Town of Winthrop : Record of Deaths 1900-1903, Part 31

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 31


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


Sex, Mail


Color,.


Condition, es


(White, Black, Mixed, Chinese, (Single, Married, Widowed or Indian, etc.) Divorced.) e


Age, y Years, Y Months, 7 Days. Occupation, of factier Valor


Residence, Washington we. Ward,


Place of Death, (Wenttrofe wasd.


State year, month and day.)


Place of Birth,


Date of Birth, May 6-1903


Name and Birthplace of Father,


Herbert Alien


Maiden Name and Birthplace of Mother,


Elepalette Casey, westar wars


Place of Interment,


Vtrosi te Lave Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, May 6 1905


Still Born


Name and Age of Deceased, Date and Washington are Withropo (bass). Age, years.


Place of Death,* ) Chief cause.


.......


Disease - Contributing cause, Chief canse,


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 an institution, state how long an Inmate and previous residence.


May 6" 1903 1 Hled Mayy"1963


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, May 9"


190


Full Name of Deceased, Danach Wordside


Maiden Name, macon


If a married or divorced woman or a Widow give also


Name of Husband, David Dordeide -


Sex, no Color,


Single, Married, Widowed or Divorced,


Age, 7 Years, 10 Months, 3 Days. Occupation,


* Residence { If out of town, } Winthrope Wass


( also state fully. ) ..


Place of Death, 19 butter & Well


Place of Birth, P. S. Opland


Name and Birthplace of Father, William Neueon - England


Maiden Name and Birthplace of Mother, Barbara Steadman 3. 6 Gbland


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


Dated at


Signature and


on may


190 3


place of business of Undertaker. Winthrop6 Mars


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t Sarah Wordeide


Age, 7/ Y. /0 M. 3 D.


Place and Date of Death,


died at OVinthis10


may 9 "


190-3.


Disease or Cause of Death, #


Primary, Immediate,


Senility


Duration,


Cerebral Hemorrha Duration,


2 days


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


Signature and Residence HJ. Partir M. D.


of Certifying Physician. Winthrop Mass.


Date of Certificate, May 11. 1903.


* Give aleo 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


Sarah Hordeide OF


at


19 Coulter Sheet


Date, ... ........ May


190 3


Filed, May 11 1.90 3


[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]


SECTION 6. Every householder in whose house a death vecnrs 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 ". 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 ocrtificate setting forth the required facts. If of a child born dead, both the birth and death shall be reported as " stillborn ". Penalty for negleet 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 sneh 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-


sedeusions and transmit it to the clark of the city or town for registration. Penalty for violation not exceeding fifty dollars.


[7.'00.37-XX.M.]


Permit No.


RETURN OF DEATH. BOSTON.


L Year, 1903


Years, 58


Date of death Month,


Birth


Year, 1844 Month,. any Age Months, 9


i Day, 19


Day 9


Days, 19


Name in full, Emilim Ra. S. Omarnão 1


Residence,


Maiden name, Emilien de Spron


Sex-


Mate. Female. Conjugal condition


Singte. Married. Widowed.


Color


White. Black (Negro or mixed) Indian. Chinese. Japanese.


Wife of +


Place of death S Street, 136 maiball


Number,


Place of birth.


Occupation +


Name of Father, Stin T. Sem Maiden Name of MothersHip.


Isebelt.


Birthplace of Father, Ceny Mam Birthplace of Mother,


Place of interment,


1


I'ndertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,.


withich , Mon. May 20 th 1900


Name and age of deceased, Emeline C.S. Sylvester Age, 58 years.


Date and place of death,* My 19th 1903. Withwoh, Man.


Disease


Chief cause, Cancer of Breast


Contributing cause, Results q au operation.


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, A. B. Doman


winthrop , man. 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., 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.


! Divoresd. Widow ofx


Emeline C.S. Sylvester May 19" 1983 Filed May 200 1903


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,. may 26'


190 3.


