USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 21
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Penalty f violation not exceeding fifty dollars.
[2-01-37-XXXM.]
Permit No.
RETURN OF DEATH.
BOSTON. Winterof
1902
Date of death Year, Month, June Birth
\ Day, 22 00
Year, Month,
1 Day , .....
Days Residence, 123 Shirley D. Wrathof White. Black (Negro or mirred).
Sex Conjugal condition
Color
Indian Chinese. Japanese.
Wife of Thomas &. Barber
Place of death? Street, 1123 Shirley Dr. Winthrop
Number,
Place of birth, Hamurdale Pa
Occupation, Номера
Name of Father, , Patrick Manmuy Maiden Name of Mother Hanmah English Birthplace of Father, Geland Birthplace of Mother, Theland
Place of interment, ( Abb, Benedict
Nicholas Ab. Williams
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Wrathof June 24" 1902
Name and age of deceased, Kary V. Carter
Age, 4 years. Date and place of death,* June 22 h 1902 123 Shirley Bb. Werethenol
Disease Chief cause, ..
Contributing cause, ... Neurasthere
Chief cause, The attack Canted from afternoon to ireally
Duration- Contributing cause, midnight.
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ? Frank Ni Aller M D. of physician,
* If in an institution, state how long an inmate and previous residence. 223 Shirley It, Hmlich.
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.
Years, 40
Age 3 Months,.
Name in full, Mp any V. Corbett
Maiden name, Manning Single. Married. Widowed. Divorced. Widow of.
Female.
mary t, Corbett June 25, " 1902
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.)
Date of Death, .
uly 9' 190 2
Full Name of Deceased, Mary A. Dinham
Maiden Name, 11
If a married or divorced woman or a widow give also ( Name of Husband,
Sex, Fe Color,
Single, Married, Widowed or Divorced,
Age, 80 Years, 6 Months, Days. Occupation,
* Residence { If out of town, } 228 Mars avenue Breton
{ also state fully. } Movie Street- Winthrop Beach Place of Death, Place of Birth,. England
Name and Birthplace of Father,
Unknown
Maiden Name and Birthplace of Mother, Unknown
Place of Burial (Give name of Cemetery)
Mand Cubrir Comeley
SummerFloyd
Dated
July 10,11
.. 190 2
on
Signature and
place of business
of Undertaker.
18 Hermann Street-
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Mary
Age, 80 Y.
M.
D.
Place and Date of Death,
died at
Winthrop
July 9 190 %
Primary,
Disease or Cause of Death, # Immediate, Apoplexy
Duration,
Duration,
3 days
I certify that the above is true to the best of my knowledge and belief.
S. A. Kimball
Signature and Residence
of
S
Certifying Physician.
Fatou Maxo
Date of Certificate,
July 10
190 2.
* 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
M. D.
No.
RETURN OF THE DEATH
OF
Mary a Dínham Moore steel at
Date, July 9 " 1902
Filed, July 10
190 2
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death occurs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, cause notice thereof to be given to the board of health or to the town clerk.
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 snch death. SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other anthorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor who served in the war of the rebellion, give both the primary and the secondary or immediate canse of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tificate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making snch return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS. ]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth- . ...... .. ... w. for touristration Penalty for violation not exceeding fifty dollars.
Winthrop (SEE TERMS TO BE AVOIDED, OF THE OTHER SIDE.)
July 11
THIS IS TO CERTIFY,
To the best of my knowledge and belief, Name of deceased in full. Horatio G. Antes That
age 64 years 1 months days, died on the 11 day of July
A. D. 189-1902.
Give briefly disease or other cause of death. If deceased was a soldier in the war of rebellion give both primary and secondary or immediate cause of death.
Cerebral apoplety
of
Its duration* was 5 days
There was also
Its duration* was ..
Was there an autopsy ?
200
Was death unexpected?
20
, Mass.,
July 11
1802
Signed at
HEJ alvesou M. D.
