USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1904-1906 > Part 14
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
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 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 occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in 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 countersign and transmit the same to the clerk of the city or town for registration.
4.'04.37. LM.]
Permit No ..
RETURN OF DEATH. BOSTON, MASS.
Name in full, Kate 6 Temps
Orate & Dexter - Angraham tempton
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Female Color, White Condition, Married
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, 40 Years,~ Months. Days.
Occupation,
Otousenfe
Residence, 17 Beal Street
Ward,
Place of Death, annex B 52 Winthrop Steel
(State year, month and day.)
Place of Birth,
Date of Birth, Sejet 11 "1864
Name and Birthplace of Father,
John a. Derfler Overa Sortia
Maiden Name and Rate Syra Nova Scotia
Birthplace of Mother,
Place of Interment,
It inthe Cemetery Winthrop Was
Summer Ofloyd
Undertaker. 18 Herman Sweet
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, ..
June 5" 1905.
Name and Age Pale 6. Exempelin of Deceased,
Age, 40 years.
Date and June 4. 1905-anney to 52 Winthrop Sweet
Place of Death,*
Chief cause,.
Embolismo of mesenteric artery
Disease Contributing cause,
Chief cause, 4 days
Duration Contributing cause,
I certify that the above is true to the best of my knowledge and belief.
Name and Residence )
of Physician,
C. Johnson.
M.D.
* If an institution, state how long an Inmate and previous residence.
Date of Death,
une 4 " 1905
C
[4.'04.37-LM.]
Permit No. ......
RETURN OF DEATH. BOSTON, MASS.
Same 5,05
Name in full,
Soacha Finnegan
(If a married ør divorced woman give maiden name, also name of husband.)
Sex, Color,
Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, Years, 6 Months, 14 Days. Occupation,
Residence Pear 26 Sunnyeste VE.
Place of Death,
Samir
Place of Birth,
Boston.
Date of Birth,
2 David A.
Boston
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Place of Interment,
many Of Coughlan
Drew Calvary
Choroby
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
1900-
Name and Age ) of Deceased,
bauchh Finchegan Age6mm years 14 des
Date and Place of Death,* Primona
Chief cause, .
Disease
Contributing cause, one week
Chief cause, One week
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.
21
Date of Death,
Ward, 1
(State year, month and day.)
[4.'04-37.L.M.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Name in full,
(If a married or divorced woman give maiden name, also name of husband.)
Sex,
male
Color White
Condition, Nidoned (Single, Married, Widowed or Divorced.)
Age, 68 Years, 7 Months,
Days.
Occupation,
Residence, auburn Name
Ward,
Place of Death, my Pauline Street Handhope Mass
Place of Birth, Wrathtert me Date of Birth, Oct 29 " 1836 Jonathan Pendleton - (England)
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Place of Interment, ......
Bunce Dunkmate- (England)
Belfast Marie Summer Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, .. Printerop Mas Que-1905.
Name and Age ? nathan E. Pendleton
Age, 68 4 years. Y mas
of Deceased,
Date and June 6, 1905: 1077 Pauline St, fructul
Place of Death,* Chief cause,. Gastric Harmorrhage.
Disease - Contributing cause, Gastric Ulcer
Chief cause, 2 days
Duration
Contributing cause, .
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ) of Physician, 1
ICHruwan. M.D.
* If an Institution, state how long an Inmate and previous residence.
122022
une 6"1905
Date of Death, @Valhan E, Pendleton
(White, Black, Mixed, Chinese, Indian, etc.) Shoemaker
(State year, month and day.)
.'04.37. L.M.]
Permit No.
RETURN OF DEATH.
Winthrop BOSTON, MASS.
June Burgos
Vame in full,
Date of Death, Serge D. It yanda
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Male Color White .Condition, Widener (Single, Married, Widowed or Divorced.)
(White, Black, Mixed, Chinese, Indian, etc.)
Age,
81 Years, 11 Months, 18 Days.
Occupation, Retired
Residence, Car Shirley and Dass Ste Ward, Place of Death,. 11 11
Place of Birth,
Point Shirley Date of Birth,
(State year, month and day.)
Vame and Birthplace of Father,
Elchane Htyman-Billerica mas Maiden Name and Many Jeustury- Deu deland
Birthplace of Mother, S Place of Interment,
Winthrop Cemetery
Summer@Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, .. June 9" 190 5.
Vame and Age ) of Deceased, SengeOr. Olyman
Date and
June 8" 1905-Cor Shirley and Ceros Sts
Place of Death,*
Chief cause, ..... Coronavirus Ochervas
Disease V
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, 5 Personel call M.D.
