USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1907-1909 > Part 11
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Friuliof Boston, May 6 190 g .
Name and Age ? Daniel Sullivan Age, 43 years.
I hereby certify that I attended deceased from 1907 , to.
190 >that I last saw 1
tue alive on the. 6 the day of. may 190 8
that died on the. 6 th
4 day of. May 1908, about 1080 o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of. his death
was as follows : Valorela Heart Disease Brights Discou
Chief cause,
Disease Contributing cause,
Duration
Chief Cause, Contributing cause,
* If an Institution, state how long an Inmate and previous residence.
M. D.
of Deceased,
the
(State year, month and day.)
(White, Black, Mixed, Chinese, Indian, etc.) Sile Mazan
Daniel S. Sullivan May 6. 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
Winthrop (CITY OR TOWN.)
FULL NAME
Samuel A Mas Donnell
Registered No. 858
Place of l
Winthrophas 217 Cliff cher
Death *
5
Residence
Cambridge chass
Age
46
... years.
months. 20 .days
STATISTICAL DETAILS
SEX
COLOR
White
SINGLE, MARRIED,
WIDOWED, OR
DIVORCED
MAIDEN NAME t . HUSBAND'S NAME t
BIRTHPLACE #
Ireland
NAME OF
FATHER
Samuel A, Mas Donnell
BIRTHPLACE
OF FATHER+
Ireland
MAIDEN NAME
OF MOTHER
Matilda Unas
BIRTHPLACE
OF MOTHER $
Oreland
OCCUPATION
INFORMANT §
&, A Mac Donnell
PLACE OF BURIAL OR REMOVAL II
Cedar Grove
DATE OF BURIAL
May 12
190 ....
UNDERTAKER
A, L, Eastman
ADDRESS
251 Tremont SL
Boston
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from May 7 190& ... to May 9 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 : appendicitis
(DURATION).
Contributory :
Fatty degunuation of
Nach
(DURATION) DAYS.
(Signed).
M.D.
May 9 1908 (Address).
SPECIAL INFORMATION only for Hospitals, Institutlons, Translents, or Recent Residents.
How long at
Placo 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, glvo Its NAME Instead of street and number.
t In case of married or divorced woman, or widow. # Stato or country | also city, town or county, if known.
§ Name and address of person giving statistical details. Il Name of cemetery.
ALL NAMES TO BE IN FULL
Date of ¿
Ucan 4 h
190
Death
38 T
Lammel a. Mac Douwall May 9. 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
adecision. H. IMler
Registered No.
Date of l
Death
May 11
190
Residenc
Age
76
.years.
6
months. .days
STATISTICAL DETAILS
SEX
Male
COLOR
While
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME t
HUSBAND'S NAME +
BIRTHPLACE ¢
NAME OF
FATHER
Daniel Tyler
BIRTHPLACE OF FATHER$
MAIDEN NAME OF MOTHER 1.
BIRTHPLACE OF MOTHER$
L
L
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last 1. 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 : Primary : Garcena
enelfinito (DURATION). DAYS
Contributory :
(OURATION). . DAY8
(Signed)
M.D.
may 16 1908 (Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Translents, 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 II Mulforme Mars
DATE OF BURIAL Unay 17 . 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 detalls. | Name of cemetery,
PIAAS !!
ALL NAMES TO BE IN FULL
Place of
S
Death *
.
39
Gadrian do. Tyler May 11, 1908
[6.'07.146. VM.]
(FOR POST-MORTEM EXAMINATIONS ONLY.)
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, May 12 1908
Name in full, alici
Celafunam
Loud
Sex, Finale Color,
(If married or divorced woman give maiden name, also name of husband.)
White Condition, Lenger
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.
Age, 22 Years ...... 9 Months,.
Indian, etc.) Days. Occupation, none
Residence,
6) mumsor th Roxbury
Ward,
Place of Death, Wenchet muss
Place of Birth,
Burton-
Date of Birth,
Name and Birthplace \ augustus. I. Loud Plymouth me of Father,
Maiden Name and Boulon- Mass. alici Chapman
Birthplace of Mother,
Place of Interment,
Undertaker.
MEDICAL EXAMINER'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, May 120 190 5.
I hereby certify that I viewed the body of
Name, 1 Alice Chapman Loud
Age, 2 2 years.
who died on the high of 11-12
day of .... May 190 8 , and to the best of my knowledge and belief, the cause of The death was as follows:
Autopsy
Chief cause,
Herecintat Drowning 1
Disease, Contributing cause,
M. D.
21
(State year, month and day.)
alice Chapman Loud May 12. 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
Frank, Carl unut Schell-
Registered No ..
