Town of Winthrop : Record of Deaths 1907-1909, Part 10

Author: Winthrop (Mass.)
Publication date: 1907
Publisher:
Number of Pages: 768


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1907-1909 > Part 10


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).


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[4.'07-37-LM.]


Permit No.


RETURN OF DEATH.


Winthrop


BOSTON, MASS.


Date of Death, March 14Th 190 8


Name in full, Eliza Dutone Eliza Hanley- James Lyons Female (If married or divorced woman give maiden name, also name of husband.) Color, White Condition, Ikidown


(White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.)


76 Years, -


Age, Years, - Months, ~ Days. Occupation,


Indian, etc.) Home


Residence,* 131 Winthrop Sr Ward,


Place of Death, 13) Winthrop th


Place of Birth, Ireland


(State year, month and day.)


Date of Birth,


Name and Birthplace ! of Father, Maiden Name and Birthplace of Mother, Place of Interment, ..


Patrick Hankey-


Deland


Elizabeth Unknown- Ireland


Malden Dorchester


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,


1908


Name and Age ? of Deceased, Eliza Syna Age,. 76 years.


I hereby certify that I attended deceased from 1908, 01 Feb. 22


190%, that I last saw


alive on the 22 nd day of Fel . 190 %, that .. she .. died on the fourtutte


day of march. 1908 , about - o'clock


A.M., or P.M., and that, to the best of my knowledge and belief, the cause of


Disease Chief cause, nuyelitis


Contributing cause, Senility


Chief Cause, Tur mouthis .


Duration Contributing cause, Edward J. Granger


M. D.


· If an Institution, state how loug an Inmate and previous residence.


021


... .


hier death was as follows :


mar. 14-1908


[3.'06 37-LM.]


Permit No.


RETURN OF DEATH.


Dinthropo BOSTON, MASS.


Name in full,


Date of Death, March "y "1908 Frank Ot. Overens


(If married or divorced woman give maiden name, also name of husband.)


Sex, Male Color,


(White, Black, Mixed, Chinese, Indian, etc.) Salesman


Age, OM Years, Months, ~Days. Occupation,


Residence,* Or anthropo Mass


Ward,


Place of Death, 15. 6nose Steel


Place of Birth, Royaldón VT-


(State year, month and day.)


Date of Birth,


Julia Div -north Reading mace


Place of Interment,


Name and Birthplace \ of Father, Maiden Name and Birthplace of Mother, Forest Of ille Cemetery Summer Cloud Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, March 18 1908


Name and Age ?


of Deceased, Front it nevers


Age, 57 years.


I hereby certify that I attended deceased from May 1907 , to March 17


1905, that I last saw the


alive on the. 16 day of March 1908,


that died on the 17 day of .108, about 1 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,


Cerebral apoplety


Contributing cause,


Chief Cause, Since they 07


Duration Contributing cause,


Unterio salen is


M. D.


* If an institution, state how long an inmate and previous residence.


21


Condition, Married


(Single, Married, Widowed or Divorced.)


Track H. herewe than 17-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


FULL NAME.


Yasal Sur Randall


Registered No.


Place of Death


metcalf Hospital, Heterok, Mass


Date of Death


march 2 0 1908.


Age


29


. years


months


.days


STATISTICAL DETAILS


SEX


COLOR


White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME Ť


Sarah Faux Connor


HUSBAND'S NAME t


Thomas E. Randall


BIRTHPLACE #


England


NAME OF


FATHER


hours Connor


BIRTHPLACE


OF FATHER#


Meland


MAIDEN NAME


OF MOTHER


Sarah Sharkey


BIRTHPLACE


OF MOTHER #


halaud


OCCUPATION


INFORMANT §


Tomar E. Randall


PHYSICIAN'S CERTIFICATE


[ HEREBY CERTIFY that I attended deceased during last illness, from Mch. 20. 1908 to Much. 271908, 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).