* If an institution, state how long an inmate and previous residence. 2
21
Age, 81 .years.
4.'04.37. LM.]
Permit No.
Winthrop
RETURN OF DEATH. BOSTON, MASS.
Date of Deaths.
June 8h 1905
Name in full, Elizabeth Hasson
Elizabeth Hasson- John Hasson (If a married or divorced woman give maiden name, also name of husband.)
Sex Female Color,
Condition, (White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.)
Indian, etc.)
Age, 67 Years, 11 15 Days. Occupation,.
Residence, 10 Fair View
Place of Death, 10 Fair View
Ward, -
Place of Birth,
Meland
Date of Birth,
Name and Birthplace John Hasson - Ireland
of Father, Maiden Name and Birthplace of Mother,
Mary Mullen- freland
Place of Interment,
Holy Cross Malden
M. J. Kelly
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Boston, June 8℃.
Name and Age Elizabeth Hasson
Age,
6%
years.
Date and June 8" 1905. 10 Fair View
Place of Death,? "
Chief cause, apoplex cy
Disease-
Contributing cause, ...
Chief cause, 5 months
Duration Contributing cause,.
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ? Himmel call
M.D.
of Physician,
* If an institution, state how long an Inmate and previous residence.
21
1903
of Deceased,
(State year, month and day.)
4-'04-37. LM.]
Permit No.
RETURN OF DEATH.
BOSTON, MASS.
Name in full, Job S, Duran
Date of Death,
June 13"1905
(If a married or divorced woman give maiden name, also name of husband.)
Sex,
male
Color,
White
(White, Black, Mixed, Chinese,
Indian, etc.)
(Single, Married, Widowed or
Divorced.)
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
Christie a Spiller
Registered No.
97
Place of
Miteal Hospital
Death *
Residence
292 Washington ave ChelRed
67
years ..
1
months.
days
STATISTICAL DETAILS
SEX
Female White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť me teau
HUSBAND'S NAME + leharlend Spiller
BIRTHPLACE # Sidney bake Britter
NAME OF
FATHER
Donald Mc Bean
BIRTHPLACE OF FATHER# Scotland
MAIDEN NAME
OF MOTHER
Christine Campbell
BIRTHPLACE
OF MOTHER #
Scotland
OCCUPATION Housewife
INFORMANT § Huskand
PLACE OF BURIAL OR REMOVAL I
lem
DATE OF BURIAL
UNDERTAKER
ADDRESS
let Faunae le hetera
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. 6 4th 1904- that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary : Compania Direction of amble
.(DURATION) DAY8
Contributory :
Tetanus
.(DURATION) . DAYS
(Signed)
B76 Metcal
M.D.
Dama 11th 190.
Para
.(Address)
SPECIAL INFORMATION only for Hospitais, Institutions, Transients, or Recent Residents.
How long at
Piace of Death ? 7 day years months days
Where was disease contracted, Su von Areva Carrera Pan
If not at place of death ?.
Filed
190
Clerk
* City or town, street and number, if any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special information." If In a Hospital or Institution, give its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country; also city, town or county, If known.
§ Name and address of person giving statistical details. Il Name of cemotery.
Condition, Married
Winthiof
Date of l
Same 11
190 3
Death
COMMONWEALTH OF MASSACHUSETTS
Wirthund (CITY OR TOWN.)
RETURN OF A DEATH
FULL NAME
Christie à Spille
.Registered No. 97
Place of
Miteal Hospital
Death *
Residence
292 Washington Que Chelsea 67
.- years ..
.months ... .... .days
STATISTICAL DETAILS
SEX
COLOR Female White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME + Me Peau
HUSBAND'S NAME + Charlene Spiller
BIRTHPLACE # "Sidney bake Britta.
NAME OF FATHER Donald Mc Lean
BIRTHPLACE OF FATHER# Scotland
MAIDEN NAME OF MOTHER Christine Campbell
BIRTHPLACE OF MOTHER # Scotland
OCCUPATION
INFORMANT § Huskand
PLACE OF BURIAL OR REMOVAL !! Woodlawn Everett
DATE OF BURIAL
Price/4/0 5
UNDERTAKER
ADDRESS
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. 4th 1906 to 6) a 11h905, that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary : Compania Direction of ankle
(DURATION) DAYS
Contributory : Detonnes. ....
.....
(DURATION) DAYS
(Signed)
B76 Metcal
M.D.
Jan 14 90.
... (Address).
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at Place of Death ? 7 day years
months days
Where was disease contracted, Heron Aveva Carrera Pan If not at place of death ?
Filed
.190
Clerk
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # State or country ; also city, town or county, If known.
