USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 27
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Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
-
Primary,
Disease or Cause
of Death, ţ Immediate,
Caroline S Magen
Age, 76 x. 8 M /2D.
Jucy
Jany 12 1903.
M. D.
RETURN OF THE DEATH
OF
Caroline S. Nagel
-
95 Main St Winthrop at
Date,
January 1
Filed
Dannang 18 3 1.90
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death oceurs 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 elerk.
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. If of a child born dead, both the birth and death shall be reported as " stillborn". Penalty for neglect fifty dollars.
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 n 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- with countersign and transmit it 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.)
Date of Death, 23 Sarah Chuson Full Name of Deceased, ...
Maiden Name,
Chase
If a married or divorced woman or a kilow give also
Waller Dann Johnson,
Name of Husband, Sex, Bem ale Color, White single, Married, Widowed or Divorced, of M. D. Johnson, Age, /3 Years, 11 Months, 23 Days. Occupation,
* Residence ( If out of town, ) [ also state fully. ] 37 Revers It Minthaof Mass
Place of Death, Fordlant MI Place of Birth,
Name and Birthplace of Father, 2
Maiden Name and Birthplace of Mother,
Place of Burial (give name of Cemetery Winthrop Cemetery
Dated June 28rd
Celas. R. 18 Ennison
190 3
Signature and place of business of Undertaker. Winttaof Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Sarah &Johnson
Age, 70 8. 11 M. 2 J.D.
Place and Date of Death,
died at
Winthrop
Jan 2 3 190 3.
Primary,
Senile Degeneration
Duration,
1 year
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
Winthrop Mass
Date of Certificate, kan 23
1903.
· Give also street and number, if any. # Givo 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,
Uremia
M. D.
Certifying Physician.
No.
RETURN OF THE DEATH
OF
Sarah Co. Johnam 37 Rene Street at
Date, January 2.3 1903
Filed,
January 23 1903
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose honse a death oeenrs 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, 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 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 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 seetion 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 canse 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.
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, S January 26 " (FILL OUT WITH INK. ALL NAMES TO BE IN FULL.) 1903.
Full Name of Deceased,.
Sweetom Infant (Kuentz) 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, Years, Months, Days. Occupation,
* Residence ( If out of town, } { also state fully. . ...
85 Bordon a Hinttrue, 11
Place of Death,
Place of Birth, 11 Jelen Kuentz, Quiédient
Name and Birthplace of Father,
Maiden Name and Birthplace of Mother, Marie M. Omnis HI.S.
Place of Burial (Give name of Cemetery), ..
Dated at
Summer Floyd
on Jamay 26 1903
Signature and place of business of Undertaker.
18 Hemin Drie
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Duellen enfant-
Age, CYNMOD.
Place and Date of Death,
died at Hanthinh
190 5
Disease or Cause - Primary,
of Death, # Immediate,
Still born Duration,
I certify that the above is true to the best of my knowledge and belief.
i. g. quite M. D.
signature and Residence S of Certifying Physician. far 2,5 190/3
4 Flashingten tre,
Date of Certificate,
* 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.
Atill low Duration,
"1
RETURN OF THE DEATH
OF
Cuenta
@ We tom Anfaul
85 Bowdoin Shell at
Date, C
January 25 1903
Filed, January 25. 10 3
[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. Peualty 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. If of a child born dead, both the birth and death shall be reported as " stillborn ". Penalty for neglect fifty dollars.
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- 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.]
Permit No.
RETURN OF DEATH. BOSTON.
1903.
-
Year, Month, ( Day,
Age Months,
Dạy 6 th
Name in full, Daniel Gergin
Maiden name,
Female. Male. Sex Conjugal condition
Single. Married. Widowed. Divorced. Widow of
Color
White. Black (Negro or mixed). Indian. Chinese. Japanese.
Wife of.
Place of death Street, Number,
Vo Pumuyerde ave; Winthrop.
Place of birth Seeland
Occupation More
Name of Father, Dennis
Maiden Name of Mother,
Birthplace of Fath er celand
Birthplace of Mother, Ireland
Place of interment, Calvary Cenneteur
OK. Fallen
Undertaker
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, February 7 190 3.
Name and age of deceased, Daniel Bergin Age, 84 years,
Date and place of death, *.. Fiebrey ( 2 KS Sunnyside Si Chief cause, .. acute Nepritão
Disease
Contributing cause .. Senility
Chief cause .. about me month
Duration Contributing cause
I certify that the above is true, to the best of my knowledge and belief.
Nume and residence ! of physician, Christofles Lyna. 3dl ShawnA ave
* 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., 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, 84
Date of death Year Month, + el.
Birth
i Days, .... Residence, 15 Jumpide Cuve
Daniel / Sergisi February 6"1903 Filed Filly "1903
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, ichwany (FILL OUT WITH INK. ALL NAMES TO BE IN FULL.) 1903.
Full Name of Deceased, 1, Charles adams Hammond
Maiden Name,
married or divorced
woman or a Widow give also Name of Husband, ...
Sex, 700 Color, Single, Married, Widowed or Divorced,
Age, 5% Years, 10 Months, 26 Days. Occupation, Builder
( If out of town, } Hy Locust Street Hrantrop Mars.
