USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1904-1906 > Part 21
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Name and Age ?
May 20, 1906 20.66
1
€
A
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME
Perley a Worse
Registered No.
Place of Death *
20 Cottage Park Road, Winthrop
Date of Death
May 28, 1906
Age
24
. years
7
.months
18
.days
STATISTICAL DETAILS
SEX
male
COLOR
white
SINGLE, MARRIED, ,
WIDOWED, OR
DIVORCED
single
MAIDEN NAME + HUSBAND'S NAME +
BIRTHPLACE+
Boston, Mass
NAME OF
FATHER
Edward Perley Worse
BIRTHPLACE
OF FATHER+
Nashua, N.J.
MAIDEN NAME
OF MOTHER
Cecilia Currier
BIRTHPLACE
OF MOTHER+
Sagetown, M.B.
OCCUPATION Clerk
INFORMANT §
Edward P. Worse
20 Cottage Park Road
Whichrop
Filed
190
Clerk
PLACE OF BURIAL
Winthrop, Mass
DATE OF BURIAL
Way
190 6
UNDERTAKER
Albaterman Sous
ADDRESS
Boston
PHYSICIAN'S CERTIFICATE
i HEREBY CERTIFY that I attended deceased during last illness, from no phone argo to
may 28 .190 6, 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 : W.B. Turner christian swantest weather Primary :
daily on toast 10 dans
(DURATION).
1 1/2 jrs
DAY8
Contributory :
(Signed)
Biomedical
(DURATION). DAYS
M.D.
ť
2 ª 1906 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Translents, or Recent Residents.
Former or
Usual Residence
How long at
Place of Death ?
Days
Where was disease contracted, if not at place of death ?
* 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. Il Name of cemetery.
ALL NAMES TO BE IN FULL
Perley A Morte May 28 1906
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH Lathearius Fitpatrick
FULL NAME
Place of Death * 33 JE EMout If Heichrok
.Registered No.
mars
Date of Death
May 28 00- 1906
Age
.. years
months .days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
-
MAIDEN NAME Ť
HUSBAND'S NAME +
BIRTHPLACE # A land
NAME OF FATHER The Fiftypatrick
BIRTHPLACE
OF FATHER+
Irland
MAIDEN NAME OF MOTHER Catherine
BIRTHPLACE
OF MOTHER #
Finland
OCCUPATION Domestic
INFORMANT §
PHYSICIAN'S CERTIFICATE
.to 1 HEREBY CERTIFY that I attended deceased during last illness, from 190. may 28. 190 6, 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 : Pneumonia
(DURATION)
4
. DAYS
Contributory :
nutral regarculation
.(DURATION).
2
. DAYS
(Signed)
310 mil call
M.D.
29/90
.(Address).
5-20 hullof st
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
Former or Usual Residence
How long at Place of Death ? .Days
Where 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. 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.
ALL NAMES TO BE IN FULL
PLACE OF BURIAL OR REMOVAL II Ty Coons base Malden
UNDERTAKER
DATE OF BURIAL Thay 30 1906
ADDRESS 146 Justusa Id.
Catherine Fitzpatrick May 28, 1906,
COMMONWEALTH OF MASSACHUSETTS
ther
RETURN OF A DEATH For
Marks. Registered No.
14 Tico ave Wirelles Duaso
Date of Death
May 2'8 x 1906.
Age.
. years months . .days
STATISTICAL . DETAILS
SEX Boy
COLOR
White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME +
HUSBAND'S NAME t
BIRTHPLACE +
winther Mars
NAME OF
FATHER
gym F. Marks
BIRTHPLACE OF FATHER# Provincetown Mas.
MAIDEN NAME
OF MOTHER
Unna. R. Ryan
BIRTHPLACE OF MOTHER + Calas me
OCCUPATION
INFORMANT § Father
PHYSICIAN'S CERTIFICATE
- HEREBY CERTIFY that I attended deceased during last illness, from June 190 ..... 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 : ried Read in Utero
(DURATION). .DAYS
Contributory :
(DURATION). ... . DAY8
(Signed)
M.D.