§ Name and address of person giving statistical detalls. || Name of cemotery.
Date of l Same 11 190 3
Death
[-'04.37. LM.]
Permit No.
RETURN OF DEATH.
BOSTON, MASS.
Name in full,
Date of Death,
S/ob S, Durant
June 13"1905
(If a married or divorced woman give maiden name, also name of husband.)
Sex, male Color White
Condition, Maria
(Single, Married, Widowed or
Divorced.)
Age, 04 Years, Months, Days.
Occupation,
Residence, Winthrop Mass Ward,.
Place of Death, 20 Perece Sheet
(State year, month and day.)
Place of Birth, Borcherter Congland Date of Birth,
Name and Birthplace ) of Father, Maiden Name and ? Birthplace of Mother, S Place of Interment, ..
aree Durand (England)
Undhomme
(England)
Minttuof Cemetery
Juniner Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Doston
June 13
1905
Art S. Durant
Name and Age of Deceased, Date and June 13 "1905-20 Percre Street
Place of Death,*
Chief cause, .. Locomotor alexia with. General Paresis
Disease ‹
Contributing cause,
Chief cause,
2 yes
..... Duration Contributing cause, ......
I certify that the above is true to the best of my knowledge and belief.
Name and Residence } 631 Mel call
of Physician,
* If an Institution, state how long an Inmate and previous residence.
untho mass M.D.
2:
Age, 54 years.
(White, Black, Mixed, Chinese,
Indian, etc.)
Parlée
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME
Susce Coleman mack.
Registered No.
99
Place of Death *
54 whenthop 2X
Date of Death
June 15mm
Age
36
. years
-
months
.days
STATISTICAL DETAILS
SEX Female COLOR
SINGLE, MARRIED, WIDOWED, OR" DIVORCED
MAIDEN NAME T
Juste Coleman
HUSBAND'S NAME +
Patrick & mach
BIRTHPLACE #
Ambert mars
NAME OF
FATHER
mathew Baleman
BIRTHPLACE
OF FATHER#
Ireland
MAIDEN NAME
OF MOTHER
Ann Gleason
BIRTHPLACE
OF MOTHER +
Theland
OCCUPATION
House work
INFORMANT § Husband
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. xml 7 190 5 to true 15 1905 that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary : operation on uterus
Contributory :
Haemovitale
(DURATION)
. DAY &
(DURATION)
2
. DAYS
(Signed)
31 Miel call
M.D.
1
ml.15
190.2 ... (Address).
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
Former or
Usual Residence
How long at
Place of Death ?
Days
Whore was disease contracted, If not at place of death ?
Filed
.190 ...
Clerk
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of married or divorced woman, or widow.
# State or country ; also city, town or county, If known.
§ Name and address of person giving statistical details. [] Name of cemetery.
PLACE OF BURIAL OR REMOVAL II
Holywood
DATE OF BURIAL
.... 190
ADDRESS
UNDERTAKER FI waterman com
2526 washington Boston
45
[4.'04.37-L.M.]
Permit No.
RETURN OF DEATH. Winthrop BOSTON, MASS.
Date of Death, June 2320 1965
Name in full, Stelton me Carthy
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Female
Color, White
Condition,
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.)
Indian, etc.) Fathers
Age, Years,~Months, .... Days. Occupation,
Residence, 4/ Main Lt Ward,
Place of Death,
54 Winthrop It
Place of Birth, Winthrop mary, Date of Birth,
(State year, month and day.)
Frank D. M. Carthis
Boston
many . Donovan Tast Boston
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Place of Interment, Hast Boston bemiting M. J. Kelly. Undertaker
49 Warrick Agp. E. Boston.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
(Femali).
Boston,
my 23
190 5
Name and Age)
of Deceased,
Date and
Place of Death,*
Chief cause, Premature forth
Disease -
Contributing cause,.
Chief cause, süll bom 1 Duration Contributing cause,
I certify that the above is frite to the best of my knowledge and belief.
Name and Residence ? (31 med call
of Physician,
* If an institution, state how long an Inmate and previous residence.
withonly .... M.D.
21
- Imccarthy
Age, ... years.
[4.'04-37.LM.]
Permit No.
RETURN OF DEATH. Thrithe BOSTON, MASS.
Name in full,
Date of Death, Victor D. Curry
June 26"1905
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Male Color White- Condition, Married
(White, Black, Mixed, Chinese, Indian, etc.) Shipper
(Single, Married, Widowed or Divorced.)
Age, 37 Years, 10 Months,. 4 Days. Occupation,
Residence, .. 4. Read Steel Winthrop Ward,
Place of Death,.