Place of l
Death *
5
63 Thorton Park
Date of l
May 12
Death S
190
Residence
Age.
.years.
months ........
days
STATISTICAL DETAILS
SEX male.
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Imjer
MAIDEN NAME +
HUSBAND'S NAME t
BIRTHPLACE + Holagone Arcelo
NAME OF
FATHER
Emil Fr Schull
BIRTHPLACE
OF FATHER$
Licenceza
MAIDEN NAME
OF MOTHEP.
Halda. C. Terazeder
BIRTHPLACE OF MOTHER+ Starta Suceder
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last iliness, from Cefv. 26 . 1908 to May 12908. 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 : Septic Mi
.
15
(DURATION)
DAYS
Contributory :
Pulmonary
Oedema
(DURATION).
2
. DAYS
(Signed)
M.D.
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.
ALL NAMES TO BE IN FULL
PLACE OF BURIAL OR REMOVAL I
DATE OF BURIAL
Memy 14
190
8
UNDERTAKER
ADDRESS
Frank beach august Schult May 12, 1908
Y
COMMONWEALTH OF MASSACHUSETTS
Beyergian
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
Rosa Bedergian.
Registered No.
Place of 2
Death * S
Residence
63 matthews Street Chelyen 1
.years
6
.months. .. days
STATISTICAL DETAILS
SEX
Freirenie
COLOR
Mute
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME +
HUSBAND'S NAME +
BIRTHPLACE # Chelica Mass
NAME OF
FATHER
arkal Bedurgian
avatal Bezen dian
BIRTHPLACE OF FATHER+ Bulgarici
MAIDEN NAME OF MOTHER
BIRTHPLACE OF MOTHER + Bulgaria
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from Abril 11 190 10 may /1 190. .. to 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 : malmetritra -
(DURATION). .... . .. DAY9
Contributory :
.(DURATION) DAYS
(Signed)
Birmetcalf
M.D.
190.
.(Address)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
6 mecky
months.
days
Where was disease contracted,
if not at place of death ?.
Chelsea
....
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.
ALL NAMES TO BE IN FULL IUSA W CI CIUIC 'VNI VIIM
150 9914
PLACE OF BURIAL OR REMOVAL li
DATE OF BURIAL
May 26
8
190
UNDERTAKER
ADDRESS
Date of ¿
Death
190
43 Joseph Henry Sich May 19, 1908
[3.'06 37-LM.]
Permit No.
Harithrope
RETURN OF DEATH. BOSTON, MASS.
Name in full,
Date of Death, Away 20"1908 Tilltru Antand (Vorder)
(If married or divorced woman give maiden name, also name of husband.)
Sex, Female Color White
Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or
Divorced.)
Age Years, Months,. Days. Occupation,
Residence,* Quanthope
nass
Ward,~
Place of Death, 59, Fremont Sheel
(State year, mouth and day.)
Place of Birth, 11 11 11 Date of Birth, May 20"1908
Desejoh & boarder-Winthe
alice M. Virkham- Breektin Mass
Place of Interment,
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Hinutrop Chcetey - Mitrop Mass 10 unter @ floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop
Boston,
May 201
190 8.
Name and Age ?
of Deceased,
(Cordes) } Age, ................ 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 : Still box al
Chief cause,
Disease Contributing cause, .
Duration
* If an Institution, state how long an Inmate and previous residence.
Chief Cause, Contributing cause, IS. Porter M. D.
21
May 20, 1908
COMMONWEALTH OF MASSACHUSETTS 4
RETURN OF A DEATH
(CITY OR TOWN.)
1184
Registered No.
Place of 1
2 Burnett Terrace Reur 130 Pauline SX
Date of l 12eumy 22 190
0
Residence
Age
59
.. years.
.months. .days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME +
HUSBAND'S NAME +
BIRTHPLACE # Theateam guay 11. 4.
NAME OF FATHER
BIRTHPLACE
OF FATHER#
Malden
MAIDEN NAME OF MOTHEP.
BIRTHPLACE OF MOTHER #
OCCUPATION
AIMRIR
INFORMANT § €
PHYSICIAN'S CERTIFICATE
190 .. to I HEREBY CERTIFY that i attended deceased during last iliness, from 1901 may 22. 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 : apoplexy
(DURATION).