Jus 4 190 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
Former or Usual Residence
How long at
Place of Death ?
Days
Where was disease contracted, If not at place of death ?.
Filed
190
Clerk
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL
6
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 married or divorced woman, or widow. # State or country; also city, town or county, If known.
§ Name and address of person giving statistical details. li Name of cemetery.
ALL NAMES TO BE IN FULL
FULL NAME
Place of Death *
Still Born Marks May 28 1906
4 1
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME
Henry Wand Callian
Registered No.
Place of Death *
30 College Park Road
Date of Death
18-106.
Age
58
. years.
10
months
.days
STATISTICAL DETAILS
SEX
male
COLOR
white
SINGLE, MARRIED, WIDOWED, OR -DIVORCED
MAIDEN NAME +
HUSBAND'S NAME t
BIRTHPLACE #
Boston, mas
·
NAME OF
FATHER
Hey ward colin
BIRTHPLACE OF FATHER+ Hull, England.
MAIDEN NAME OF MOTHER mary ann Orton
BIRTHPLACE OF MOTHER +
Coventry , England.
OCCUPATION Copper Smitte
INFORMANT § wife
PLACE OF BURIAL OR REMOVAL II
Woodlawn . Everett, was
DATE OF BURIAL
June 4
190.
UNDERTAKER Ey Grown
ADDRESS
6. Boston
PHYSICIAN'S CERTIFICATE
.to | HEREBY CERTIFY that I attended deceased during last illness, from 190
.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 : mitral Insulfunc
(DURATION).
The year DAYS
Contributory :
(DURATION). DAYS
(Signed)
M.D.
190.2 ... (Address)
52 Winthrop 55
SPECIAL INFORMATION only for Hospitais, Institutions, Transients, or Recent Residents.
Former or Usual Residence
How long at
Place of Death ?
Days
Where 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 detalls. I{ Name of cemetery.
-
1 - -
ALL NAMES TO BE IN FULL
-.
.....
.
Mary A. Sampson June 3, 1906.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME gare
whB Passons
Registered No ..
Place of Colonial In Shirley State of
Death *
5
Residence
Best
mass
Age
78
years ..
2
.months.
27
.. days
STATISTICAL DETAILS
SEX
Male
COLOR
White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Married
MAIDEN NAME Ť HUSBAND'S NAME t
BIRTHPLACE #
nort milton Mass
NAME OF FATHER
Samuel Parsons
BIRTHPLACE OF FATHER+ Northampton Mass
MAIDEN NAME OF MOTHER Caroline Russell
BIRTHPLACE
OF MOTHER #
nortman
upton Mass
OCCUPATION State Pensionagent
INFORMANT § Edns WStanding
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL june 7 1906
UNDERTAKER
W. Q. Stakes
0
PHYSICIAN'S CERTIFICATE
1 HEREBY CERTIFY that I attended deceased during last illness, from May 25 1906 to aune 4/ 1906, 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 :
. (DURATION)
11
DAY8
Contributory :
Exhaustion
(DURATION) . DAY8
(Signed)
Edu Vita
€
M.D.
June 4, 1906 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
years.
months.
10
days
Where was disease contracted,
If not at place of death ?..
uncertain
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. Hi Namy of cemetery.
Lass
42Su
ita
ADDRESS West Roth
Death
5
game 4th 190 6
ALL NAMES TO BE IN FULL
Joseph B Parsons Janice 4, 1906,
[4.'04-37-I_M.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, June 8# 1406
Name in full, annie Gross
with of Chas Jums
(If a married or divorced woman give maiden name, also name of husband.)
Sex,. Témala Color,
(White, Black, Mixed, Chinese, Indian, etc.) Condition,
(Single, Married, Widowed or Divorced.)