Full Name of Deceased, gove Marenghi


1 Maiden Name,


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


Sex, Color, 01 Months,


Single, Married, Widowed or Divorced,


Age, Years,


Days. Occupation,


* Residence


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


Of interop Mass


Place of Death, 123 Shirley Street


Place of Birth, It withof mass


Name and Birthplace of Father, Drony Marenghi


Maiden Name and Birthplace of Mother, marguerite


Place of Burial (Give name of Cemetery), toly Chose Cemetery (Malden)


Dated at Minthap


Signature and


Summer Floyd


on May 27th 190 3


place of business of Undertaker.


18 Herman Sheel


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t Loque Marenghi Age, / Y.// MOND.


Place and Date of Death, died at 123 Thiskey Street- May 26190 3.


Primary, Broncho-pneumonia Duration, 2 weeks.


Disease or Cause of Death, } Immediate, Pulmonary ordena Duration,. 3 days.


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


Signature and Residence of


Dr.f. Carter M. D.


Certifying Physician.


Winthrop, Mass.


Date of Certificate, May 27 th 1903 .


* Give also street and number, if any. | Give sex of infant not named. If still born, so state.


{ If a Soldler 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.


RETURN OF THE DEATH


OF


Lowè Marenghi 123 Shirley Sheel at


Date, .. may 26


190 3


Filed, May 24


...


190 3 .. .


[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]


SECTION 6. Every houscholder 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 hc has attended during his last illness, at the regnest 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 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 fec 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 transinit 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, une


190 3


Charlotte no, Gewkelly Full Name of Deceased,


Maiden Name,


Charlotte no, Henderson


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


Herman B. Sewolshuy


Sex, Color, 21


Single, Married, Widowed or Divorced,


Age, 70 Years, Months, 19 Days. Occupation,


* Residence { If out of town, { J Douglas Sheet Winthrop ¿ also state fully. 5 ...


Place of Death, Picto Nova Scotia Place of Birth,


Name and Birthplace of Father,


William Henderson (Sortland)


Maiden Name and Birthplace of Mother, Mary Radcliffe (Sortland)


Place of Burial (Give name of Cemetery), Printtrop Cemetery (Svintherope mass)


Dated at


Summer Floyd


on


190 3


Signature and place of business of Undertaker. 18OdermanSweet Winthrop mass


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t


Charlotte. W Tewksbury Age, JOY. ~ M. 19D.


died at: 5 Sanglas Street Dance 9 1903.


Place and Date of Death,


Disease or Cause of Death, # Immediate,


Primary,


Heart disease.


Duration,


5 years


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


Signature and Residence


HG. & Soul.


M. D.


of


Certifying Physician.


Winthrop


Date of Certificate, June 9th 1903.


* 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.


Duration,


18 months


NO.


RETURN OF THE DEATH


OF


Charlotte DU. Jewsbury 5 Douglas Sheet at


Date, June 9" 190 3


Filed, June 1 June 11 190 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 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- tificato 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 conntaraion and transmit it to the clerk of the city of town for registration. Penalty for violation not exceeding fifty dollars.


FORM C.


Commonwealth of Massachusetts.


No. 29


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, June 2


190 3.


Full Name of Deceased, George SE Mere


Maiden Name,


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


Sex,


Color, Single, Married, Widowed or Divorced,


Age, 79 Years, / Months, 24 Days. Occupation, Watchman.


* Residence ( If out of town, } 159 Stinthope Street, Winthrop Mass ¿ also state fully. 5 ..


Place of Death, 159 Winthrop Street-Winthrop mars


Place of Birth,


ayer Scotland


Name and Birthplace of Father, ..


Unknown- Scotland


Maiden Name and Birthplace of Mother, Unknow- Scottand Place of Burial (Give name of Cemetery), L SummerFloyd


Dated at


Signature and


June 264 190 3


place of business


of Undertaker.


18 Herman Steel-


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t George mc neil


Age, 79 8. 1 M. 24 D.


Place and Date of Death,


died at 15 touring de tritrop


freue 261903.


Primary, Sutinstitial Nephritis.


Duration,


5 years


Disease or Cause of Death, } Immediate, Aceto Unaquica


Duration, 10 days


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


1


Signature and Residence


of


Certifying Physician


Date of Certificate, With: M 2 7th 1903


p


* 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 Canse.


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


Agent of Board of Health.