10


. DAYS


Contributory :


Pulmonary Ocde


(DURATION)


DAYS3


(Signed)


M.D ..


mick. 2) 1908 (Address)


SPECIAL INFORMATION only for Hospitals, Institutions, Transients, , or Recent Residents.


Former or


Usual Residence


25 Roman dr.


How long at


:. Place of Death ? 7 Days $


Where was disease contracted,


If not at place of death ?.


25 Reade St.


Filed


190


Clerk‹


PLACE OF BURIAL OR REMOVAL II


38h, Cross, maldau


UNDERTAKER


DATE OF BURIAL


Mar 294


190


8


ADDRESS


Frank N. Inalousy 35offrestrop It


* 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 orr 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.


20 Sarah Jane Landal Man 27- 1908


COMMONWEALTH OF MASSACHUSETTS


4


RETURN OF A DEATH


FULL NAME


William McMillan


Registered No.


Place of Death


*


310 Shirley St Minthaof


Date of Death


March


29-1908


Age


. years


months


.days


STATISTICAL DETAILS


SEX


male


COLOR


White


SINGLE, MARRIED, WIDOWED, OR- DIVORCED


MAIDEN NAME Ť


HUSBAND'S NAME +


BIRTHPLACE #


albury Prince Edward Island


NAME OF FATHER alexander Mc millan


BIRTHPLACE


OF FATHER#


alluny P.E. ?


MAIDEN NAME OF MOTHER Mary Hayden


BIRTHPLACE OF MOTHER # P. E.Z


OCCUPATION


INFORMANT § hur J. E. Podle


PLACE OF BURIAL OR REMOVAL II Fivert Hills


DATE OF BURIAL


March 31


8


UNDERTAKER 1. J. Matermans ker's


ADDRESS


Roxbury man


PHYSICIAN'S CERTIFICATE


| HEREBY CERTIFY that I attended deceased during last illness, from Jak IS 1908 to Mck. 29 19080 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 : bar


(DURATION) DAY8


Contributory :


(DURATION). DAY8


(Signed)


M.D.


Bok 30198 (Address)


SPECIAL INFORMATION only for Hospitals, Institutlons, 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 "Speclal 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.


ALL NAMES TO BE IN FULL


26 Willian In: rueban Frau 29-1908


[3.'06 37-LM.]


Permit No.


RETURN OF DEATH.


BOSTON, MASS.


Date of Death, Mene 11908 1


Name in full, Julian De Witt Orcutt


(If married or divorced woman give maiden name, also name of husband.)


Sex, male Color,


(White, Black, Mixed, Chinese, Condition, Single


Indian, etc.)


(Single, Married, Widowed or Divorced.) balesmarc


Age, 28 Years, &. .. Months,. 6 Days. Occupation,


Residence,* Skinthropo


Mass


Ward,


Place of Death, 160 Somerset arene


Place of Birth,


Street Medford Date of Birth,


William D, Orcutt= Georgia


Name and Birthplace of Father,


Maiden Name and Patie E. Wheeler-Milford N. O.


Birthplace of Mother,


Place of Interment,


Summer floyd Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, april 3


190 8


Name and Age ?


of Deceased,


I hereby certify that I attended deceused from. Zum 21 1908, to april 1


190 8, that I last saw


alive on the day of 1908,


that died on the day of afrie 1908, about 130 .. o'clock


A.M., op P.M., and that, to the best of my knowledge and belief, the cause of huis death was as follows:


Disease Chief cause,


Septicemia


Contributing cause,


Chief Cause, .


Duration Contributing cause,


M. D.


* If an institution, state how long an inmate and previous residence.


21


28 years.


(State year, mouth and day.)


Juliana DE Mett april 1,1908


[3.'06 37-LM.]


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Winthrop


Date of Death, (Marie 4" 19.08


Name in full, Lenora NO. Ofamiliar


Sex, Female Color While


Condition, Ihdoved


(White, Black, Mixed, Chincse, Indian, etc.)


(Single, Married, Widowed or Divorced.)