* Reckoned from time of invasion to death.
UNDERTAKER'S RETURN OF DEATH.
Name of deceased in full.
Horatio & butter
Maiden name.
Date of death. July 11 1902 189
Condition (1)
مسكين
Married
Widogy
Age,
64 years,
/
months,
days.
Wife or widow of
Sex
#Color
-Residence,
131
Occupation
Place of birth (2)
Father's name Nathaniel
Mother's maiden name Elija Billings
Plage Interment at. Pul
This return is made by Undertaker Josephus Waterman
Dated -July 11
ABD. 2
Of , Fortowo
1 Erase the words which do NOT indicate the condition.
2 Insert town and state.
1 W., White. B., Black.
Countersigned and approved this day of 189
Agent Board of Health. [SEE BACK.]
E
UNION
FOUNDED 1630. IN
NON
CORPORATED A TOWN NAI
NIS88. A CITY 1873.
AM
male,
Place of death (2)
Point Shirley Winthrop
Warren ave Bostonstreet, Ward.
His birth place (2) Barnstead VN. Her birth place (2) Boston Date July. 14 1902
Extract from Report of Committee on Certificates of Death, of the Massachusetts Association of Boards of Health.
0
" The following list comprises the principal terms which your committee believe should be either avoided or modified or further explained when employed in certificates of death."
Accident-Specify the method or form.
Albuminuria-A symptom only.
Anascara-A symptom of dropsy, and usually a symptom only; specify the source or cause.
Anthrax-A vague term; if carbuncle is meant, use preferably the English word " carbuncle; " if malignant pustule, use this term.
Apoplexy-specify the part affected.
Asphyxia-Specify the method.
Asthenia-Too vague.
Atrophy-Too obscure; use specific term if possible.
Cardialgia-Too vague.
Cephalitis-Too vague.
Childbirth-Specify as follows : (1) Was the death due to some disease of pregnancy; (2) to some disease or accident incident to delivery; or (3) to some disease following delivery.
Colic-Specify; rarely fatal.
Coma-Specify.
Concussion of the Brain-State whether accidental, suicidal, or homicidal.
Covulsions-State the cause, if possible. Debility-Too obscure.
Dentition-Avoid this term, if possible to be more specific.
Dropsy-Synonym of anascara; state source or cause.
Dystocia - (See Childbirth).
Eclampsia-(See Convulsons).
Exhaustion-Too obscure.
Fever-Specify what sort of fever.
Heart failure, paralysis of heart, cardiac exhaustion-Avoid these terms, if a more definite term can be given.
Hemorrhage-Specify.
Inanition-Too obscure.
Indigestion-Too obscure.
Malformation-Specify as to form, or part affected.
Marasmus-l'oo obscure.
Miscarriage-Specify.
Natural causes-Specify.
Old age-This term should never be used when the exact nanwe of the cause of death can be stated.
Palsy, Paralysis-Symptoms; specify the cause; state whether due to cerebral hemorrhage, lead poisoning, traumaticor other causes.
Premature birth-Specify.
Shock-Specify.
Sore throat-Specify.
Syncope-Too obscure. Tumor-State location and character.
Extracts from Public Statutes.
A physician who has attended a person during his last illness shall, when requested, forthwith furnish, for registration a certificate stating to the best of his knowledge and belief, the name of the deceased, his age, the disease of which he Med the duration of his last sickness, and the date of his decease. * *
* * If a physician neglects or refuses to make a certuucare) as aforesaid, or makes a false statement therein, he shall be punished by a fine not exceeding fifty dollars.
No undertaker, sexton, or other person shall bury in a city or town or remove therefrom a human body until he has receivedl a permit so to do from the Board of llealth or its duly appointed agent, or, if there is no Board of Health in such city of 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, togetherarith the certificate of the attending physician, if any, as required by scction 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.
Extracts from Regulations: Board of Health, City of Newton.
