USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 6
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
Birthplace of Father, Birthplace of Mother Marchand
mass.
Place of interment,. Old Cambridge Catholic Cemeter Fraule J. Maloney. Undertaker .
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH. Hauttrop, mass, Saff- 20cm 1900
Name and age of deceased,
years.
Date and place of death,* Dypt- 20 01900, Hinter of Mass, Hice Born.
Chief cause,
Disease
Contributing cause, ......
Chief cause.
Duration Contributing cause,
I certify that the above is true, to the best of my knowledge and belief.
Name and residence } of physician, fot of D Dormay 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 i 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.
mass,
Female.
1
Divorced.
Widow of
O Brien Residence Winthrop Mass
Birth
Commonwealth of Classachusetts.
No. 45
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.)
Name,
Catherine Trines Foster
Sex,
Color,
Date of Death,
Defetember 26" 1900
;
Age,
83 Years,
11
Months, 12 Days.
Maiden Name, { If married, widowed ) Catherine Vinner
or divorced.
Husband's Name, Eden Burroughs Foster
Single, Married, Widowed or Divorced, Widewed Occupation, at Nome
* Residence, { If out of town, } ¿ also state fully.
Lowell Mare
Place of Birth, Highland
*Place of Death,
Cheque
Name of Father, Oranel
Pinner
Birthplace of Father,
Maiden name of Mother, Eunice Hough
Birthplace of Mother, ....
Place of Interment, (Give name of Cemetery),. Lowal Ivass
Sunner Floyd
Dated at
Signature and
19.00
place of business of Undertaker.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Cart. P. Farten
Age, 83 5. 11 N 12 D.
Place and Date of Death, #
died at
Highlands, Mass. 189
Disease or Cause of Death, §
Pamaty vw
Duration of sickness,
a year or more.
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
Certifying Physician.
21 Finnas St-Lamal Mas.
1900
Date of Certificate,
september 29
FSg
Give also street and number, if any.
t Or sex of infant not named. If still-born, so state. # If child died immediately after birth, so state.
§ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
M. D.
on Sejet 26"L
I tanover N.A.
.
No. RETURN OF THE DEATH
OF
at
Date,
189
.
Filed,
189
/
The provisions of chapter 444 of the Acts of 1897 require that every houseliolder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred. (Sce section 6.)
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. (Sec section 7.) Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. (Sec section 8.)
A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts. (See section 10.)
Penalty for refusal or neglect, ten dollars. (See section 11.)
Any person having charge of the funereal rites preliminary to the interinent of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[7-'00.37-XX M.] 220 46
Permit No.
RETURN OF DEATH. BOSTON.
Date of death
Year, 1900 Month Sepet Birth
Year, 1882
Years, 18
Month, July, Age 3 Months, 2 Day,. 28 Day, 1 John J. Sonovou Residence, ..
Days,
27
Crest are.
Name in full, Maiden name, Male.
Sex Conjugal condition
Female.
Single. Married. Widowed. Divorced. Widow of
Color
White. Black (Negro or mixed). Indifin. Chinese. Japanese.
Wife of.
Place of death Street, Great Que.
Place of birth,
Number, East Baslow
Occupation, Name of Father, Diivan 2.
Maiden Name of Mother, Mary a. Harrington
Birthplace of Father, Ireland Birthplace of Mother,
Ibland
Place of interment, .. Holy Gravs" Malden
Thos. I have.
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, 4x128 190 ℃.
Name and age of deceased, John f. Donovan Age. 18 years.
Date and place of death, *. De01 281400 Greelano
Disease Chief cause,. Cappendicitis
Contributing cause,. Lepli: Peritonitis
Chief cause ... 6
Duration Contributing cause .. 2 days
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ) I france get
of physician, "losillerde au V/ 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 : - Saturdaya, 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.
Commonwealth of Massachusetts.
No. 47
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.)
Name,
Luth Mabel Cleveland
Sex, F .Color,
Date of Death,
October 2"1900 xo; Age, ~ Years,
6 Months, 24 .Days.
Maiden Name, {If married, widowed ) or divorced.
Husband's Name,
Single, Married, Widowed or Divorced, / Occupation,
*Residence, {If out of town, )
Hanthrop Mars
? also state fully.
·
Place of Birth,
24 atlantic St
*Place of Death,
24 atlantic Street
Name of Father, William a Cleveland
Birthplace of Father, Somerville mass
Maiden name of Mother, Marie I, Jordan
Birthplace of Mother,. Charles Com mass Darthrap Cemetery
Place of Interment, (Give name of Cemetery),
Dated at .. Winthrop
Summercloud
on October 3"19W x58
Signature and place of business of Undertaker.
Winstrol Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Ruth Mabel Clealand Age,
.Y. 6 M. 24 D.
Place and Date of Death,# died at Bunchof Mass. Och. 2ª 1900 .189-
Disease or Cause of Death, §
Broncho-pneumonia
Duration of sickness,
Atour one month
I certify that the above is true to the best of my knowledge and belief.