Age, y 4 Years,


... Months, Days. Occupation,


Residence,* St inteiof mass


Ward,


Place of Death, 19 Beach Road


Place of Birth,


Nova Sartia Date of Birth,


James Miller- Nova Scotia


Margaret Campbell Eastwood me


Place of Interment,


Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Findewword Leveling Stineham Mas Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Winthrop Boston, apr. 5. 1908.


Name and Age ?


Age, 7 years.


of Deceased,


I hereby certify that I attended deceased from.


2 1908,to Cfr. 4.


190 , that I last saw ·her alive on the. 3d


day of. apr. 1908,


that. whe died on the .. 4 day of Ufer. 190 8, about 7 o'clock


death


A.M., or P.M., and that, to the best of my knowledge and belief, the cause of. 1 was as follows :


Disease < Chief cause, Mitral Regurgitateon


Contributing cause,


Chief Cause,


Duration


Contributing cause, . It &. Porter M. D.


* If an Institution, state how long an Inmate and previous residence.


521


(State year, month and day.)


(If married or divorced woman give maiden name, also name of husband.}


Mer. 4-1908


[4.'07-37-I.M.]


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Date of Death,


LA pril 4


1908.


Name in full, Martin F.


Kelly


(If marrled or divorced woman give maiden name, also name of husband.)


Sex, M Color


Condition,


(Single, Married, Widowed or Divorced.)


Age, 27 Years, Months, Days. Occupation,


Residence, *


79 Atlantic St.


Ward, ..


Place of Death, 79 Atlantic St.


(State year, month and day.)


Place of Birth, East Boston Mass.


Date of Birth,


Name and Birthplace ? Patricks


Ireland


of Father,


Maiden Name and Bridget Keough


Ireland


Birthplace of Mother,


Place of Interment, Holy Cross. Malden J. J. Jane


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, april 6


190 8.


of Deceased, Martin F. Kelley Age, 27 years.


I hereby certify that I attended deceased from Dec 17 1906, to. Feb 22, 1908, that I last saw himme alive on the. 22nd day of Fel 1908.


that ... he died on the 4 the .day of. april 1908, about o'clock


Lio death was as follows :


Disease Chief cause, Pulmonary Tuberculosis Contributing cause, Laryngeal Tuberculosis


Chief Cause,. 16 months


Duration Contributing cause, .. about 1 year


D. B. I truly M. D.


· If an institution, state how long an inmate and previous residence.


20 Chelsea S. E. B. 21


A.M., or P.M., and that, to the best of my knowledge and belief, the cause of.


Name and Age?


(White, Black, Mixed, Chinese, Indian, etc.) Labour


29 Martin F. Kelley 1/20. 4-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Augustine Knowles


Registered No. 42 1.33 PM


Piace of


Death *


Westlow Insane Hafrital, Westhow, Mass


Date of l


April 6,


1


1908


Residence


Winthrop, Mass.


Age


46


.. years.


11


.months. 1 days


STATISTICAL DETAILS


SEX male


COLOR


White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME Ť HUSBAND'S NAME +


BIRTHPLACE 1


Belfast, me


NAME OF


FATHER


Raymond Knowles.


BIRTHPLACE


OF FATHER$


Belfast, me.


MAIDEN NAME


OF MOTHER


Susa "itz gerald


BIRTHPLACE


OF MOTHER #


Lowell, Mass.


OCCUPATION Electrical Engineer


INFORMANT §


Hospital and


E. a. H-nowles.


10 Washington St. Boston, Trass.


PLACE OF BURIAL OR 'REMOVAL!


It. Auburn bern.


Cambridge, Mass.


DATE OF BURIAL


Afinil I 190 5


UNDERTAKER ADDRESS EL Word Westhorst, mass.


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last iliness, from June 28 190.to abril 6 1908, 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 : Cerebral arteriosclerosis


( OURATION ). .DAYS


Contributory :


alcoholic Insanity


(Chronic)


(DURATION) OAYS


(Signed).