Read Street Hintnos,
Place of Birth, Windsor O. S.
(State year, month and day.)
Date of Birth, aug 22"1867
Devi Curry, etalmonth Of, S.
Mary De Href = Cmmallis et. 8
Summer Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Clinttrop Boston, ... June 27 " 190.5.
Name and Age of Deceased, Victor DO. Cung ~ Age,. 37 years.
Date and June 26" 1905- Read Street, Spinthrop, Place of Death,* Chief cause, manca
1 Disease -
Contributing cause, .. Schtic Endocardial
Huawebons
Chief cause, Ten days
Duration
Contributing cause, few hours.
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ) of Physician, 1
M.D.
· if an Institution, state how long an inmate and previous residence.
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Place of Interment,
[4.'04-37.L.M.]
Permit No.
RETURN OF DEATH. Thrithe BOSTON, MASS.
Name in full,
Date of Death, Victor D. Cuny
June 26"1900
..... ....
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Male Color While- Condition, Married
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.) 1
Age, 37 Years, 10 Months,. 4 Days. Occupation,
Residence,. 4. Read Steel Minttuop Ward,
Place of Death,
4 Read Street Shirtnay,
(State year, month and day.)
Place of Birth, Hinder Or. S.
Date of Birth, aug 22"1867
Jevi Curry, etalmonth Of, S.
Name and Birthplace ) of Father, Maiden Name and Birthplace of Mother, ) Place of Interment,
Summer Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Clinttrop Boston, ... June 2 190.0.
Name and Age ) of Deceased, Victor DO County - Age, 37 years.
Date and June 26" 1905 -" Read Street, Sintho), Place of Death,* Acute bobas Pneumonia
Chief cause, ..
Disease -
Contributing cause, Static Endocardial
Huawebons
Chief cause, Ten days
Duration
Contributing cause, few hours,
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ) of Physician, 1
M.D.
· If an Institution, state how long an Inmate and previous residence.
21
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
1 Theodore +
Buck
FULL NAME!
Place of l
Death *
5
72 Creat ine
Residence
lemuria mass
Age
6H
years
months.
th .... 6 .days
STATISTICAL DETAILS
COLOR
ihale Habite
1
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť
HUSBAND'S NAME +
BIRTHPLACE Buckshort 18.
NAME OF
FATHER
David Buck
BIRTHPLACE
OF FATHER$
MAIDEN NAME
OF MOTHER
Mary Bradley
BIRTHPLACE
OF MOTHER $
Buckshock THE
OCCUPATION
Funder dealer
INFORMANT §
.
PLACE OF BURIAL OR REMOVAL II
DATE OF BURIAL
UNDERTAKER
ADDRESS
PHYSICIAN'S CERTIFICATE
| HEREBY CERTIFY that I attended deceased during last 11 illness, from. 1903 .. to July . 190 .... , that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
Paralysis
2/2 / (DURATION).
Contributory :
ap operatie allack
. DAYS
(Signed) .M.D. pily/ 3 1905 (Address). 18, Coletul
SPECIAL INFORMATION only for Hospitais, institutions, Transients, or Recent Residents. How long at Place of Death ? years ...... ....... .. months .. ..... ..... days
Where was disease contracted, if not at place of death ?.
Filed
1
...
Clerk
* City or town, street and number. If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special information." If In a Hospital or institution, give Its NAME Instead of street and number.
t În case of married or divorced woman, or widow.
# State or country; also city, town or county, If known.
§ Name and address of person giving statistical details. Il Name of cemetery.
C.
Registered No.
Date of ¿ July 11
190J
Death
v
47 July Petites
[4.'04-37.L.M.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death,.
ily 25"1905
Name in full, Minné Cselon Sullivan
(If a married or divorced woman give maiden name, also name of husband.)
Sex, ofemale
Color
‘Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, C Years, Months, 12 Days. Occupation,.
Residence,
Mass Ward,
Place of Death, 33 Read Blivel
Place of Birth, Winthrop Masz Date of Birth,
(State year, month and day.)
Name and Birthplace ? of Father,
Daniele, Sullivan South Boston
Maiden Name and Florence Su, Davis-Dorchester
Birthplace of Mother, S
Place of Interment, .. Winthrop Cemetery
Summer Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Boston, July 24' 1905
Name and Age of Deceased, Minnie Evelyn Sullivan Age, 12 year Days
Date and July 25" 1905 - 33 Read Street
Place of Death,*
Chief cause,. Haemophilia
Disease - Contributing cause,
Chief cause, Two days
Duration Contributing cause, Twelve days
I certify that the above is true to the best of my knowledge and belief. Name and Residence ) of Physician, 1
M.D.