Age, 41 Years, 3 Months, 29 Days. Occupation,
Residence, 11 Gulman anc Cambridge Mano
Place of Death, 14 Beaux It Wonthey
(State year, month and day.)
Place of Birth, Manchester EnflacDate of Birth,
Name and Birthplace) In Such manchester of Father, Maiden Name and 3 Birthplace of Mother,
Place of Interment,
Oakwood Comely Tivy M1. 4
ER Dann
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
190
Date and Place of Death,*
Chief cause,. Butone Hourmorrhage
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, 5 HE Parter nTes M.D.
* If an institution, state how long an Inmate and previous residence
2 1
Name and Age of Deceased,
Age, 41 years. 2
Annuel Tross. June 8, 1906
1
[3.'06-37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, June 10, 1906
Name in full, Paul Richard Nugent
(If married or divorced woman give maiden name, also name of husband.)
Sex,
male
Color,
White
Condition,
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.)
Indian, etc.)
Age,. Years, 10 Months, 27 Days. Occupation, -
Residence,* 2 b harles 88 Ward,
Place of Death, 8 6 harler RR.
Place of Birth, Roxbury Mars
Date of Birth, July 14,1908
Name and Birthplace \ Mearge R.
Halifax n. 8.
of Father, Maiden Name and Kate @ Sawyer Saca Marine
Birthplace of Mother, Place of Interment, Winchester Cemetery 1X m. White Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Boston, linen, 190 6
Name and Age of Deceased, Paul Richard Augent Age, 10 years.
I hereby certify that I attended deceased from .. 190 , to.
190 , that I last saw ... ........ alive on the. day of. ....... 190,
that ..... died on the. day of. 190 , about. o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of. death was as follows :
Disease
Chief cause, Marcusmano
Contributing cause,.
Chief Cause, .. 6 mar.
Duration
Contributing cause,
M. D.
* If an Institution, state how long an Inmate and previous residence.
anouthe
(State year, month and day.)
Paul Richard Nugent James 10, 1906
1
[4.'04.37-I.M.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, Line 10# 1406
Name in full,
George affet Malson
(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.)
(Single, Married, Widowed or Divorced.) Pattern Maken
Age, 43 Years,. / Months,.
Days.
Occupation,
Residence, 1260 Queen IL Web, Toronto Paraleído 7
Place of Death, 5 trustat Core are Wirtual Mass
Place of Birth, Darkkunet Ing Date of Birth,
(State year, month and day.)
Name and Birthplace ? This Watson
India
of Father, Maiden Name and Many O'Connell Feland
Birthplace of Mother, Place of Interment, Int Hohe Toronto online Le Pidemia
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Leurum 11. 1906 ..
Name and Age? of Deceased, lo. alfred Hatten
Age, 43 years.
Date and Hinetop, June 10. 1906.
Place of Death,* Chief cause,.
Disease Contributing cause,. Interstitive Nephritis
Chicf cause, 10 hrs.
Duration Contributing cause, 18 mor.
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ) of Physician, 5 H.S. Partes M.D.
* If an institution, state how long an Inmate and previous residence.
21
Jeorge Alfred Walow June 10, 1906
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, Name in full, Sarah. Sarah g. Rotelle
(If married or divorced woman give malden name, also name of husband.)
Condition, Info of Haschell Flox (Single, Married, Widowed or (White, Black, Mixed, Chinese, Indian, etc.) Divorced.) 1 Age, 69 Years, > Months,
Residence,* Brooklyn Coun
Place of Death, 18 Trine an wochen mas ":" : 1."
(State year, month and day.)
Place of Birth,
Name and Birthplace ! of Father, Maiden Name and Birthplace of Mother,
Un know-
Place of Interment, Brooklyn
Brooklyn Com
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
. 190 . .
Name and Agc \ of Deceased, Sarah Cax
Age, 69 .years.
I hereby certify that attended deceased from 190 , to .......