Um r Coles


M.D. april 1908 (Address) Weather, Brass.


SPECIAL INFORMATION only for Hospitais, institutions, Transients, or Recent Residents.


How long at


Piace of Death ?


years


9


months.


9


days


Where was disease contracted,


if not at place of death ?.


Filed


abril, 1908


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 detalis. Il Name of cemetery.


T


augustine knowles apr-6-1908.


COMMONWEALTH OF MASSACHUSETTS


2finstrop. maso (CITY OR /TOWN.)


RETURN OF A DEATH


FULL NAME


Place of ) "fisetterap), Hines,


Death *


Residence


× 355 Fruttuob it, Histick


Age


61


.. years.


.months .. .days


STATISTICAL DETAILS


SEX


mule White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME Ť


HUSBAND'S NAME Ť


BIRTHPLACE #


Wostore, Dass,


NAME OF FATHER 7


Ascholar Psclassant


BIRTHPLACE


OF FATHER+


MAIDEN NAME


OF MOTHER


BIRTHPLACE


OF MOTHER #


OCCUPATION


INFORMANT §


Sister,


PLACE OF BURIAL OR REMOVAL II


DATE OF BURIAL


UNDERTAKER /ADDRESS Frank S. Maloney Fiostructure.


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from 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 :


gestern web.


(DURATION). DAYS


Contributory :


Juanition


(DURATION). 8 .. DAYS


(Signed) Hamentek


M.D.


april 9 19 (Address) 3555


uthump SV


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


* 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.


Registered No ..


Date of ], tasil 9's


1908.


Death


30 Lawrence Verderque apri q. 1908


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1908.


CITY OF BOSTON.


FULL NAME


-Callan


Registered No.


3728


Place of Death ¿


Boston


Boston Lying-In Hospt


and Residence S


Date of Death


Apr 14


1908. Age


years .


months. 6 days.


STATISTICAL DETAILS.


SEX


COLOR


SINGLE, MARRIED, WID., DIV.


F


W


S


Maiden Name


Husband's Name


Boston


Birthplace


Name of


Edmund B Callan


Father


Birthplace


of Father


Maiden Name


Louise Hall


of Mother


Birthplace of Mother


Portland Me


Occupation


Informant


Place of Burial or removal


Mt Hope


Undertaker L Jones & Son


Usual Residence


Winthrop H'ds(62 Temple


Ave ) ...


Filed.


Apr 24


1908.


A true copy.


Attest :


ErMSlenen


Registrar.


T


AR'S


PATRIBUS


TP


.SITD Proany (Dura Gòn)


Prematurity


CITY


IS


FICE:


BOSTONIA CONDITA AL.


A.1822


N. MAS.S.


Contributory : {


Inanition


(Duration)


(Signed)


H F Day


M. D.


Apr 16 1908


SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.


Portland Me


PHYSICIAN'S CERTIFICATE.


| HEREBY CERTIFY that I attended deceased during last illness,


from


1908, to


1908, 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:


CTVTTATISRE TISREGIMINE DONATA A BOSTON


Callour ayer-14-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Sophie Wil mouse


.Registered No.


Place of )


Date of ¿


Death S


Residence


a


Age


83


.. years.


X


.months .. ......... .. days


STATISTICAL DETAILS


SEX


female


COLOR


voluto


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME Ť


Sophie Weil


HUSBAND'S NAME Ť


BIRTHPLACE #


Ball Germany


NAME OF


FATHER


abraham Weil


BIRTHPLACE


OF FATHER#


Bahl German


MAIDEN NAME


OF MOTHER


BIRTHPLACE


OF MOTHER#


e 1


OCCUPATION


( -


INFORMANT §


Filed


190


Clerk


PLACE OF BURIAL OR REMOVAL II


Wakefiel mans


DATE OF BURIAL


-


UNDERTAKER


CR Benson.