Albert Vo. Somman
M. D.
Signature and Residence S of Certifying Physician. 1)2 Winthrop St., Mutton,
Date of Certificate,
Och HIX
100.
.189 -.
Give also street and number, if any.
t Or sex of infant not named. If still-born, so state. { If child died immediately after birth, so state.
§ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
-
No.
RETURN OF THE DEATH
OF
at
Date,
189
Filed,
189
The provisions of chapter 444 of the Acts of 1897 require that every householder in whose house a death oceurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death oeeurred. (Sce section 6.)
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. (See section 7.) Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. (Sec section 8.)
A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required faets. (See section 10.)
Penalty for refusal or neglect, ten dollars. (Sec section 11.)
Any person having charge of the funereal rites preliminary to the interinent of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the faets required by section 1, to the board of health or to the clerk of the city or town in which the death oceurred.
Commonwealth of Massachusetts.
No.
48
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
Name,
Bertha appleton Stewart
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Sex,
Color,
Date of Death,
Detaber 13 "19985 ; Age, Years,
Months, 13 .. Days.
Maiden Name, or divorced.
Husband's Name,.
Single, Married, Widowed or Divorced
Occupation,
*Residence, { If out of town, }
¿ also state fully. §
Mittway, Mass
Place of Birth,
Sea New Street (Thondin Station)
12
*Place of Death,
1,
Name of Father,
John G. Stewart
11
Birthplace of Father,
Cambridge Mass
Maiden name of Mother,
Bertha Mr. appellen
Birthplace of Mother,
Chelsea mass
Place of Interment, (Give name of Cemetery), Mirthrop Cemetery (Children got)
Summer Floyd
on Octobre 1 3 . 19 00
place of business
of Undertaker.
Ot introje mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
died at . withop. oct 13 18000
Disease or Cause of Death, §
Diphtheria
Duration of sickness,
3 days
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
Bit Metcalf
M. D.
Certifying Physician.
52 Winthrop St
Date of Certificate,
Get 15
189 80
Give also street and number, if any.
+ Or sex of infant not named. If still-born, so state. If child died immediately after birth, so state. § If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Bertha appre con Stuart
Age,.
M./ D.
Dated at
Signature and
No.
RETURN OF THE DEATH
OF
at
.........
Date,
189
.
Filed,
189
The provisions of chapter 444 of the Acts of 1897 require that every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred. (See section 6.)
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. (See section 7.) Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. (Sec section 8.)
A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts. (See section 10.)
Penalty for refusal or negleet, ten dollars. (See section 11.)
Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death ocenrred.
FORM C.
Commonwealth of Massachusetts.
No.
49
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.)
Name,
Emily Smith.
Sex,
Color,
26
Date of Death,
deloter 26"
190 0 ; Age, ..
Years, Months, Days. This
Maiden Name, { If married, widowed ) or divorced.
(
1
3
Husband's Name,
-
Single, Married, Widowed or Divorced,
Occupation,
18 Sagamore avenue H. Highlande
*Residence, ¿ also state fully.
§ If out of town, {
Place of Birth, "i 11 "
*Place of Death,
11
11
albert Smith-Brooklyn NY.
Name and Birthplace of Father, Many H, Holhook -Queinnato, Maiden Name and Birthplace of Mother, Greenwood Cemetery A.M.
Place of Interment, (Give name of Cemetery), Summer Floyd
Dated at
It cultural
Signature and
on
October 26"
190 0
place of business }
of Undertaker.
Minisirop (quase
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Emily Smith
Age,
Y.
. ...
M.
9/24 D.
Place and Date of Death,
died at
18 Lagamine av.
Clev 2.6
1900.
Disease or Cause S
of Death, #
Secondary,
Primary,
Congenital Cardiac Disease Duration, Duration,
I certify that the above is true to the best of my knowledge and belief. .
signature and Residence §
of
M. D.
Certifying Physician. 1
Date of Certificate,
7
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 Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
.......
28 Laralogan 23
.
No.
RETURN OF THE DEATH
OF
it
........
Date,
190.
Filed,
190
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death oceurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in whieli a death oceurs, shall, within five days after the date of sueli a death, give notice thereof to the board of health or to the elerk of the city or town in which the death occurred.
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 who has attended a person during his last illness shall forthiwith after the death of said person, upon request, furnish for registration a certificate setting forthi the required faets.
SECTION 11. In ease the deceased was a soldier 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. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with seetion 10, and return it, together with the facts required by seetion 1, to the board of health or to the elerk of the eity or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a eity or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the elerk of the eity or town for registration.
SECTION 5. Penalty for violation not exceeding fifty dollars.
FORM C.
No 2× 50
Commonwealth of Classachusetts.
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.)
Name,
May francis Call
Sex,
Color,
Mert
Date of Death
22 0v. 4"1900
7900: Age,
26 Years,
/
.. Months,
18
Days.