July 11"1902
RULE 12. When any person dies of any of the diseases specified in rule 10, section b, (i. e. cholera, yellow fever, small pox varioloid, diphtheria, membranous croup, scarlet fever, typhus fever, or measles) the body shall be buried in accordance with the following instructions: No public conveyance shall be used unless the samc shall be afterwards fumigated under the direction of the Board of Health, or its agent; if placed in a receiving tomb it shall be enclosed in a metallic casket and hermetically sealed; no draperies shall be used; every undertaker or person acting as such shall immediately notify the Board of Health upon receiving notice of a death from any of the above diseases, and it shall be his duty to see that the instructions of the Board of Health are complied with.
RULE 33. The person having charge of the body of any person who has died of scarlet fever or diphtheria, shall cause such body to be immediately washed with a solution of corrosive sublimate (2 drachms to 1 gallon of water), wrapped in a sheet saturated with a solution of corrosive sublimate, same strength, and immediately placed in a tightly sealed coffin.
O
FORM C.
Commonwealth of Massachusetts.
LAR MEN ANDWOMEN
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.)
Date of Death, ..
truly 13
.¿ 90
2
Full Name of Deceased, James
D'un lay
Maiden Name, ..
If a married or divorced woman or a widow give also Name of Husband,
Sex, 7.1.0. Color,
Single, Married, Widowed or Divorced,
Age, 76 Years, - Months, Days. Occupation, Retired
* Residence { If out of town, ) { also state fully. ] Commercial it. marble head wass
Place of Death, 34 Beal Sr. Winthrop
Place of Birth, ) reland
Name and Birthplace of Father, Not Kuoure
Maiden Name and Birthplace of Mother, ... "
Place of Burial (Give name of Cemetery), marblehead, mass, (Catholic)
Signature and John Dowovan Dated W rutfroh
place of business
on
14 Helly 1902
of Undertaker.
Le y un, wass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
James
Dunken Age, 76%. M. .D.
Place and Date of Death, died at. 34 Bral IST
1
Disease or Cause of Death, ţ Immediate,
Primary,
July 13
190 2
Chrmic nutral insuffquency. Duration,
04
Duration, yr
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence of
Bir Me/call
1
M. D.
Certifying Physician.
Date of Certificate,
144
190 2.
· 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No.
RETURN OF THE DEATH
OF
James Dunday ....
34 Beal Rs ( Winthrop) at
Date, July 13" 190.
2
Filed,
July 14 190.2
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose honse a death occurs and the oldest next of kin of a deceased person in the city or town in which the death oceurs, shall, within five days thereafter; cause notice thereof to be given to the board of health or to the town clerk.
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 elerk 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 shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other anthorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor who served in the war of the rebellion, give both the primary and the secondary or immediate canse of death as nearly as he can state the same. Penalty for refnsal or neglect, ten dollars.
SECTION 12. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tificate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making such return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS.]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shull be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth-
Tanalto for violation not exrowling 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.
Date of Death,. July 20
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Full Name of Deceased,.
Susie & Driecoll
190
2
Maiden Name,.
If a married or divorced woman or a widow give also
Name of Husband, ...
Sex, Color,
Single, Married, Widowed or Divorced,
Age, 22 Years, Months,
Days. Occupation,
* Residence { also state fully. § { If out of town, { Cambridge, mass
Place of Death, 28 Fremont Street Winthrop, Mass Boston mars
Place of Birth,.
Name and Birthplace of Father, Timothy Driscoll
Maiden Name and Birthplace of Mother, Rosanna Fannernan
Place of Burial (Give name of Cemetery), .
Calvary Ceneley ( H. Polly
Dated at Printtrop
on July 20 1902
Signature and place of business of Undertaker.
Summer floyd
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Queied Driscoll
Age, 22Y.
Place and Date of Death,
died at.
Nuittrop 28 Fremail 21 July 2002.