ADDRESS


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last iliness, from.


mch . 15 90 8 to Caps. 18/908 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 : Fatty Degunuation of Primary : 86carff


(DURATION). . DAY &


Contributory :


(DURATION). .... . DAYS


(Signed) 28. com M.D 2. 2/ 1968 (Address)


SPECIAL INFORMATION only for Hospitais, Institutions, Translents, or Recent Residents.


How long at Place of Death ? . years .. ............ .. months.


...... 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 statisticai detalls. Il Name of cemetory.


190 8


Death *


5


28 Trydent are


.


31 Sophie well Morse- ayer 18- 1908


-


|4.'07.37. L.M.]


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Name in full,


(3) Tiellomontant)


h (If married or divorced woman give maiden name, also name of husband.)


Sex, Otimale Color, It hite Condition,


Stillon


(White, Black, Mixed, Chinese, ludian, etc.)


(Single, Married, Widowed or Divorced.)


Age,. Years, ~ Months, ~ Days. Occupation,


Residence,* Sfinthurto Mass


Ward,


Place of Death, 149 Lincoln Street


(State year, month and day.)


Place of Birth, 11 11


Date of Birth, ajoue 23"1908


Name and Birthplace ! of Father,


Edward J, Greenmad China Sentia


Maiden Name and Birthplace of Mother, S Blanche E, Greenmad ONva Pertra


Place of Interment,


Junhoer Floyd


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, ... ajene 25 2 1908


Stillhun of Deceased, Ruth Greenwood Age, ... years.


I hereby certify that I attended deceased from A4.23 190%, to AM.23


1908, that I last saw her on the 23 day of. que . . 190 8. She died on the 8/3 day of 190 g, about 10 o'clock that


w P.M., and that, to the best of my knowledge and belief, the cause of. her .death was as follows :


Disease - Chief cause, Stillborn.


Contributing cause,


Chief Cause, ..


* if an Institution, state how long an Inmate and previous residence.


Duration Contributing cause, A.B. 200 M. D.


621


Date of Death, Puth Greenword'


Okul 23' 1908


Name and Age ?


Nev. 23, 1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH Herbert a. sweetland.


(CITY OR TOWN.)


FULL NAME


Registered No.


Place of


322 kins Une.


Death *


Residence


22 Kings way.


Amit trop Age


39?


.. years.


months .days


STATISTICAL DETAILS


SEX


.


COLOR


SINGLE, MARRIED, WIDOWED, OR ĐIVOROSO


In.


MAIDEN NAME t HUSBAND'S NAME +


BIRTHPLACE # Least Coston thass.


NAME OF


FATHER


adamiron weer


BIRTHPLACE


OF FATHER


Rockland Ml.


MAIDEN NAME


OF MOTHER


Georgeanna Gruber


BIRTHPLACE


OF MOTHER#


Canzo N.S.


OCCUPATION


Grocer


INFORMANT §


mother


Ama G & sweetland


PLACE OF BURIAL OR REMOVAL II


Woodlawn Everett.


DATE OF BURIAL


april 26


1908


UNDERTAKER


E. G. Brown


ADDRESS


6. Boston


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from. 1900 to


Marie 24 90 S. 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 : Typhoid Fever


about 24


... DAY8


Contributory :


X


(DURATION) ...... DAY8


(Signed).


M.D.


Chris 2 4908 (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


* 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 cemetery.


Date of ¿ april 24 1908


Anthrop Mass.


Death S


33 Herbert a. Sever bland You. 24 1908


ALL NAMES TO BE IN FULL


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL 'NAME


Grace May Sawyer


Registered No.


Place of )


23 Concerto Wucht


Death *


5



Age


26


.years.


100


22


.months ..