5
.DAYS
Contributory :
Locomotor ataxia
.. (DURATION).
3 More
(Signed)
simelcall
M.D.
May 23 190.8 .. (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 II
DATE OF BURIAL Hewey 25 1900
UNDERTAKER
È l' Pereccioni
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 detalls. Il Name of cemetery.
ALL NAMES TO BE IN FULL
FULL NAME
William Henry Oakes
Death *
S
Death S
6
43~ William Henry Cakes May 22 , 190 8
[4.'07-37.LM.]
Permit No.
RETURN OF DEATH.
L'hivtrap BOSTON, MASS.
Date of Death, May 27' 8
190
Hannah ann Freeman (Taylor) Name in full,
& a. Fruman
(If married or divorced woman give maiden name, also name of husband.)
Sex, Female ...... Color,
Condition, named -
(White, Black, Mixed, Chinese, (Single, Marrled, Widowed or Divorced.)
Indian, etc.)
Age, 61 Years, 8. Months, ~Days. Occupation,
Residence,* Stinttoto Mass Ward,
Place of Death, 6) Washington avenue
Place of Birth,
Chatham Mais Date of Birth,
(State year, month and day.)
Sefel 27-
John Taylor = 6 clean Mars
Name and Birthplace of Father, Maiden Name and Hanmah une Taylor=Challiam mass
Birthplace of Mother,
Place of Interment, Ianthropo Cenetery Dunfer Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, may 28 1908.
Name and Age ?
of Deceased, 1 Jamah
anny Fuman Age, 61 years.
I hereby certify that I attended deceased from Irmarty .. 190 ), to.
190 , that I last saw
alive on the
- day of. .. 190 ,
1908, about o'clock that died. on the 27 day of
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of death was as follows : Locomotor alexia
Chief cause,
Disease Contributing cause,
Chief Cause, 2
* If an Institution, state how long an Inmate and previous residence.
Duration Contributing cause, 31Met call M. D.
May 27, 1998
ALL NAMES TO BE IN FULL
PLACE OF BURIAL OR REMOVAL II
DATE OF BURIAL
. 190
UNDERTAKER
ADDRESS
PHYSICIAN'S CERTIFICATE
[ HEREBY CERTIFY that I attended deceased during last illness, from Muy 3/ 1908 to May 31 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 :
Stillbritts du Lí ders delais
cord wound weeks (DURATION) .. .......... . . DAYS
Contributory :
(DURATION). ........ DAYS
(Signed)
M.D.
190.
.. (Address).
Ju: Banks, Hanno.
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.
# Stato or country; also city, town or county, If known.
§ Name and address of person giving statistical details,
Il Name of cemetery.
0
Death *
5
V
Luc
Age.
fears.
.months.
days
STATISTICAL DETAILS
SEX
mule.
COLOR
White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME +
HUSBAND'S NAME Ť Holston
BIRTHPLACE#
NAME OF FATHER Daniel Holston
BIRTHPLACE OF FATHER# Breman Germany
MAIDEN NAME OF MOTHER Sumie. C. Kelley
BIRTHPLACE OF MOTHER $ Phil Pa
OCCUPATION
INFORMANT §
Daniel Holston
......
Registered No.
Place of l
tor 1- 3 antes
Date of l
May 31
190
Death S
Residence
COMMONWEALTH OF MASSACHUSETTS
Unitinota Mas. (CITY OR TOWN.)
RETURN OF A DEATH
FULL NAME
Holston
falster
May 31, 1908
COMMONWEALTH OF MASSACHUSETTS.
RETURN OF A DEATH-1908.
CITY OF BOSTON.
FULL NAME
John " Crompton
Registered No 5248
Place of Death ¿ Boston
and Residence S
Date of Death
Jun 3
1908.
Age
54
. years.
months. ......... ... days.
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
W
M
Maiden Name. ....
Husband's Name ..
Birthplace Boston
Name of
John Crompton
Birthplace
Boston
of Father
Maiden Name Phoebe Brereton
of Mother.
Birthplace of Mother.
Produce dealer
Occupation
Informant.
Place of Burial or removal Mt Hore J & Waterman % Sons
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
.1908,
from 1908, to 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 :
RAR'S
.SITO Primacy (Duration2
Gen.Ac. Peritonitis - 4 dys
TA /D. 1822
. MAS.S. Contributory : 2 Diphtheritic Colitis with (Duration)
- perforation, Carcinoma of Sigmoid 4 ... d.ys
(Signed) J L Belknap ...... M.D.
