Town of Winthrop : Record of Deaths 1900-1903, Part 24

Author: Winthrop (Mass.)
Publication date: 1900
Publisher:
Number of Pages: 564


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 24


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36


I'mderich L. Briggs


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,. Seph. 10th 1902.


Name and age of deceased,


Chef (En). Whitmore Age, 20 .. years.


Date and place of death,* Seff- 10th Wintherof Beach


Disease Chief cause, Asphyxia Contributing cause, forend drowned. 1


Duration


Chief cause, Contributing cause,.


I certify that the above is true, to the best of my knowledge and belief.


Name and residence ?. of physician, Francis @Harris


* If in an institution, state how long an inmate and previous residence.


Hede bains .M D).


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.


Name in full, Maiden name,.


Sex


Male. Romulo .- Conjugal condition


Chester &. Whitmore Residence, Single. Married. Ttdowed. Color Divorced. Widow of Number, Nuntrop Beach. Cambridge Muss.


[2-01-37-XXXM.]


Winthrop


Permit No.


RETURN OF DEATH. BOSTON.


Date of death Year, .1902 Month, Defit Birth Doy, 12 Name in full, Manningsint Maiden name, Male. Fomate.


Year 1844 Month Lov Day , 1 10


Years.


Sex Conjugal condition


Singte. Married. Widowed. Divorced. Widow of.


Age 3 Months. /0 Days, 2 . Residence, 18 tremont dt. Winthrop White. Color Black (Negro or mixed). Indian. Chinese. Japanese.


Wife of.


Place of death Street, 1/8 tremont SA. Winthrop


Number,


Place of birth, Occupation, Freeport And. Name of Father, James Sia Haftain Maiden Name of MotherJarah Brinton Birthplace of Father Theport A.S. Birthplace of Mother, Geht Tome A.S. Place of interment, Winthrop Cemetery E. G. Brown


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,.


Dept 12 190 2.


Name and age of deceased, sect Manning Lent .


Age, 38 years.


Date and place of death,* Dept 121902 fremont St Henthink


Disease Chief cause,


Contributing cause, Chief cause, Few na macht


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.


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., excapt during tha months of Juna. July, August and September, when the offica 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.


Manning Level Sejetember 12" 1902 Returned Sepet 15" 1902


[2-01-37-XXXM.]


Finiturap


Permit No.


RETURN OF DEATH. BOSTON.


Year, 1841.


Years, 6%.


Date of death


1902 Year, Month Sept- Birth


Month,


Age Months, 4.


Day, .. 24.


1 Day, 28.


Days, 26. Name in full, optimia J. Jrish


Maiden name, Mate. Female.


Single .- Married. Widowert.


Chinese .- Japanese. Widow of


Place of death Street, Wave Way are. Winclu op.


. Number,


Place of birth,


quetery mi


Occupation,


Name of Father, her, More


Maiden Name of Mother, other Day WE


Birthplace of Father, Place of interment,


Woodlawn ( mit. Brown.


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,. Detet. Vn


Name and age of deceased, rich Age, 61 years. Date and place of death /div. Vigor. "~ Wave Way ans Nuestrop


Disease Chief cause, meumore


Contributing cause,.


Embolism of The Heart


Chief cause ........


Duration Contributing cause, .. about 2 days


I certify that the above is true, to the best of my knowledge and belief.


Name and residence }. of physician, 03. Campbell 6. Barton M.D.


* If in an institution, state how long an inmate and previous residence.


Tha office of the Board of Health will be open for tha granting of permits for burial, as follows : - Saturdays, 9 A.M. till [ P.M .. except during the months of Juna, July, August and September, when the office will ba closad 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.


Residence, Y Wave Way a. Riley. .


White. Black (Negro or mixed).


Sex


Conjugal condition


Color { Indian.


Wife of. Richard It.


Birthplace of Mother,


8 days


>


FILL EVERY BLANK, AND WITH INK ONLY, WRITE VERY PLAINLY.


