Health.
Chanfulani
Age, O Y. O. M. D. July5 190/
Disease or Cause of Death, } Secondary,
Primary,
M. D.
Maiden Name.{If married, widowed ) or divorced.
No. 33
RETURN OF THE DEATH
OF John Whitman mkilain Minttuop Mass at
(Ocean Chemie)
Date, July 5'. 190 .... 1
Filed, July 6
190 __ / ... .
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death oceurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such deatlı.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
1-11 --
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Eliza artella Mattheus
... Sex,
Color,
Date of Death,
July 17'
.190/ ; Age, 33 Years, 1 Monthy, 24 Days.
Maiden Name, If married, widowed {
or divorced. Eliza a. Hudson
Husband's Name,
Ojemy Mattheus
Single, Married, Widowed or Divorced, Occupation,
*Residence, also state fully.
§ If out of town, {
interrato mass
Place of Birth, P & Deland
*Place of Death, 135 Shirley Sheet
Name and Birthplace of Father, ... William B, Ohudson
Maiden Name and Birthplace of Mother, Barbara Nickelson
Place of Interment, (Give name of Cemetery),
Winthrop Cemetery
Dated at
Winthrop
Summer Floyd
on
July 18"
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