Jun 4 1908 ...
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Admitted to hospital May 31,1908
Usual Residence.
Winthrop (78 Crystal Cove)
Jun 6
Filed 1908.
A true copy. Attest :
Registrar.
ST
PATRIBU
CITY
TYITATISRE
BOSTONIA
CONDITAA.
Father
BOSTON
DONATA A.
Undertaker
Mass Gen Hospt
Joly I. Cirruption Jour 3-1908.
COMMONWEALTH OF MASSACHUSETTS.
RETURN OF A DEATH-1908.
CITY OF BOSTON.
FULL NAME
William A Buckley
Registered No .. 5292
Place of Death }
Boston
Carriage between Hotel Plaza & E. Boston
and Residence S
Date of Death
Jun 5
1908.
Age
. years
.... . months. .days.
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
M
Maiden Name
Husband's Name
RE
SICUT PA Primary (Duration) SIG
Tatty degeneration of Heart
AFICE:
Oedema of Brain, Alcoholism
BOSTONIA
Name of
Father Charles M Buckleo's "DONATA A
Birthplace Augusta Me
of Father.
Maiden Name
Carrie Buckley
of Mother
Birthplace Portland Mie
of Mother
Occupation Insurance
Informant
Place of Burial or removal .
Winthrop" Winthrop Com
Undertaker
Summer Floyd
Winthrop
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
.1908,
from 1908, to 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:
ISTRAR'S
Birthplace
Portland Me
CITY
IVITATISR
TA A. 1822.
N. MAS.S.
Contributory : ( (Duration)
(Signed) G B Magrath , Med . Ex. M.D.
Jun 6 908
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Usual Residence.
Winthrop( 47 Washington St.
Filed Jun 8
1908
A true copy.
Attest.
ErMSlenen
Registrar.
45
William A Buckley June 5, 1908
[4.'07-37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Name in full, nul Sarah Pul
June 7" 1908.
Date of Death, Sarah Melinda Capeen
Sarah Melinda Floyd (If married or divorced woman give maiden name, also name of husband.)
(White, Black, Mixed, Chinese, Indian, etc.) Condition, Married Sex, Female Color
(Single, Married, Widowed or Divorced.) Age, .. 65 Years, ~ Months, Days. Occupation,
Residence,* Winthrop Mass Ward,.
Place of Death, 30, atlantic Stiel
Place of Birth, Winthrop, Mas Date of Birth, (State year, month and day.)
Name and Birthplace ) Phileines D. Floyd - Chelsea Man
of Father, Maiden Name and 1 Birthplace of Mother, S Sally ann Floyd - Chelsea Maso
Place of Interment,
Summer land
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and Age ?
of Deceased, S. malinda
Boston, Capsend
8
190 A
Age, 60 years.
I hereby certify that I attended deceased from Annel 14, 1907, to Family,
1900", that I last saw.
alive on the. 7 Th. .. day of. 1908. that she died on the. 7th day
1900, about 4 o'clock
I.H., or P.M., and that, to the best of my knowledge and belief, the cause of her death was as follows :
Disease Chief cause,
Carci soma.
Contributing cause, Cardiac Apportertrophy, about three years.
Chief Cause,
Contributing cause, Several years.
1 M. D.
* If an Institution, state how long an lomate and previous residence.
19 Winthrop At., Windles.
20
Duration
Sarah melinda Capena June 7-1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME adelaide M Rogers
Registered No.
Place of l
165 River Road
Date of l
June 10
.190
Residence
2
Age
21
.years.
11
.months. 21 .days
STATISTICAL DETAILS
SEX temala
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Single
MAIDEN NAME +
HUSBAND'S NAME T
BIRTHPLACE # Charlestória Mais
NAME OF FATHER James .F. Rogers
BIRTHPLACE OF FATHER# Boston mass
MAIDEN NAME
OF MOTHER
adelia action
BIRTHPLACE
OF MOTHER #
OCCUPATION School Evil
INFORMANT § Sister
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from, Sun 11 1908 to June 10 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 : Cardial Dropsy
two
(DURATION) . DAYS
Contributory :
Brights Dewaal
4 ruot
.. (DURATION) ........ .DAYS
(Signed)
Ihr. Partir
M.D.
face 12 908 (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 II
DATE OF BURIAL
190 .. 8
ADDRESS
UNDERTAKER CMPerson
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, give facts called for under "Speciai 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
Death *
5
Death
1
49 adelaide Ir Rogues
947
[6-'07-146. VM.]
