USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 36
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, Color,
Single, Married, Widowed or Divorced,
Age, 45 Years, Months, ( Days. Occupation, Ansenife
* Residence ( If out of town, } also state fully. }
mass
Place of Death, 26 Somerest Chenne
Place of Birth, Nova Scotia
Name and Birthplace of Father, James Broyerley Ina Coolva
Maiden Name and Birthplace of Mother, Rebecca Elliot Aura Solía
Place of Burial (Give name of Cemetery), ... Winthrop Cemetery
Dated at Winthrop
Signature and Burner floyd
on December 6 1903
place of business of Undertaker.
18 Oderman Sheet-
Stiritrop mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
ada Porking
Age, 5Y. ~ . ~ D.
Place and Date of Death,
died at ...
Minitrop 26 Inverser are De 2 190 3.
Primary,
Chronicgados can datas
Duration,
several years
Disease or Cause of Death, # Immediate,
Paralisis (hemiplegia)
Duration,
two weeks
I certify that the above is true to the best of my knowledge and belief.
M. D.
Signature and Residence of Certifying Physician.
Date of Certificate,
20
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.
RETURN OF THE DEATH
OF
ada SerRuíz
26, Somerset avenue at
Date, (December) 4 1.90 3
Filed, December 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 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 fce 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, .. December 10."
190 3.
Full Name of Deceased, Cinque Nac Iones. nnes.
Maiden Name, ٢٠٢٠
If a married or divorced woman or a Widow give also} Name of Husband,
Sex, 200
Color, Single, Married, Widowed or Divorced,
Age, 26 Years, 5 Months, 18 Days. Occupation, Book Maker
* Residence { If out of town, }
Place of Death,
Drakefield Wass ( also state fully. ) Rear of 35 Marshall Sheel
Place of Birth, B. ORland
Name and Birthplace of Father, Martin Não Onnes
Maiden Name and Birthplace of Mother, annie Matheson P. E.l.
Place of Burial (Give name of Cemetery), .. Winthrop Cemetery
Dated at Winthrop
Signature and
Summer Floyd
December 11 1903
place of business of Undertaker. 18 Oderman Sheet
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Cinque Mac ennes Age, 26 4. 5 M. 18 D.
Place and Date of Death,
Disease or Cause
-
Primary,
of Death, # Immediate,
.... Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
C. & Johnson M. D.
Certifylng Physician.
Date of Certificate, December 121903.
* 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.
died at. Winthrop Bear of 35 marshall et- 1903. Pulmonary LulucularisDuration, 2 Jeans
900.10
RETURN OF THE DEATH
OF
Angus Mac Omnes at 35 Warshace Street
Date, 2December 10 " 1903
Filed, December 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, 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 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 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 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.
[7.'00.37.XX.M.]
Permit No.
RETURN OF DEATH. BOSTON.
Year,
#1903
Year,
1842
Years, 6/
Date of death Month, Dec Birth
Day, 23
Month, 1 Day thu an Age Months, 11
Days 17
Name in full, Tom. C. Brown
Residence, 135 Wmichio/ 51-
Maiden name,
Male.
Sex Conjugal condition
Female.
Single. Married. Widowed.
Color
White. L Black (Negro or mixed). Indian. Chinese. Japanese.
Wife of Z
Place of death Street, Number, Bastano (2x) as
Place of birth,
Occupation, Ship Caller
Name of Father,. Go. Brown Maiden Name of Mother Elizabeth Chiel Birthplace of Father, England
Birthplace of Mother, Przyland
Place of interment, Woodlawn Gimelany Wort Man le. (. Pst22
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, ..
1903.
Name and age of deceased, ...
Age, ... 61 years.
Date and place of death, *.
135 worshopst.
Disease
S Chief cause, Contributing cause,
Coronary Sclerosis. angina Pector's
Chief cause,
3 weeks.
Duration Contributing cause,
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ? of physician, Birrelay 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.
1
Divorced.
Widow of
1
William@Brown Died Die 23/1903 Filed Dce 24/1903
-
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, December
190 3
Full Name of Deceased, Catharine D. Bardwell
Maiden Name, Catherine LO, Perry
If a married or divorced woman or a widow give also Name of Husband, Damon a, Bandonele
Sexe Female Color, While Bing Single, Married, Widowed or Divorced,
Age, /2 Years, Months,
Days. Occupation, none
* Residence It of t 96 Sagamore avenue Hartrop He'ds { also state fully. ]
Place of Death, 16 Sagamore avenue Winthrop Highlands Jayden Mase Place of Birth,
Name and Birthplace of Father, alee Perry
Maiden Name and Birthplace of Mother, Nancy Smith Perry
Place of Burial (Give name of Cemetery), .. annis anderen = Shellun Falls mars
Summer Floyd
Dated at December 28 190 3 on
Signature and place of business of Undertaker. 18 Oderman Steel Hothots mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Catharine 2 /Bandwell Age, 28. 2.V./ D.
Place and Date of Death,
died at Natury December 27 .190 3.
Cerebral Hamontage
Duration,
.
of Death,
Immediate,
Disease or Cause - Primary,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence } of Certifying Physician.
M. D.
Date of Certificate, Lee 28
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.
RETURN OF THE DEATH
OF Catharine , Bardwell at 16 ДадатыЗОление
Date December 27 190 3
Filed, December 27 190 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 oceurs, shall, within five days thereafter, eanse 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 ?, five dollars.
SECTION 10. A physician shall forthwith after the death of a person whom he has attended during his last ilhiess, 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 eanse of death as nearly as he ean 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 faets 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 eents.
[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, nutil 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.
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.