190 , that I last sdursstein alive on the .. day of of treatment bout. 150 ,abgut o'clock
science
1 190 .
that. died on the day of
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of death was as follows : Cancer ? Uterus
( Chief cause,
Disease Contributing cause,
Chief Cause, .. 2 yrs
Duration Contributing cause, Bitmetall
* If an Institution, state how long an Inmate and previous residence.
charity brand of statt. M. D.
Sex, Female .Color white
Days. Occupation,
Ward,
Date of Birth, Nw 291833
C. P.a su
2
Sarah J. Cox June 22,1906.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
Winthrop ... (CITY OR TOWN.)
FULL NAME
Albert ...... H ...... Taft ..
Place of )
Death *
Siren, St. Winthrop
Mass.
Residence
Winchester .....
.N.H.
Age
68
. . years.
6
.. months
2
.days
STATISTICAL DETAILS
SEX
Male,
COLOR
White,
SINGLE, MARRIED,
WIDOWED, OR
DIVORCED
Married,
MAIDEN NAME Ť HUSBAND'S NAME t
BIRTHPLACE #
Nelson
N.H.
NAME OF
FATHER
Nathen
Taft,
BIRTHPLACE
OF FATHER#
(unknown ) N.H.
MAIDEN
NAME
OF MOTHER
Achsie Hardy,
BIRTHPLACE
OF MOTHER#
(unknown) N.H.
OCCUPATION
Physician,
INFORMANT § A.A. Taft.
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from may 21st 190 G to May 23d .. 190.6. 7 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 : Several arterio Sclerosis, Cardiac Hypertrophy +dilatation, Chronic nephritis death due to loss of Compensation
(DURATION) .. some years
Contributory :
few hours of final
lacs compensation
.(DURATION)
...... DAYS
(Signed)
Elleringe G. Cutter
.M.D.
June 26
1900 ... (Address)
414 Bercow St
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 1 Winchester N.H.
UNDERTAKER A. L. Eastman.
DATE OF BURIAL
June
6.
190.
ADDRESS
251 Tremont SE
Boston Mais
* 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. li Name of cemetery.
at the Hospital and had reports by telephone
* gave advice frequently since (over
Registered No ....
Date of
Death
1
June
25"
19 06
DE Taft came over in the Same Hleaves witte que prome Liverpool loot september. "He had an ittade facute loss of Cardiac compensation on Board Fit wor thought he might die then. Re rallied however of war following any advice all winter - with how & africe ane acute attack. He went to New York & was under I quiby's cure for a few days Took the Pneumatic cabinet treatment for a short Time Early in may 1906. He was Entitled to die almost any time in fact few moments. Elleridge Y Cutter
214
Willowb
June 25, 1906.
Allery ,
Permit No. ....
[4.'04.37-J.M.]
RETURN OF DEATH. BOSTON, MASS.
June 280 1806
Date of Death,
Name in full, Fany. F. Porch
Ta
(If a married or divorced woman give maiden name, also name of husband.)
Sex. male Color White Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or
Divorced.)
Age, 22 Years, X Months, X Days. Occupation, Such. Y. M.E. a. Sofia.
Residence,.
305-K. L
SonBarton
Place of Death,
(State year, mon@and day.)
Place of Birth,
Date of Birth,
28 June
Name and Birthplace of Father, Maiden Name and 2 Mani Porch
Birthplace of Mother, )
Place of Interment, Greensburg -15
G. R. Bennison.
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
1906
Name and Age ? of Deceased, Harry F. Porche
Age, .22 years.
Date and June 281/06 . 13 ostan Starben
Place of Death,* Chief cause, .. Drowillems
Disease - Contributing cause,. Accident
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 Gracias aStaris M.D.
· If an institution, state how long an Inmate and previous residence.
7 Ed. Soarin
P21
Found July Body
Majkl- atoute 165 To 175
Marking Outing Shirt Black & white Blue Lunge Pants (outing hand-)
Light umcen Dano Leche- Belt Black
Black
Just good
1906.
Ange in Park podet marked Harry. Pecul Handle
June , 28,
Henry F.