-


M. D.


RETURN OF THE DEATH


Charge Na Heil OF


15g Winthuge Sheet at


,


1


June 26 190 3


Date,.


Filed, June 27


190.


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 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 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.


[1].'02-37-L.M.]


Permit No ..


RETURN OF DEATH. BOSTON, MASS.


Date of Death, July 19 1903 Name in full, Michelina Sacco


(If a married or divorced woman give maiden name, also name of husband.)


Sex, F. Color


Condition, ( White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.)


Indian, etc.)


Age ... 1 Years, 9 Months, 20 Days. Occupation,


Residence, 32. Putman It Hritherap


Place of Death, 32 Putnam St


Place of Birth, Orient Nights


Date of Birth,


Staty


Name and Birthplace of Father, Luigi


Maiden Name and


1


Maria Puzza


Birthplace of Mother,! Place of Interment, Haly trois walden A. Akadaracco


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,


Writtenp July ve .Age, / years.


1903.


Name and Agc ) Michelina Sacco of Deceased,


Date and July 1900 Winthrop Mass Place of Death,* Chief causc,. Cholera infantum Disease -


Contributing cause, Digestión deanla


Chief cause, two weeks Duration


Contributing cause, Three weeks


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


Name and Residence ? of Physician, O


Winthrop M.D.


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


1


Ward,


(State year, month and day.) Sept 11th /901


Michelina Sacco July 1" 1903 Filed July 2" 1903


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 3


Full Name of Deceased, Perry allen,


Lindsey


Maiden Name,


Ta married Or divorced woman or a widow give also Name of Husband, ..


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


Age, 63 Years,


Months, / / Days. Occupation,


Coles


* Residence ( If out of town, { 18Winthrop2 St Winthrop Mass { also state fully. f ..


Place of Death, 11


Place of Birth, Vjetar Mass


Name and Birthplace of Father, William Lindsay: Pristal Pl.


Maiden Name and Birthplace of Mother, ..


Crigusta Perry- Metin Mass


Place of Burial (Give name of Cemetery),


Wilfred Cemetery, milford Mass


Dated


al


Signature and


Summer Floyd


OD


190 S


place of business


of Undertaker.


Avanttrop mass


PHYSICIAN'S CERTIFICATE.


Name and Age of Deceased, t


Place and Date of Death,


died at


Permiten Lindsey


Age, 6 3 %. ) .M. / D.


July 3d


190-3


Disease or Cause


of Death, #


Immediate,


. Duration,


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


signature and Residence S


of


Certifying Physician.


Winthrop mas


Date of Certificate,


July 3"


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 Immediate Cause.


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


Agent of Board of Health.


1


M. D.


Carcinoma of Intestines


Duration,


2 yrs


Primary,


No.


RETURN OF THE DEATH


OF


Perry allen Lindsey


---


18 Winthrop Steel


at


Date, June 3'


1903


Filed, July 4 " 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 elerk 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. 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 sneh 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 linman 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-


of isa the land of the site ou towns for unaintestines


Penalty for violation not exceeding fifty dollars.


(11-'02.37-LM.]


Permit No ..


RETURN OF DEATH. Winthrop , MASS.


Date of Death, ...


July 20'1903


Name in full, .. Sarah Larson


(If a married or divorced woman give maiden name, also name of husband.)


Se.x, Color,. White Condition, Single


(White, Black, Mixed, Chinese, Indian, etc.)


(Single, Married, doncFor Isiorcer


Age, 60 Years, 5 Months, / 8 Days. Occupation, At Home


Residence, 14 Sargent St Winthrop Ward,


Place of Death, 14 Sargent St Winthrop


Place of Birth, Waterville Me


State year, month and day.)


Joseph CO.


Exeter N.H.


Mary alexander Northfield Mass


Woodlawn Cemetery Everett E. G. Brown 286 Meridian 8f EnBoston


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, July 20


190 3


Name and Age ? of Deceased,


Sarah Pearson


.Ige. 60 years.


Date and July 20-03 - 4- Sargent St Winthrop


Place of Death,*


Chief cause. Chronie Interstitial neploritis, Disease


Contributing cause, Cardioe Dilatation.




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