USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1904-1906 > Part 3
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Maiden Name,
If a married or divorced woman or a widow give also Name of, Husband,
Sex, Male (ale Color, ferite Single, Married, Widowed or Divorced, Single
20 Years, 3 Months, / Days. Occupation, Scenic artist Age,
* Residence [ If out of town, } 10 Terrace Avenue Winthrop Mass.
( also state fully. ] Winthrop, Wass. (Ho Jenrack arence) Place of Death,
Place of Birth,
New york City
Name and Birthplace of Father, Father, hin alfred Thompson New York City
Maiden Name and Birthplace of Mother, Margaret Keeley New York City
Place of Burial (Give name of Cemetery), Winstwop Mars.
Dated at Winetrop Class
on March 19 1 1904
Signature and place of business of Undertaker.
Summer Cloud 18 Oferman Street
Mimeticoto mars
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Charles a. Thompson Age, 26 4. 3 M. /3D.
Place and Date of Death,
died at Winthrop Mah. 19. 1904.
Primary,
Brighter Divan
Disease or Cause of Death, ț
Immediate,
Duration, 4 gers Pulmonary Ocdeme Duration,
I certify that the above is true to the best of ny knowledge and belief.
HJ. Carter M. D.
Certifying Physician.
Winthrofe.
Date of Certificate,
Mch. 19.
190%
· Give also street and number, if any. | Give sex of Infant not named. If atill-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 toum.
Agent of Board of Health.
Signature and Residence S of
No.
RETURN OF THE DEATH
OF
Charles Ofred hamfeson at - Гегласа СЛения
Date, March 19
190 4
Filed, March 19 190 4
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every honseholder 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 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician shall forth with 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-
FORM C.
Commonwealth of glassachusetts.
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, "2varch 22' 190 4.
Full Name of Deceased, mary Morecroft
Maiden Name, ... mary Sheeni's
If a married or divorced woman or a widow give also Name of Husband, andrew morecroft
Sex, Color, Single, Married, Widowed or Divorced,
Age, 35 Years, Months, Days. Occupation, Annenije
* Residence { If out of town, ) ¡ also state fully. §
128 Border Street Earl Balon
Place of Death,
41
Fremont Street. Stinthoy.
Place of Birth, Oreland
Name and Birthplace of Father, Thomas Sherin = Oveland
Maiden Name and Birthplace of Mother, Catherine Shammerly = Greland
Place of Burial (Give name of Cemetery),
Dated at Winthropo
Signature and Summer floyd
3
on
March 22 1904
place of business of Undertaker. 18 Herman Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
mary morcroft
Age,
38x
M. D.
Place and Date of Death,
died at.
mch 2 2 190 4.
Disease or Cause of Death, #
Primary,
Immediate,
Candace
Duration,
3 yrs
I certify that the above is true to the best of my knowledge and heljef. Biometcalf M. D.
Signature and Residence of Certifying Physiclan. mch 239
Date of Certificate,
... 190 4/
· Give also street and number, if any. | Give sex of infant not named. If stiil-born, ao state.
If a Boldler 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
Duration,
the year ?
No.
RETURN OF THE DEATH
OF
mary Nuovesoft 41 Fremont Sheet at
Date, March 22" 1904.
Filed, March 23 190 4
[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. 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 after 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, nntil 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-
*** Bfty dollars.
FORM C.
Commonwealth of
assachusetts.
No.
RETURN F. A DEATH.
To the Clerk of the City
Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Date of Death, March 23"
190
4.
Full Name of Deceased, Marie a. Howard
If a married or divorced woman or a widow give also
Maiden Name, mary & Barnel Name of Husband, Voupr & Howard
Sex, Color,
-Single, Married, Widowed or Divorced,-
Age, 24 Years, 10 Months, 15 Days. Occupation, 3 Summit avenue Winthrop * Residence [ If out of town, { [ also state fully. } Wintrop Mass 3 Summit avenue Cast Conston
Place of Death,
Place of Birth,
Name and Birthplace of Father, Ser & Paguee middletown, bonn
Maiden Name and Birthplace of Mother, Catereen bec kenney feeland
Place of Burial (Give name of Cemetery), Holywood Cemetery Brookline
Dated at Stinthop
Signature and Dummer Cloud
place of business 3 on March 24 190 4
of Undertaker. 18 Oterment Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
marie a Howard Age, 278.10 M. 18 D.
Place and Date of Death, died at umshop mass. meh 23 190 4.
Disease or Cause of Death, ţ Immediate,
Primary,
Dipsomania
Duration, 2,
Heart Failure
Duration,
Immelhátil
I certify that the above is true to the best of my knowledge and belief.
1215 Metcalf
M. D.
Signature and Residence S of Certifying Physician.
Withrob mass
Date of Certificate,
mch 24h
1903
· Give also street and number, if any. | Give sex of Infant not named. If still-born, so state.
If a Soldier or Bailor 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
-
43 Vaiquer & may 23
-
No.
RETURN OF THE DEATH
OF
Marie a. Otomarde 3 Виття Ониние at
Date, March 23
190 4
Filed, March 24 190 4
[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. 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-
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, .. march 25" 190 4.
Full Name of Deceased, Dr John Daniel Jama
Maiden Name,
If a married or divorced womall or a widow give also Name of Husband,
Sex, Color,
Single, Married, Widowed or Divorced,
Age, 64 Years, Months, Days. Occupation, Physician
* Residence { If out of town, } Winthrop Mass
{ also state fully. }
Place of Death, Cor brest avenue + Jeukshig Street,
Place of Birth,
Corina manie
Name and Birthplace of Father, almi Yama, Unknown
Maiden Name and Birthplace of Mother, Marchla Winchester
Place of Burial (Give name of Cemetery), Lamerce aes
Dated at ... Drinthis
Signature and Duman floyd
place of business on March 26(") 190 C of Undertaker. 18 Overa Sweet
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t John Daniel Gang
Age, 648220.