Parch
Watch Chan techer
"
Fiche y m. e.u . 1904 Bulan
2 Bunches of
Black oxford Shoes Tam Sinkamp
2 Bill Change
10 cm
[3.'06-37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Name in full, William
Date of Death, & Thomas.
June 29. 1906
(If married or divorced woman give malden name, also name of husband.)
Sex, Male Color, White
(White, Black, Mixed, Chinese, Condition, married
Age, 65 Years, 8 Months, Days. Occupation,
Indian, etc.) Salesman.
Residence,* 29 Bigiler St-Lam Bridge Mars Place of Death 21 Charles St- Winthrop (State year, month and day.)
Place of Birth ing ton mars Date of Birth, Nr. 30. 1844 Name and Birthplace Der um: Thomas- Unknown of Father, Maiden Name and Julia Braley Lakerile mars.
Birthplace of Mother, Place of Interment Cambridge Cemetry HuraceD Litch field 40% thears, ar.
Undertaker.
Je ambridge
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
29.
190 6
Name and Age !
of Deceased, William E. Thomas
Age, 65 years.
I hereby certify that I attended deceased from a 29 190 €, to
190 , that I last saw him alive on the. 29. day of fire 1905
that died on the. 29 day of 1906, about 4 o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of his . u Raciónis death was as follows :
Chief cause, angine Pretorio
Disease Contributing cause, so, Chante Indignation
Chief Cause,
Duration
Contributing cause,. 16 hours
M. D.
* If an Institution, state how long an Inmate and previous residence.
21
(Single, Married, Widowed or Divorced.)
William EThomas June 29, 1906
[4.'04-37-I.M.]
Permit No.
RETURN OF . DEATH.
Name in full,
To Jely 4 1-1986.
Date of Death, ....
Cont
my aunt manica, wife of Himy. H. Long (If a married or divorced woman give maiden name, alsoname of husband.)
Sex, tumale Color, White Condition, Жалкий
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Indian, etc.) Divorced.) .
Age, 3 8 Years, 11 Months, Days. Occupation, housewife
Residence, 14 Grover an
Place of Death, 17 Grover an
(State year, month and day.)
Place of Birth,
Gardner maine Date of Birth,
Name and Birthplace \ of Father, Maiden Name and Susan Spraquel Ler
um H. Sunt, Gardner Mr
Birthplace of Mother,
Place of Interment, Garcerer me
T. R. Benson
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
wirthent Boston,
4 th 1906
Name and Age of Deceased, my May Song
Age,. 38 years.
Date and 1. 45 1906. Withnah, Mass.
Place of Death,*
Chief cause, ameer of Whenis of Queries Disease
Contributing cause, Embolie
Chief cause,
Duration Contributing cause, .. a few hours
I certify that the above is true to the best of my knowledge and belief.
Name and Residence ) of Physician, 5 Ednim ding M.D.
* If an institution, state how long an Inmate and previous residence.
July, 4, 1904,
8H
[4.'04.37-LM.]
Permit No. .
RETURN OF DEATH.
Winthrop BOSTON, MASS.
Date of Death,
Jury
Lucy 8" 1906
Name in full, Dovele (Stilltom)
(If a married or divorced woman give maiden name, also name of husband.)
Sex, male
Color, White-
Condition,
(Single, Married, Widowed or Divorced.)
Age, .. Years, 1 Months, ....
Residence, Winthrop
Mass Ward,
Place of Death,
14 Sami Street
Place of Birth,
150mm Steel Date of Birth,
(State year, month and day.) July 81906
Benjamin F. Daniel Cambridge Mars
Name and Birthplace ) of Father, Maiden Name and Gertrude Smullen Portland me
Birthplace of Mother,
Place of Interment,
Shumer Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Drintuo Boston, July 9 " 190 6
Name and Age ? of Deceased, 5
Stillborn
Age, -years.
Date and
Place of Death,*
Chief cause, Stillborn
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, 5 M.D.