No. of Death


UNDERTAKER'S RETURN OF A DEATH


Vinterene SOMERVILLE, MASSACHUSETTS


Date of ( Death Tepl- 28 190.2_ Full Name S


Messig & M ullen


Maiden Besos L Hamile Full Name of Husband § * David Re Name


Marred. Sex Termal Colort While Single, Married, Widowed, or Divorced Date of Birth


Supposed Age 3 3 Yrs. + Mos. Days. if obtainable 1


Residence


1019 A Winthrop ML Duration of Residence


Place of Death ( and Number


-


Somerville Ward


Name of Institution, if any, in which Death Occurred


Length of Time Deceased ( was an Inmate


And Previous Residence


Occupation at- house


Place of Birth


Name of William & Pheresof Mother


Maiden Name }


Father


Birthplace ) of Father 1 Boston Mas Birthplace of Mother S


Place of Interment Sentin Genelés . Cemetery 1 Town or City, and State , 6 16 Spachhave Signature of Undertaker 88 balles


Residence


(No)


( Street )


( Town or (ity )


*If a married woman, or a widow, or divorced.


tWhether White, Black ( Negro or Mixed ), Indian, Chinese, Japanese.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH


Name of ) Deceased S Messy & Bullen


Supposed Age B 3 Yrs. ^{Mos. Days. Place and Date of Death 2019 A Numberof Mansich Deft-28 190 2


Disease or Primary or Immediate Cause


Cause


of Death Secondary or Contributing Cause + Con mément


DURATION 8 days


Place where Disease was Contracted, ? if other than place of death


I certify that the above is true, to the best of my knowledge and belief.


Signature of Physician


621 Metcalf


( Town or City ) M. D.


muss.


Residence 5-2 (No.) ( Street)


Winthrop st


# If a Soldier who served in the War of the Rebellion, both the primary and secondary causes of death MUST be given.


The Office of the Board of Health will be open for the granting of permits for burial as follows: Saturdays, 8 A. M. to 12 M .; other days (Sundays and Legal Holidays excepted ), 8 A. M. to 4 P. M.


Street


( No.) ( Street ) Town or City, and Salte,


Sarah A Buratino 1


formenle


( No.) ( Street ) Peritométis


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, .. Detaber 3 190 2_ Ray Verna De Formex Pay


Full Name of Deceased, ..


Maiden Name, ..


woman or a widow give also If a married or divorced


Name of Husband,


Sex, Fe te Color, 21 Single, Married, Widowed or Divorced, Age,. 7 Years, Months, 3 Days. Occupation,


* Residence also state fully.


Place of Death, Winthrop


Place of Birth,.


Mira.


Name and Birthplace of Father, Walter Scott Roy W. Harrington ME Maiden Name and Birthplace of Mother, Mary addie alexander Walpole Was


Place of Burial (Give name of Cemetery), Hintrop Demetey Sinthof Mass


Dated at October 3


Deminer Floyd


on


190 2


Signature and


place of business


of Undertaker.


18, Oferman Sheet


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t Verva De Forrest Pay Age, 7 8. 11 M. 3 D.


Place and Date of Death,


died at


Ministros Serverest Onine Oct.8 19020


-


Primary,


Diphtheria


Duration,


4 days


Duration,


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence


of S A. B. Dorman M. D.


Certifying Physiclan.


WirThoof War.


Date of Certificate,


Och.


4th


1902. *


· 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 Immediate Cause.


Countersign and transmit to the clerk of the city or town.


Agent of Board of Health.


Disease or Cause


of Death,


Immediate,


....


Somerset avenue Hontrop


[ If out of town, }


No.


RETURN OF THE DEATH


Verna De Freet Ray imenset Unevere'


Date,!


190 2


Filed, October3. 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 occurs, shall, within five days thereafter, cansc 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 nnder 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 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 hnman 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- with countersign and transmit it to the clerk of the city or town for registration. Penalty for violation not exceeding fifty dollars.


5.'02.37.XXM.I


Permit No.


1


RETURN OF DEATH.


BOUTON.


