USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 33
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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 countersigu 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, august 10'
190 3
Full Name of Deceased
Edward Eugene Robbins
Maiden Name,
If a married or divorced } woman or a widow give also Name of Husband,
Sex, m Color,
Single, Married, Widowed or Divorced,
Age, 28 Years, 13 Months, Days. Occupation, Clerk.
* Residence { If out of town, } ( also state fully. ]
mais
Place of Death, Belmont Cottage
Treaters Avenue
Place of Birth, East Livermore Muame Name and Birthplace of Father, .. . 1 Fried E, Robbins, autour me
Maiden Name and Birthplace of Mother, Ella Goding Lawistimme
Place of Burial (Give name of Cemetery), Houthiop amely
Summer Lloyd
Dated at august 111 190 3 on
Signature and place of business of Undertaker. 18 Oteren Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Edward &, Robbins Age, 28 Y. 3 M. D.
Place and Date of Death,
died at.
Ocean Spray august-10
190 3
Disease or Cause of Death, # Immediate,
Primary,
addison's Disease
Duration,
4 mas
I certify that the above is true to the best of my knowledge and belief.
O& Johnson.
Signature and Residence S of
M. D.
Certifying Physician. Ceny 12
Date of Certificate,
190 3.
Duration,
* 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
Edward Eugene Robbins at sident Theme O, Jeray
Date, august 10 ( 1903.
Filed, august 10º 190.3. 6
[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 oity 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 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 eity or town within the Commonwealth at which his vessel first arrives after such death.
SECTION S. 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 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 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 eity 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 aud transmit it to the clerk of the city or town for registration. Penalty for violation not exceeding fifty dollars.
[1]-'02.37.LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Name in full, Christopher &
Date of Death, Aug 12/1903 Spenceley
(If a married or divorced woman give maiden name, also name of husband.)
Se.v. male
Color,
(White, Black, Mixed, Chinese, Condition, Married (Single, Married, Widowed or Divorced.)
Indian, etc.)
Age, 63 Years, Months, Days. Occupation,
Residence, 367 WValmet Hi Roy Ward,
Place of Death, 4 butler it nuinthis
Place of Birth, Wiscasset Maine Date of Birth, Aug 16 1540
(State year, month and day.)
William
England
Name and Birthplace of Father, Catherine Colby Vistasset Maine
Maiden Name and 1 Birthplace of Mother, )
Place of Interment,
Billricker mans J & Waterman & Sons Undertaker S.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and Age 4 3 years. of Deceascd, Christopher I Spencely Ise, Boston, aug. 13. 1903.
" Britter It ? inthe wp
Date and
Place of Death,* ) Chief cause, Tuberculosis Disease Contributing cause, Diarrhoea
Chief cause, E Indefinite
Duration Contributing cause, Five days
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ) of Physician, 1
A.J. Porter M.D.
* If an institution, state how long an inmate and previous residence.
21
Christopher & Spencerley auquel 12" 1903 Filed aug 13"1903
FORM C.
Cooley 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,. august 14' 190
Full Name of Deceased Marian Reardon
Maiden Name,.
If a married or divorced woman or a widow give also ( Name of Husband,
Sex, Female Color, While Sing
Single, Married, Widowed or Divorced,
Age, @ Years, Months, Days. Occupation,
* Residence ( If out of town, ) ( also state fully. ) .
Winthrop Mass
Place of Death, no , I houten Park
Place of Birth,. Cambridge mass
Name and Birthplace of Father, William Reardon Cambridge
Maiden Name and Birthplace of Mother,. Marian &r; Phillips Syracuse
Place of Burial (Give name of Cemetery), ... Cremated at mount autumn
Dated at
Winthrop
Signature and Summer Floyd
ny
on
august
190 3
place of business
of Undertaker.
18 Exteriores heel
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Marian Reardon
Ageç
20 %.
M. . D.
Place and Date of Death,
died at
Winthrop august 14 " 190 3
Disease or Cause of Death, ţ Immediate,
Primary,
Duration,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
& H. Melcall
M. D.
of Certifying Physician.
Date of Certificate,
august 15" 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.
No.
RETURN OF THE DEATH
OF
Marian Reardon of Shutton Park at
Date, auquel 1H
190 3
Filed, august 1.5 190 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 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 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 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.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Date of Death, august 16' 190 3.
Full Name of Deceased, Walter It, Cumnock
Maiden Name, 0
If a married or divorced woman or a widow give also Name of Husband, ...
200 Color, Single, Married, Widowed or Divorced, Sex,
Age, 58 Years,
2
Months,
3
Days.
Occupation,
Manufactura
Louisville Kentucky * Residence { If out of town, l ( also state fully. ) . Winthrop Mass (argyle Stolet) Place of Death,
Place of Birth, Johnston Scotland
Name and Birthplace of Father, . Unfrom Johnston Scotland
Maiden Name and Birthplace of Mother, Margaret Goodlet Johnston
Place of Burial (Give name of Cemetery),.
Henderson Kentucky Serttard
Dated at Winthrop
Signature and
Summer Floyd
on
august 17℃
190 3
place of business
of Undertaker.
18 Otema Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Walter Neumnoch Age, 58 Y. 2 M. 3 D.
Place and Date of Death,
Primary,
died at Winthrop august 16" 190 3 Perconte por Pertoration Duration, 12 hours
Disease or Cause
of Death, ¿
Immediate,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
Bethel caff
M. D.
Certifying Physician.
Date of Certificate,
au( 1)
1905
* 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
...
NO.