* If an institution, state how long an Inmate and previous realdeyer.
21
(White, Black, Mixed, Chinese, Indian, etc.) Days. Occupation,
49
1
Howell
(Stillborn)
July , 19 6 .
2
[3.'06 37-LM.]
· Permit No.
RETURN OF DEATH. BOSTON, MASS.
July 8 1956
Name in full,
, Date of Death,, aun Matilda Johnson ama M.Johnson Charles aJohnson (If married oy divorced oman give maiden name, also name of husbands
Sex, Color White Condition, Widomal
(Single, Married, Widowed-er
(White, Black, Mixed, Chinese, Indian, etc.)
Age, 63 Years, 2 Months,
Months 2
Days. Occupation,
Residence,* 3 Lea Tien an Winthrop ward,
Place of Death 1
Place of Birth,
Portsmouth NA
(State year, month and day.)
"Date of Birth,
John& Johnson Garden
Name and Birthplace of Father, Maiden Name and Birthplace of Mother,
Margaret Pintiman Portemouth Houst Hills Cremator
Place of Interment,.
Summer Floyd Winthrop
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, July 9 190 6.
Name and Age ? aun Matilda fokuson Age, 63 years.
of Deceased,
I hereby certify that I attended deceased from. July 190 5, to July
1906, that I last saw her alive on the. 200g .day of June 1906
day of. July 1906, about. 8 o'clock that she died on the
A.M., or F.H., and that, to the best of my knowledge and belief, the cause of death was as follows :
Chief cause, bare of the Stomach Disease Contributing cause,
Chief Cause, Twelve months
Duration Contributing cause, A. M. Houghton M.D.
* If an institution, state how long an Inmate and previous residence.
2021
Uma Matilda Johnson July . 8, 1906.
[11.'02.37.L.M.]
Permit No. .
Winthrop
RETURN OF DEATH. BOSTON, MASS.
Name in full, ..
Date of Death, Francis Carden Altron
July 9-1906
(If a married or divorced woman give maiden name, also name of husband.)
Sex,. male Color, White Condition,
(Single, Married, Widowed or Divorced.)
White, Black, Mixed, Chinese, Indian, etc.) Age, 8 Years, 5 Months, 15 Days. Occupation,
Residence,. 82 Lincoln Street
Ward,
Place of Death, Winthrop mass
Place of Birth, Winthrop Mass . Date of Birth,
(State year, month and day.) Jan 24 "1898
James Christian Gelen
Boston
Name and Birthplace ) of Father, Maiden Name and Fannie Raty - Cambridge mas
Birthplace of Mother, )
Place of Interment,.
Dianes Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Printer Preston,
190 6
Garden Francis, MaloGo
Age, 8 years. 5mm, 52
Name and Age ) of Deceased, 1 Date and Place of Death,* ) Chief cause, Drooling 1 July que new Scienter and Win Throf bridge 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, 1
* If an institution, state how long an Inmate and previous residence.
Francis Carden Nelson 120616 Fim
[4.'04.37.I.M.]
-Permit No.
RETURN OF DEATH. BOSTON, MASS. ' Wucchiof Mass
Date of Death, July 10 c# 1906,
Name in full,
John. W. Grave
(If a married or divorced woman give maiden name, also name of husband )
Sex, Male Color Thete
Condition, Manuel
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age,
56 Years, 3 Months, //. Days. Occupation,
Residence, .. 15Chester are Ward, 2
Place of Death,
(State year, month and day.)
Place of Birth,
Date of Birth, 7400 22
Chase. Trans Lexington Ky
Marie Garris € ,
Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother, Place of Interment, Mr. auburn (Gromation) Cancelar Ce. S. Bonne com . Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
190 ℃
Name and Age? of Deceased, John. W. France.
Age, 56 years.
Date and 15 Chester are Worthit Man
Place of Death,* Brights disease
L Chief cause,
Disease
Contributing cause, Chief cause,. 2 10
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