Date of death Year, .1902


Month Ceet.


Birth


Month,


Day, .... 13 th


1 Days, ..


Name in full, Michael J. Watch


Maiden name,


Sex Male.


Ferrato


Divorced.


Chinese. Japanese.


Wife of


Widow of~


Place of death Street, .18 Cottage ave Winthrop Mare Number, Place of birth, Galway Ireland. Mason


Occupation,


Name of Father, Patrick.


Maiden Name of Mother, Minifreq Rave


Birthplace of Father, Galway Ireland. Birthplace of Mother, Galway Ireland


Place of interment Galvery GenetEry Forthand Mane John Bryanto Love


Undertaker &


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Let . 13 th


1902.


Name and age of deceased,


Boston, Michal Platek Age, 87 years.


Date and place of death, *..


Det. 13th 18 CottageQue


Disease Chief cause,. Contributing cause, Senility Duration ‹ Contributing cause,.


I certify that the above is true, to the best of my knowledge and belief.


Name and residence ?


of physician, M.g. Pantin, Winthrop, Mass. M.D.


* If in an institution, state how long an inmate and previous residence.


The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A. M. till 1 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.


to Make.


Year,


1815


Years, 87


Age Months,


Day, 13th


Residence, Winthrop Mare


White. Black (Negro or mixed)


Conjugal condition


Single. Married. -Widowed.


Color Indian.


automatic Bronchitis


Chief cause. Three years .


21


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, ... October 15"


.190 Z.


Full Name of Deceased, Marion D. Barter


Maiden Name, ...


If a married or divorced woman or a widow give also Name of Husband,


Sex, Color, 21 Single, Married, Widowed or Divorced,


Age, .. "1 Years, 6 Months, 20 Days. Occupation,


Perere Street= Winthrop Mass * Residence { If out of town, } [ also state fully. )


Place of Death, Revere Street (Floyd Court) Winthrop Mass


Place of Birth, Winthrop mass.


Name and Birthplace of Father, William H. Barton - Washington 10, 0


Maiden Name and Birthplace of Mother, Mary & Larkin Bolon mass


Place of Burial (Give name of Cemetery), Winthrop Cemetery


Dated at Winthrop


Summer Floyd


on


October 16"


1902


Signature and place of business of Undertaker.


Printron Wass


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t


Marion P, Barker


Age, 11 Y. 6 M 20 D.


Place and Date of Death,


died at


Winthrop Och 15.


190 2.


Disease or Cause of Death, # Immediate,


Primary,


Anaemia


Duration,


3 054 months.


Follicular tonsillitis


Duration,


7 a8 days.


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence S -


D.3.Domman


M. D.


of


Certifying Physiclan.


Date of Certificate,


Och. 17Th


1902


· 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 Immediate Cause.


Countersign and transmit to the clerk of the city or town.


Agent of Board of Health.


No.


RETURN OF THE DEATH


OF Marion P. Barker


at Winthrop mass


Date, Detaber 1.5 190 2.


Filed, October 16" 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 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 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 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-


~ ilin alool of those


Dasalter for violation not avending fifty dollars.


FORM C.


Commonwealth of Massachusetts.


60218


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, October 18'


190 2


Full Name of Deceased, Sadie Male Si, Quarrie


Maiden Name,


If a married or divorced woman or a Wlow give also }


Name of Husband, .


Sex, Color, Single, Married, Widowed or Divorced,


Age, 25 Years, 4 Months, Days. Occupation,


* Residence { If out of town, } [ also state fully. j


It intlust?


Mass


treel-


Place of Birth, Dielow Nova Scotia


Name and Birthplace of Father, Samee O, Suc 2 yanie Nova Scotia


Maiden Name and Birthplace of Mother, Catherine Cameron Nova Scotia


Place of Burial (Give name of Cemetery) . Pietou nova Portia


Dated at Winthrop? C


Summer Ofloyd


on October 19 1902


Signature and place of business of Undertaker.


18 OvernionSteel


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t Cadie Make M° quarrie. Age, 25 x 4 M. D.