* Residence [ also state fully. ) ... Place of Death, 17 Locust Sheet Winthrop Mass
Place of Birth, Despre NO, Of,
Name and Birthplace of Father,
Ossipee NOV,
Maiden Name and Birthplace of Mother, .. Eliza a, Blake-Wakefield ICH,
Place of Burial (Give name of Cemetery)
Temporary Depois Peauing Tons
Dated at. Otintrojo
on
Stebinary 19
190 3
Signature and
place of business
of Undertaker.
June Floyd
18 Sterman Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
chas adams Hammond.
Age, SYY.11 N. 26 D.
Place and Date of Death,
died at
47 Le versy st
Fu6 17
190 3.
Primary,
Pneumonia
Duration,
10 days
acute Infection is conveveces Duration,
48 horas
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence of Certifying Physician.
6318 metcal
M. D.
Date of Certificate,
26.20
190
3.
* 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.
Somermet To be at Cesifece 12. or,
Disease or Cause of Death, ţ Immediate,
No.
RETURN OF THE DEATH
OF Charles adam Hammond at
Date,- February 1/ 1903
Filed, 6February 10 1903
[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 cause 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 fortiwith 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, natil 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- with countersign and transmit it 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.)
Date of Death, February 21%
190 3.
. Full Name of Deceased, Harry
Maiden Name,
If a married or divorced woman or a widow give also Name of Husband,. 1
Sex, malu Color,
Single, Married, Widowed or Divorced, Single
Age, 211 Years, Months, Days. Occupation, saltitos.
* Residence { If out of town, } ( also state fully. §
Banger Manie
Place of Death, Fork Mands, mars .
Place of Birth, Banger manie.
Name and Birthplace of Father,
Lenge S, Head Banger me
Maiden Name and Birthplace of Mother, Clara Is lostgan Zonele me
Mitrop Ferry 22
Place of Burial (Give name of Cemetery), Mount tapee Cemety Branger She Summer Floyd
Dated at
Signature and
on
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Harry S. Itranh
Age, PSY.
.M.
D.
Place and Date of Death,
died at.
Fort Backs, Mais.
Jul. 21"
190 3.
Primary,
addiran's disease.
Duration,
Ihrer months
Disease or Cause
of Death, #
Immediate,
Duration,
I certify that the above is true to the best of my knowledge and belief.
signature and ResidenceS of
Certifying Physician.
M. D. 12 ius. aut. hurgron, leg.a.
Date of Certificate, 22. 1903.
* 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.
1903
place of business
of Undertaker.
18 Otermin Plet
X ....
RETURN OF THE DEATH
OF Hrany Ofunk 0 For Banks Hospital at
otelmany 21 1903
Date,
Filed, Germany 24 3
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 such death.
SECTION S. 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. If of a child born dead, both the birth and death shall be reported as " stillborn ". Penalty for neglect fifty dollars.
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 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- with countersign and transmit it 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.)
Date of Death,.
21" 190 3.
Ella Byltina Crafté Full Name of Deceased, -.... Maiden Name,. Colla Byltona Mallette
If a married or divorced woman or a widow give also ( Name of Husband, I Chancellor Crafts
Sex, Color, 21 Single, Married, Widowed or Divorced,
* Residence (If out of town, } ( also state fully. f .
Age, 50 Years, Months, Days. Occupation, 48 Quincy avenue N. Highlands
Place of Death, 11
Place of Birth, Fatto maine
Name and Birthplace of Father, action b. Mallette
Maiden Name and Birthplace of Mother, Lattes ashburnham
Place of Burial (Give name of Cemetery), ...
Jempenauf Dejessit Winthrop, "Ree Tomb
Internet in newton Cemetery later
Dated at
on Felmany 22 1905
Signature and
place of business
of Undertaker.
Summer Floyd
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Ella Syltuma Crafto Age, SOY. _M. .D.
Place and Date of Death,
died at
Winthrop Highlands
Freby . 21, 1903.
Primary, - Disease or Cause of Death, Immediate,
Recurrent Carcinoma
Duration,
18 mos.
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
S
Thomas Et gott
M. D.
Certifying Physician.
+2 Vinay avec
Date of Certificate,
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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
...
No.
RETURN OF THE DEATH
OF Gilla Byllina Crafts
at H& Juicy Creme a Winthu100highlands Date,
Hebuary 21 1903.
Filed, Chary 22 190 3
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every honscholder 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, 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 sneh death.
SECTION S. 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 nndertaker or other person shall bnry 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.
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, Schwary 24-" 1905.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Full Name of Deceased, Ona angeline Names
Maiden Name, ..... '/.
1 Stone
3 = = married or divorced woman or a widow give also } - Name of Husband, Edward CV, Olame
Sex, Color, 21 Single, Married, Widowed or Divorced,
Age, 60 Years, Months, 21 Days. Occupation,
* Residence ( If out of town, ) ( also state fully. )
Winthrop Mass
Place of Death, 18 Cottage Park Road
Place of Birth, Comisk Vermont
Name and Birthplace of Father, George D. Stine
Maiden Name and Birthplace of Mother, Mary ann Russere DanvilleVT
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