(FOR POST-MORTEM EXAMINATIONS ONLY.)
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death,
June 11, 1908
Name in full, Alice May Wadsworth -D Hier many Habeis
( If married or divorced woman give maiden name, also name of husband.)
Sex, JAmal. Color, HILFE Condition,
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced. Indian, etc.) 1
Agen 23 Years, / Months, ~ Days. Occupation,
Residence 29 meny sidetor, Mit un dass,
Place of Death,
metcalf Hospital, Winthrop-
(Sta year, month and day.)
Place of Birth, Arbury Set DelowDate of Birth,
Name and Birthplace of Father,
barrio Istas tur qo
Maiden Name and Birthplace of Mother, Holy Cross, Waldre
Place of Interment,
Frank Ve maloury, Undertaker.
MEDICAL EXAMINER'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, June 2, 1908.
I hereby certify that I viewed the body of
Name, alice May Wadsworth
Age, 23 years.
who died on the
day of me 1908.
and to the best of my knowledge and belief, the cause of her death was as follows:
Autopsy acute
al peritonitis consequent
al ortion probably self.
Chief cause, Disease, Contributing cause," performeda Lenge Burgers hagrat, med Exam Suffolk Co.
2
Though & Starren
Doutor
alice may Hadworth. June 11, 1908.
alice M. Wadsworth-
947
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Name in full,
Date of Death,
Daniel, lowell
Verne 181908
(If married or divorced woman give maiden name, also name of husband.)
Sex, 7/Late Color,
Condition, granied
(Single, Married, Widowed or
Divorced.)
Age, 58 Years, 9 Months, 13 Days. Occupation,
Residence,*
It anthropo mars
Ward, 1.6
Place of Death, 23 Shown in Park
Place of Birth,
Of Flour, ter Me. Date of Birth, ..
(State year, month and day.) Je1015 "1849
Name and Birthplace Lorenzo Stanete- Day me of Father,
Maiden Name and Unkumar
Birthplace of Mother, Stodlawn Seeley
Place of Interment,
Summerteflonde Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Dirittolo Boston, Januar 19" 1908
of Deceased, Daniel Stinvele Age, 58 years.
I hereby certify that I attended deceased from
alive on the 12 th
day of June 1908,
that died on the 18-4
day of. Jene
1908, about 6 o'clock
A.M., or P.AL, and that, to the best of my knowledge and belief, the cause of.
Disease ? - Chief cause, L'arc moura of Unnan bredden
Contributing cause,
Quanition
Chief Cause,
Duration Contributing cause, Vin ponowne Cution J. Ir mitmon M. D.
* If an Institution, state how long an Inmate and previous residence.
1907, to June 17 th
190 8, that I last saw
his death was as follows :
Name and Age ?
(White, Black, Mixed, Chinese, Indian, etc.) Юридалев
Daniel Stowell June 18, 1908
COMMONWEALTH OF MASSACHUSETTS
Winthrop
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
David Smith Gordon
Registered No.
289
Place of ) Daisy Still Cottage Win.
Death * 5
Residence
10 John It Chelsea Age.
19
.. years.
10
months. .days
STATISTICAL DETAILS
SEX
COLOR
Male White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Single
MAIDEN NAME +
HUSBAND'S NAME +
BIRTHPLACE #
Lynn Mass
NAME OF FATHER David S. Gordon
BIRTHPLACE
OF FATHER#
New Hampshire
MAIDEN NAME
OP MOTHER
BIRTHPLACE
OF MOTHER#
Infront of. 9.
OCCUPATION none
INFORMANT §
Mas Q. M. Ind.
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.
PLACE OF BURIAL OR REMOVALII
DATE OF BURIAL Woodlawnslune 25,90 8
UNDERTAKER ADDRESS Off Fauna 424 Balway
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. June 22 190% to trene 23 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 : Centro-Spinal menujete
(DURATION)
1
OAYS
Contributory :
.(DURATION). .. DAYS
(Signed)
M.D.
Jan 24 .190 .. ((Address) ...
Chilena man
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 ?.
Death
Date of
June 2 3.190 8
Johnson
52 Dania Lunch Fordow fumer 23, 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH Caroline M- Post
FULL NAME
Place of Death*
106 Grover Die Winthrop
Date of Death
June 27-1908
Age
56
years
8
months
26
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.