.days


STATISTICAL DETAILS


SEX


COLOR


SINGLE, MARRIED, WIDOWED, OR DIVORCED


marked


MAIDEN NAME +


Grace May Webster


HUSBAND'S NAME Ť


2000 H. Sawyer


BIRTHPLACE #


NAME OF


FATHER


Walter Webster-


BIRTHPLACE


OF FATHER+


Conway pots


MAIDEN NAME


OF MOTHER


Minnie Lláskie


BIRTHPLACE


OF MOTHER #


Zyna mars


OCCUPATION


Hestood Housewife


INFORMANT §


Husband


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from 1900 .... to 1908, 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 :


One La (DURATION)


........ OAYS


Contributory :


(DURATION).


. 0AY8


(Signed)


15 mel calf


M.D.


190 ..... (Address)


170 huntrip 8%


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 !!


Nunchuof Mass


DATE OF BURIAL


may 3


190.


....


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. l| Name of cemetery.


.190


Death S


Date of ¿


may 1 2


. 190 88


Residence


.


34 Grace May Habeter May 1, 1908


[4.'07.37-LM.|


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Date of Death,


May H" 1908


Name in full, Donald J. Jen Rine


(If 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 Years, Months, . 3 Days. Occupation,


Residence,* Dranthropo


Mass


Ward,


Place of Death,


18 Beacon Street


Place of Birth,


Winthrop Wars Date of Birth,


ajene 30.1908


Name and Birthplace Illian 20, Sentire- South Boston


of Father,


Maiden Name and Birthplace of Mother, 5


Rosalie 6, Stord = New York


Place of Interment, Calvary Cemetery


7


Dumpertloud


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, May 190 8


Name and Age ?


of Deceased, Donald J laurino


3. days Age, years.


Op. 30th 1908, to May 4th


I hereby certify that I attended deceased from.


1908, that I last saw min .alive on the.


4×4 day of 1908,


that died on the 4 day of Illay 190 8, about 2 o'clock


A.M., or P.M., and that, to the best of my knowledge and belief, the cause of death was as follows:


Chief cause, difficult delivery + general areadiness


Disease - Contributing cause,


Chief Cause, ....


Duration Contributing cause,.


* If an institution, state liow long an inmate and previous residence.


1 newstenth 82. M. D.


2021


may


Lee


(State year, month and day.)


35 Donald & Jeukus May 4-1908


சல்


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Parsons


Place of )


252 Shore Suave


Death *


5


Residence


Age


.days


STATISTICAL DETAILS


SEX Male


COLOR


Mute


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME 1 Parsons


HUSBAND'S NAME t


BIRTHPLACE#


NAME OF


FATHER


Herbert. F. Parsons


BIRTHPLACE OF FATHER# Worcester Mars


MAIDEN NAME


OF MOTHER


Theremin Fr. Green


BIRTHPLACE OF MOTHER ¢ Woodslook It


OCCUPATION


INFORMANT §


PLACE OF BURIAL OR REMOVAL !I


DATE OF BURIAL


May 8


190 g ..


UNDERTAKER


ADDRESS


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from May 6 1909 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 : Stillborn.


Primary :


....


Destructive delivery.


(OURATION) DAYS


Contributory :


R.H. Chepaluch


........ 0AY8


(Signed).


M.D.


May/ 190. .. (Address)


1827 Bogastory 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


* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, glve 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.


Registered No ..


Date of l May 6 m


Death 1


190


مامحمد


Weay 61 190 8


[4.'07.37.LM.]


Permit No.


Donttrop RETURN OF DEATH. BOSTON, MASS.


may 6" 190 8


Name in full,


Date of Death, Daniel S. Sullivan


(If married or divorced woman give maiden name, also name of husband.)


Sex, Male Color, White Condition, Married


(Single, Marrled, Widowed or Divorced.)


Age,


43 Years,


7


Months,


13 Days. Occupation,


Residence,* Dinthiop mass Ward,


Place of Death, 18 Read Street


Place of Birth,


South Boston


Date of Birth, 001 23"1864


Name and Birthplace } of Father,


Daniel J. Sullivan- Postar Maiden Name and Helen Day - South Boston


Birthplace of Mother, S


Place of Interment, Cedar Grove Cemetery Summerfloyd Undertaker.




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