Place and Date of Death,
died at
Hinthis March 25'
190 4.
Primary,
Inflammation ; HE Ascending Colon) and disease 9 the mesenteric Veins Duration, Last Sicheneas / WK.
Disease or Cause of Death, ± Immediate,
Hemorrhage und Exhaustion
Duration,
24 hours
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence A. B. NO M. D.
of
Certifying Physician.
Witte
Date of Certificate,
March 27th
1904.
· (i.ve 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 Rebel Jon, give both I'rimary and Immediate Cause.
Countersign and transmit to the clerk of the city or toun.
Agent of Board of Health.
No.
RETURN OF THE DEATH
OF John Danie Young March 25nigdy at
Date, March 25" 1904.
Filed, March 26 190 4
[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, eausc 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 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 cause of death as nearly as he can state the same. Penalty for refusal or negleet, 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 eity 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 sneh statement and certificate, shall forth-
11
FORM C.
Commonwealth of Classachusetts. ma 26
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, .. March 26'
190 4.
Full Name of Deceased, George & Wadsworth (Gret Chene)
Maiden Name,
If a married or divorced woman or a widow give also Name of Husband,
Sex,
Color,
01
Single, Married, Widowed or Divorced, .
Age, 49 Years,
2
Months, 14 Days. Occupation,
Real Estate agent
* Residence ( If out of town, } ¿ also state fully. )
Winthrop Mass
Place of Death, 50, brest avenue
Place of Birth,
Name and Birthplace of Father, Beleg Wadsworth
Maiden Name and Birthplace of Mother, Susan Mears
Place of Burial (Give name of Cemetery), ... Winthrop? Cemetery
Dated at
on
March 28''
190 4
place of business
of Undertaker.
18 Overman Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t George Y, ademth
Age, 49 Y. 2 1 14D.
Place and Date of Death,
died at Sinthof March 26
abdomine Carcinoma
Duration,
190 4
Primary,
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
r. a . nimison
M. D.
of
Certifying Physician.
80 Princeton 24.
Date of Certificate, 190
A
· 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 Rebelllon, give both P'rimary and Immediate Cause.
M. ..
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
~
Signature and
Summer Floyd
No.
RETURN OF THE DEATH
OF Lenge L Wadsworth
at
Winthrop (Crest Chenne)
Date, March 26 " 1904
Filed, March 27 190
[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 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 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-
1
e
Dasalle far violation not aveending fifty dollars.
FORM C.
Commonwealth of Massachusetts.
Ina. 22
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, March 28'
190 4.
Full Name of Deceased, Elizabeth Glanagan
Maiden Name,
Elizabeth Fawcett
Is a married or divorced woman or a widow give also ( Name of Husband, John Flanagan
-
Sex, Color, Single, Married, Widowed or Divorced,
Age,
7 3 Years,
9
Months,
4 Days.
Occupation,
Odousempe
* Residence ( If out of town, } ¿ also state fully. § Place of Death, 1 48 philly @ Freel
Place of Birth, Oveland
Name and Birthplace of Father, andrew Fawcett= Ireland
Maiden Name and Birthplace of Mother, Catherine Wiggens
Place of Burial (Give name of Cemetery), Winthrop Wars
Dated at Winthrop
Signature and Summer Floyd
on March 29 " 1904
place of business
of Undertaker.
18 Oferman @hel
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Elizabeth Flanagan Age, YYY. 9 M. 4D.
Place and Date of Death,
died at ..
Winthrop
Mch. 28. 190 4.
- Primary,
Mitral Insufficiency
Duration,
(?)
Disease or Cause of Death, # Immediate,
acute nephritis
Duration,
2 anos.
I certify that the above is true to the best of my knowledge and belief.
signature and Residence S of
.M. D.
Certifying l'hysician.
Winthrop
Date of Certificate,
mch. 29.
190 %
· Give aleo street and number, if any. t Give sex of Infant not named. If stiil-born, so state. t 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.
---
Winthrop, Dass
No.
RETURN OF THE DEATH
OF
Elizabeth Flanagan 198 bliley @heel at
Date, March 29" 190 4.
Filed, March 31 190 4 :
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every honseholder in whose honse a death occurs and the oldest next of kin of a deceased person in the city or town in which the death ocenrs, 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 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 snch 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- and trongmit it to the clerk of the city or town for registration. Penalty for violation not exceeding fifty dollars.
FORM C.
Commonwealth of Classachusetts.
mar 31
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, March 13,1" .1904.
Full Name of Deceased, - latrell r till com
Maiden Name,
If a married or divorced woman or a widow give also s Name of Husband, Midland & tothett
Sex Female Color, white Single, Married, Widowed or Divorced,
Age, Years, Months,‹ ‹ Days. Occupation,
* Residence ( If out of town, } also state fully. f ....
Slack
Place of Death, 37 Grover Avenue Winthrop Highlands Mass.
Place of Birth, - 11
Name and Birthplace of Father, Vuillard St. Cottrell Belfast Maine
Maiden Name and Birthplace of Mother, Ade B.Miller Baston Sla 20.
Place of Burial (Give name of Cemetery), Westboro Mass, Summer Flared
Dated at. Stintino,,
on
190 4-
Signature and place of business of Undertaker. 18 Exermal Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
argent Age, Y. M. D.
Place and Date of Death,
died at. 37 Grands Menue Mar 31 1904
Disease or Cause of Death, #
Primary, Immediate,
Stice
Duration,
I certify that the above is true to the best of my knowledge and belief.
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