* If an institution, state how long an Inmate and previous residence.
49
[4.'04-37. J.M.]
Permit No. 50
RETURN OF DEATH. Winthe BOSTON, MASS.
Name in full,
Date of Death, Stilton Infant (Johnson)
July 25 "1905
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Female.
Color, While Condition,.
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, ...
Years, .. Months,
.Days. Occupation,
Residence,
Hinttrop Mass
Ward,
Place of Death, 54 Winthrop Rd ( metcal Stospecial)
Place of Birth, Metcalf tespital Date of Birth,
(State year, month and day.) July 25'19.05
John J. Johnson
Tomay
Maiden Name and Birthplace of Mother,
Name and Birthplace
of Father,
Par
arma
Orange noway
Place of Interment,
Hintenop Cemeter Winthrop mas
Summer Flera
Undertaker 18stemmen Del
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
(female.)
Name and Age } of Deceased, Jamison
Date and
Place of Death,*
Chief cause, .. Premature, Still born
Disease Contributing cause,. not Khimm
Chief cause,
Duration Contributing cause,
I certify that the above is true to the best of my knowledge and belief.
Name and Residence I 31 met calf M.D.
of Physician, 5
* If an Institution, state how long an inmate and previous residence
Boston, tiny 25 1905.
Age, ~ years.
[4-'04-37.LM.]
Permit No. 54
RETURN OF DEATH.
BOSTON, MASS.
Date of Death,
July 20
Name in full, edward tales
(If a married or divorced woman give maiden name, also name of husband.)
Sex, .. male Color While
Condition, Single
(Single, Married, Widowed or Divorced.)
Age, 72 Years, 6 Months, ~Days.
Residence, Winthrop mars
Ward,
Place of Death, 22 Summit avenue- Highlands
Place of Birth, Ina Scolía
Date of Birth,
Name and Birthplace ? of Father,
John Sales - amherst Nova Partia
Maiden Name and Elizabeth Saving - Congland
Birthplace of Mother, Winthropo Cemetery
Place of Interment,
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Trinetrop July 24" Boston, /
190.5.
Name and Age ? Kodmand tales
of Deceased,
Age, 72 years. 6m2
Date and July 25"1905-22 Summit avenue Place of Death,* S r Chief cause,. Cancer Stronach Disease 2 years Contributing cause,.
Chief cause, 1
Duration Contributing cause,
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ). of Physician,
31 Met calf- M.D.
* If an Institution, state how long an Inmate and previous residence.
>21
(White, Black, Mixed, Chinese, Indian, etc.) Occupation, Sovielor
State year, month and day.)
-
4 . 9
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH Estar Nuittural Taylor
(CITY OR TOWN.)
FULL NAME
Place of
View De Que an Wundert
Date of l Death )
.Registered No .. July 27 190 5
.months
25 .days
STATISTICAL DETAILS
SEX
male
COLOR
White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť
HUSBAND'S NAME +
BIRTHPLACE #
Nenthol mas
NAME OF FATHER Frederick / H, Taylor
BIRTHPLACE OF FATHER៛ Cehelica maso
MAIDEN NAME OF MOTHER Florence . E - Thomas
BIRTHPLACE OF MOTHER+
OCCUPATION
INFORMANT §
fischer Mother
-
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from ... July 27 1903 .... to .190.
... that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows : Primary : Enteritis
(DURATION)
4.
.DAYS
Contributory :
(DURATION). DAYS
(Signed).
H.S. Partir
M.D.
Fancy 28 1900 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at Place of Death ? . years
..... months. days
Where was disease contracted, if not at place of death ?
Filed
.190
Clerk
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL
July 29
1905-
UNDERTAKER
ADDRESS
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of marrled or divorced woman, or widow. # State or country; also city, town or county, If known.
§ Name and address of person giving statistical detalis. Il Name of cemetery.
ALL NAMES TO BE IN FULL
Death *
5
Residence
2
.Age XI ... years.
48
[4.'04-37. LM.]
Permit No ..
52
RETURN OF DEATH. Minthe BOSTON, MASS.
Date of Death,
July 27"1905
Name in full, gnes @ Lavoir
(If a married or divorced woman give maiden name, also name of husband.)
Sex, Female.
Color Orhite Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, .. 7 Years, 3 Months, 12 Days. Occupation, ..
Residence, Winthrop mass -Ward,
Place of Death, 4, Oakland Steel
(State year, month and day.)
Place of Birth,
Winthrop Waes Date of Birth,
Joseph Favorit - Canada
Name and Birthplace ) of Father, Maiden Name and Birthplace of Mother,
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.