Primary,
Disease or Cause of Death, # Immediate,
0 Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
M. D.
Certifying Physiclan.
Date of Certificate, July 20 "
190 2.
· Give also street and number, if any. f 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Tuberculosis y Limpo
Duration,
one year
..
4
No.
RETURN OF THE DEATH
OF
Susie &, Driscoll ato Femont Street
Date, July 201 1902
Filed,
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death occurs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, canse notice thereof to be given to the board of health or to the town clerk.
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 shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor 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 negleet, ten dollars.
SECTION 12. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tifieate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making such return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS.]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth-
--- Danalte 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.)
Date of Death, ..
31"
1902
Full Name of Deceased, James O. Beal
Maiden Name,
If a married or divorced woman or a widow give also (
Name of Husband,
Sex, Color, .. Single, Married, Widowed or Divorced,
Age, 60 Years, 6 Months, ~Days. Occupation, Master mariner
* Residence { If out of town, { { also state fully. f
2 Douglas Street Our Bowdown milhop
2 Douglas Street, Cor Bonden Winthrop
Place of Birth, Serige to me
Name and Birthplace of Father, William Beau-Sengeton Se
Maiden Name and Birthplace of Mother,. Eliga C, Jenet Westport me
Place of Burial (Give name of Cemetery) Tom Odajer Omeley
Printtrop
Signature and
Dimmer Floyd
Dated
July 31.
190 2
place of business 3
on
of Undertaker.
18 Oderman Sheet
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
James O, Beal
Age,.
60 x 6 M. D.
Place and Date of Death,
-
Primary,
Cancer of Stomach
Duration,
2yrs
Immediate,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
Biometcalf.
M. D.
Certifying Physician.
3
Date of Certificate, 190
* Give also street and number, if any. f 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Place of Death,
died at
Stiritrop 2 Douglas 01, Jeexp 3.1 "1 902
Disease or Cause of Death, }
No.
RETURN OF THE DEATH
James O. Jeal OF
2 Danaglas Sheel at .....
......
Date,
July 21" 190 2.
Filed, ang / 11
190 ..... 2
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death occurs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, cansc notiec thereof to be given to the board of health or to the town clerk.
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 elerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for negleet to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other anthorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor who served in the war of the rebellion, give both the primary and the secondary or immediate eause of death as nearly as he ean state the same. Penalty for refusal or negleet, ten dollars.
SECTION 12. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tifieate required by section 10, enter thereon the faets required by seetion 1, and return it to the board of health or to the elerk of the eity or town in which the death ocenrred. The person making snch return shall receive from the city or town a fee of twenty-five eents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS.]
SECTION 38. No undertaker or other person shall bury a human body in a eity, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth- .
Danalle far vialation not exceeding fifty doll-m.
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.)
Date of Death, .190 2. July 31 Theresa Rasen barn Full Name of Deceased,
Maiden Name, Theresa Lighthill ---
If a married or divorced woman or a widow give also Name of Husband,
Sex, Color, white Single, Married, Widowed or Divorced,
Age, 74 Years, 4 Months, /9 Days. Occupation, * Residence { If out of town, }
{ also state fully. )
Place of Death, 11 Place of Birth, Wartenburg 11
11 Crest Chemie
Germany
Name and Birthplace of Father, 11
Maiden Name and Birthplace of Mother, .. ...
Place of Burial (Give name of Cemetery)
Cypress
V Fall
1
Dated at Winthrop
Signature and
Summer Floyd
on
July 31"
190 2
place of business
of Undertaker.
18 Herman Strel
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Primary,
Nephatie Duration, 10 munich
avaitis
Duration,
2 march
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
arLighthice
M. D.
of Certifying Physician. 3 Date of Certificate, July 31. 190 2.
* 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Theresa Rosundaen Age, Tx Y. 4 M./5D.
died at. Winthrop Cor Crest Myrtle, 1902.
Disease or Cause of Death, } Immediate,
July 3
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