Maiden Name,
§ If marricd, widowed !
Mary Francis Stall
or divorced.
Husband's Name, serge It Coff
Single, Married, Widowed or Divorcet. Occupation,
§ If out of town, { 24 Shiver & Week
*Residence, { also statc fully. )
Place of Birth, Halifax 1H &
*Place of Death,
24 Sprity Lt
Name and Birthplace of Father, ... James ce Stall Nova Scotia
Maiden Name and Birthplace of Mother,
Place of Interment, (Give name of Cemetery),
Sumer Floyd
Datcd at.
on October 3 19000
Signature and place of business of Undertaker.
Minutiop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
mary Francis Cobb
Age, 26 Y/
M.18
Place and Date of Death, dicd at 190 24 Shirley St. Carcinoma Ateri Duration, 2yrs
- Primary,
Disease or Cause of Death, } Secondary,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
P. J. Metcalf
M. D.
Certifying Physician.
52 Winshop St
Date of Certificate, Y W.4 1900.
* 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 Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Mary me neile Ana Partia
No.
RETURN OF THE DEATH
OF
at
Date,
190
Filed,
190.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
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 deatlı. SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forthi the required facts.
SECTION 11. In case the deccased was a soldier 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. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of healthi or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a eity or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
SECTION 5. Penalty for violation not exceeding fifty dollars.
FORM C.
Commonwealth of Classachusetts.
No. 51
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.)
Name,
James Gradford Free
Sex,
Color,
Date of Death,
8
190 0; Age,.
80 Years,
~Months,
Days.
Maiden Name, { If married, widowed ) or divorced.
Husband's Name,
-
Single, Married, Widowed or Divorced,
Occupation,
Lumberman
*Residence, { If out of town, )
¿ also state fully. $
1+3 main Street
Place of Birth,
Concord Mars
*Place of Death,
Winthrop, 43 Mann SI
Name and Birthplace of Father,
Nathan Lee, Pittston She
Maiden Name and Birthplace of Mother,
Rebecca Puffer , Unknow
Harthrop Cemetery
Place of Interment, (Give name of Cemetery),
Dated at Winthrop
Summer Floyd
on
november que
190 O
Signature and place of business of Undertaker. Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Ldicd at .
Leurility neste Hydrollogan Duration,
Duration,
I certify that the above is true to the best of my knowledge and belief. -
Signature and Residence S of Certifying Physician.
2
9. SIchiudere, M. D.
Thinking, 7/2021.
Date of Certificate, .00 10 190J.
* 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 Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
--
Disease or Cause of Death, # Secondary,
Primary,
Siamo Bradford de
Age, So
Y. - M. - D.
tov 8- 1900.
No.
RETURN OF THE DEATH
OF
at
Date,
190
Filed,
190
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.] .
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, withiu five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
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 who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier 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. Any person having charge of the fuuereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried iu a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith conntersign and transmit the same to the clerk of the city or town for registration.
'. I.dime and semaine fifty dollars.
[Form No. 37.]
2.52
RETURN OF DEATH.
BOSTON.
Year, .. 1900.
Year, 182%.
Years, 79.
Date of death -- Day, 13.
Mouth , Aov. Birth
4. 1. Day, 12. Days, Name in fuit, Colmer Co. Gold
Maiden name,
Male.
Sex Conjugal condition
Forrale.
Stugte. Married. Widowed. Divorced. Willow of. South ave. C -
Wife of
Place of death
Street,
Number,
Place of birth,
Occupation,
Blackemite Graiden Name of Mother,
Name of Father,
Birthplace of Father, A.d.
Birthplace of Mother,
A.e.
Place of interment,
y Brown.
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Minitrop Nov. 13' Boston, 1900 ..
Name and age of deceased Johnes O. Sold Age, 79 years. Date and place of death, For:13' 1900# of Soulte ave Minthuy Carmona of stomach & liver.
Disease Chief cause,.
Contributing cause, edage.
Chief cause .. Six months ?
Duration Contributing cause,
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ? of physician,
Bur Jord's Metcalf. -1
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.
Permit No.
- Month, July
Age & Months, .. -
Residence, White. Color - Black (Negro or moved):" Indian. Chinese. Japanese:
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.)
Name,
Dorothy Soule (Still Run Anfait) Sex, 7
While
Color,
Date of Death,
Decenter. 5 "
1900 ; Age, L Years, V Months, V .Days.
Maiden Name, { If married, widowed ) or divorced.
Husband's Name,
-
Single, Married, Wideved Or Divorced,
Occupation,
*Residence, { If out of town, )
112 Winthrop Street-
also state fully.
Place of Birth,
11
11
7 /
*Place of Death,
11
Name and Birthplace of Father,
Horace Q, Bruce Buckefort me
Maiden Name and Birthplace of Mother,
M. deah Cool tcharlottetin P&co.
Place of Interment, (Give name of Cemetery),
Hinttrope Cemetery
Dated at
Minitrop
Summer Floyd
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.