RETURN OF THE DEATH
OF
Walter , Loumnoch Winthrop (argylestile) at
Date,
august 16 1903.
Filed, anguil 17 190 3
[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 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. If of a child born dead, both thic 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.
[11.'02.37.LM.]
Permit No .. ...
RETURN OF DEATH. BOSTON, MASS.
Date of Death Lequel . 6. 123
, futsalharina swift.
Patrick -2
(If a married or divorced woman give maiden name, also name of husband.)
Se.b, Se Female
Color: Ithite
Condition,
Married (Single, Married, Widowed or Divorced.)
Age, 49 Years, 4 Months,7 Days. Occupation,
Replace are clean way Ward, Residence,
Place of Deathleftune an cean may.
.State year, month andHay.)
Place of Birth,
Date of Birth, or 9.15 54 :
Name und Birthplace of Father, 4
Mary
nared.
Maiden Name and Birthplace of Mother, )
Place of Interment,, . Palvary W
WUndertaker.
ROXBURY BUSCAN.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
Maquet , 16 1905
of Deceased,
Date and August 16//13
Place of Death,* )
Chief cause .. initial Insufriency
(Carchac)
Disease Contributing cause, Chief cause, one year
Duration Contributing cause,
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ? of Physician, 31 Metcalf M.D.
* If an institution, state how long an inmate and previous residence.
21
Age of / years. neptune Ine. O .??
Wenche
Unkau
White, Black, Mixed, Chinese, Indian, etc.)
Reyouce
warnerme, esmgs august 16-1903 Filed aug 1 4", 1903
編
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,. august 19'
190 3.
Full Name of Deceased martha 6, barkhane
Maiden Name,
11
-
If a married or divorced woman or a widow give also ( Name of Husband,
Sex, Color,
Single, Married, Widowed or Divorced,
Age, Years, 3 Months, Days. Occupation,
Winthrop Mass
* Residence { If out of town, {
¡ also state fully. }
Place of Death, Shirley Street, Winthrop Mass Button mass
Place of Birth,
Name and Birthplace of Father, Jessie I, torkham
Maiden Name and Birthplace of Mother,
Place of Burial (Give name of Cemetery), .. Winthrop Cemetery Winthrop mass
Dated at
Signature and Summer OFloud
august 201 190 3
place of business of Undertaker. 18 Ofermin Strel
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Martha, B. barkham
Place and Date of Death,
- Primary,
Marasmus Duration, 2 1/2 mos.
Disease or Cause of Death,¿ Immediate, Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
A.J. Partia
M. D.
Certifying Physician.
Hinchaof
Date of Certificate, Dec. 21 st 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 toun.
Agent of Board of Health.
Age, MY. C. M. N/ D. 19' died at Winthrop Beach Shriley & Chig 1903.
NO.
RETURN OF THE DEATH
OF
l
Martha 6. bokham
Shirley Steel
at
Date, august 19. 190 3.
Filed, august 20 3.
190
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death ocenrs 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. 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.
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,
august 22
1903
Full Name of Deceased, Eingabethm Medford
Maiden Name, bedford
is a married Or divorced woman or a Widow give also Name of Husband, .. Samuel L. Vedford
Sex, Color,.
Single, Married, Widowed or Divorced,
Age, 67 Years, 3 Months, 9 Days. Occupation,
Phnetwork mass
* Residence { If out of town, } ( also state fully. ) Car Stillxide are + Park Place of Death,
....
Place of Birth, Hetcon Nora Pertra
Name and Birthplace of Father, Dolu Dedfine
Maiden Name and Birthplace of Mother, .. Elizabets @ fermitt
Place of Burial (Give name of Cemetery),
withof mass (Comely ]
Summer Flyde
Signature and
Dated at
august 23 %
190
3
on
place of business
of Undertaker.
18 Herman Queet
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Elizabeth Mary Bedford Age, 67 %. 3 M. 9D.
Place and Date of Death,
died at
Hawthorne Cottage till Aug 22 1903.
Disease or Cause
of Death, #
Immediate,
Duration,
",
I certify that the above is true to the best of my knowledge and belief.
Edward 7, Gage
M. D.
Signature and Residence S
of
Certifying Physician.
131. Creat Ane Winthrop
Date of Certificate,
Aug 22
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.
Primary,
Duration,
1 Week
RETURN OF THE DEATH
OF
Eligaleth M. Med fad at Cor Hillside + Park Tiene touthow to tel
Date, august 22 190 3.
Filed, august 22 190 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 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 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 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 forth with 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.
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, August 27.1903
190 .
Full Name of Deceased, Clarence A, Barney
Maiden Name,
a married or divoreed
woman or a widow give also Name of Husband,
Sex, Male Color, White Single, Married, Widowed/or Divorced, X
Age, 51 Years, X Months, X Days. Occupation, Merchant
* Residence [ also state fully. } 10 Kenmore Street .- Ward 11. Boston Mass.
Place of Death, .48 Cottage Park Road, Winthrop Mass.
Place of Birth, Boston Mass.
Name and Birthplace of Father, ... Stearns Barney
Maiden Name and Birthplace of Mother,
Place of Burial (Give name of Cemetery), Crematory of the Mass. Cremation Society
Dated at Boston
Signature and Joseph S Waterman 4 Jons
on aug. 2% 190 3
place of business
of Undertaker. Boston mass,
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Clarence a. Barney Age, 51 Y.
M ............. D.
Place and Date of Death,
( Primary,
died at Winthrop Mass. Cirrhosis + Care of liver Duration,
Disease or Cause of Death, ţ Immediate,
Deux inopti disease Duration,
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