Place and Date of Death,


died at Winthrop 86 Linesen el Och 18 1902.


Disease or Cause - Primary,


of Death, Immediate, Gangrene of luna


Duration,


6 months


I certify that the above is true to the best of my knowledge and belief.


Signature and Residence of


M. D.


Certifying Physician. 3


Date of Certificate,


190.3.


* 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, 86 Lincoln.


Tuberculosis Duration, 2 years


No.


RETURN OF THE DEATH


OF Sadie Nabel Nº quannie 2086 giveren Sheet at


Date, - October 18 190


Filed, October 19 190 ......


[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 S. Penalty for neglect to comply with the requirements of sections 6 anl 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 ocenrred. 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 fown 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-


.


.


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, .. October 22


1902.


Full Name of Deceased, Mary One Olayden


Maiden Name, ... Mary One Haney


If a married or divorced woman or a widow give also Name of Husband, Thomas Thompson Hayden


Sex, &FemaleColor,


Single, Married, Widowed or Divorced,


Age, 82 Years, 3 Months, Days. Occupation,


* Residence


{ If out of town, }


Winthrop Mass.


[ also state fully. ) .


Place of Death, 8. honton Park


Place of Birth, Beton Mass


Name and Birthplace of Father,


Edward Harvey


Scotland


Maiden Name and Birthplace of Mother, Susannah &. Hutchinson


Place of Burial (Give name of Cemetery), ...


Winthrop Cemetery


Dated at Winthrop


Summer Etford


on


October 221


190 2


Signature and place of business of Undertaker. 18 Hderman Street


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t


Mary Ore Han den


Age, 82 8. 3 M. 7 D.


Place and Date of Death,


died at Winthrop


Oct22


190 2.


Disease or Cause of Death,


Primary,


Senility


Duration,


1 year


arterio Delerinin


Duration,


3 mi


I certify that the above is true to the best of my knowledge and belief.


M. D.


Signature and Residence S of


Winthrop


Certifying Physician.


Date of Certificate,


Oct 24


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 tho Rebellion, give both Primary and Immediate Cause.


Countersign and transmit to the clerk of the city or town.


Agent of Board of Health.


Immediate,


Oct 22


No.


RETURN OF THE DEATH


OF


Mary One, Hay den 8 Shoutin Park at


Date, October 15" 1902


Filed, October 16' 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 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 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 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, nntil 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 hoor, 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-


ar Inum far raristration Ponsliv for violation not exceeding fifty dollars.


[2-01-37-XXXM.]


Interment Lec 6- Prace no 13 Single grace fal Hinthrow


Permit No. (


RETURN OF DEATH. BOSTON.


Year, .. 1902


Year, .. 1894 Month,


Years, 8


Date of death


Month, Det Birth


Dạy, . 12 Age < Months,. 8 Day, .. 26


Name in full, Mary L. Creighton Residence 24


Maiden name,


Male. Female.


Sex Conjugal condition


Single. Married, Widower.


Color


Read St Winthrop White. Black (Negro or mixed). Indian. Chinese? Japanese.


Wife of.


Place of death Number, Street, 29 Read St. Winthrop Place of birth, East Boston Occupation, Scholar' ...


Name of Father, William If Maiden Name of Mother Mary J. Whittington Birthplace of Father, Charlestown Muss Birthplace of Mother, Jakmouth V.S.


Place of interment, Winthrop Cemetery


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,. Ces 26


190 2.


Name and age of deceased, Mary L. Creighton Age, 8 years.


Date and place of death,* Det 26 1902. 29 Reed St. Winthrop


Disease


Chief cause, .. nova -


Contributing cause, Gastro Enteritis -


Duration Contributing cause, ..


Chief cause, .. wo werks. our work.


I certify that the above is true, to the best of my knowledge and belief.


Name and residence } of physician,


Jallian M.D.


* If in an institution, state how long an inmate and previous residence.


1.Princeton St.


The office of the Boerd 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 end September, when the offica 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.




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