USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1907-1909 > Part 13
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Boston, 190
..
Name and Age? of Deceased, .. .
... . 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 : - Disease Chief cause, ( Contributing cause,.
Duration
Chief Cause, .... Contributing cause,
* If an Institution, state how long an Inmate and previous residence.
M. D.
Ward,
Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother, Place of Interment, Stuhrop im -
14.'07-37-LM.] COUNTERSIGNED BY IMA JANDOR REALTY AUG 22 1/08
UHIIL
S.SECRETARY ŁTARY.
|4.'07-37-I.M. |
Permit No.
RETURN OF DEATH.
BOSTON, MASS.
Date of Death,
august 16" 190 8
Name in full, Iemand S. ayers
(If married or divorced woman give maiden name, also name of husband.)
Sex, Male Color, Ophile-
(White, Black, Mixed, Chinese, Condition,
Indian, etc.)
(Single, Married, Widowed or Divorced.) N
Age, Years, ... Months, 23 Days. Occupation,
Residence,* Dianthusto mass
Ward,
Place of Death, 56 Real Steel
(State year, month and day.)
Place of Birth,.
Startup Mass Date of Birth,. Dec 24"1907
Name and Birthplace of Father,
Daniel ayer- Manchester mass
Maiden Name and Deabella's Stidetine-Stenfoundland
Birthplace of Mother,
Place of Interment,
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Ofinttuopo Boston, auf 17 190 8 ·
Name and Age? brenard . ayer
Age, 7 years.
I hereby certify that I attended deceased from. any 14 190g,to any 16.
190 that I last saw he
alive on the 16 day of 190 f
1908, about 1 procloch that died on the 16 day of any
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,
Contributing cause, Whopny augh
Chief Cause,. 2 dias
Duration
Contributing cause, 2 weeks
M. D.
* If an institution, state how long an Inmate and previous residence.
Somer complant
of Deceased,
7
Leonardo ayero
aug 16, 1908
|4.'07-37-LM.|
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Name in full, Evelyn
Date of Death,
aug 22 1908
190
u leite
Sex, Female Color,
(If married or divorced woman give maiden name, also name of husband.)
(White, Black, Mixed, Chinese, Indian, etc.) Condition,
(Single, Married, Widowed or Divorced.)
Age, 2 Years Months, ~ Days. Occupation,
Residence, *
Eckard the Wallam Masward,
Place of Death, 311 thuley af Unithigh Pass
(State year, month and day.)
Place of Birth,
Wall ham Mare Date of Birth,
John. P. White Sincity Mass
Name and Birthplace ) of Father, Maiden Name and Many Jainy Waltham Mars
Birthplace of Mother,
1
laban Ein Stalshane Mar
this .I money # 61/2 Trallliau Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Cha 22 190 8.
of Deceased, quelin 7 White
Age, 21 years.
I hereby certify that I attended deceased from .. any 19 1908, to amy 21
190 that I last saw for alive on the. 2108 day of any 1908.
that. died on the 2/1
day of 190 & about. 7 o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of .death was as follows : Tubercular meningitis
Chief cause,
Disease ‹ Contributing cause,
Chief Cause,
mount
Duration Contributing cause, 31met calf M. D.
* If an institution, state how long an Inmate and previous residence.
3 mis
Name and Age !
Place of Interment,
Evelyn I. White Quy 22, 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
Welches (CITY OR TOWN.)
FULL NAME
allene. Heris Layland
.Registered No.
Place of l
32
Residence
-
-
Age
40
.. years.
months. 28 .days
STATISTICAL DETAILS
SEX female
COLOR
what
SINGLE, MARRIED, WIDOWED, OR DIVORCED
manuel
MAIDEN NAME + Ferie
HUSBAND'S NAME +
Frederik. W. Leyland
BIRTHPLACE # Pandemi R.G.
NAME OF FATHER Jacob. almon Ferris
BIRTHPLACE OF FATHER$ Elizabeth Común R.M.
MAIDEN NAME OF MOTHER Julia nutting
BIRTHPLACE OF MOTHER #
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. aug 16 190. ... to Qua 24 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 : Casebral Hemorrhage
seger
hereke
.(DURATION) DAY8
Contributory :
(DURATION). .DAYS
(Signed)
M. Cartão
M.D.
aug 26, 1909 (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 dotalls. || Name of cemetery.
ALL NAMES TO BE IN FULL
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL aug 27 . 190.
ADDRESS
UNDERTAKER CAR. Bennison
Date of 1
.190 JA
Death *
5
Death 5
allyne Ferir Leyland Cinq 24, 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
Winthrop (CITY OR TOUN.)
FULL NAME
Lee Crockett
Registered No.
Place of }
Boston Harbor (off Withund)
S
Death *
..
Residence
Climanad, P.2.2.
Age.
18
.. years.
.. months. .. days
STATISTICAL DETAILS
SEX
Male
COLOR
White
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Single
MAIDEN NAME + HUSBAND'S NAME +
BIRTHPLACE# Elmilate PE.4.
NAME OF FATHER folu. D. Cuchet
BIRTHPLACE OF FATHER$
Cemidal P. E.g.
MAIDEN NAME
OF MOTHER
Elizci Clarka
BIRTHPLACE
OF MOTHER $
OCCUPATION
INFORMANT § Linda
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last
ithness, from 19
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 : Drowning, accidental
. (DURATION). ......... .. DAYE
Contributory :
(DURATION) ...... .. DAYe
(Signed)
Serge Burger Magnall
M.D. Catag 28908 (Address) Med Dx. Suffolk Co
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
ADDRESS
UNDERTAKER CarPer. N
* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, glve facts called for under "Speclal Information." If In a Hospital or Institution, give Its NAME Instead of street and number. t In case of marrled or divorced woman, or widow. # State or country; also city, town or county, If known,
§ Name and address of person giving statistical details, || Name of cemetery.
ALL NAMES TO BE IN FULL
Date of l
ang. 27
190
Death
.
Lee 70 Lee levekett aug 27,1908
-
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
George. P. Puoi
.Registered No.
Date of
Death *
S
Residence
. Age
72 years.
12
months.
.days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Maneed
MAIDEN NAME +
HUSBAND'S NAME + 2
BIRTHPLACE ± Duxbury mars
NAME OF FATHER William Prior
BIRTHPLACE OF FATHER $ Duckling Man
MAIDEN NAME
OF MOTHER
BIRTHPLACE OF MOTHER $
OCCUPATION Reluat
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from .. 190€ to Buy 201 190
..... 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 :
angina Pectoris
(DURATION). .. DAYS
Contributory :
(DURATION)
2 mg
. DAY8
(Signed)
BIMel cul
M.D.
Umy 31
.190 .... (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 I
DATE OF BURIAL
Seffern 1900
UNDERTAKER
ADDRESS
* 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 numbor.
t In case of married or divorced woman, or widow.
# State or country ; also clty, town or county, If known.
§ Name and address of person giving statistical details. li Namo of cemetery.
ALL NAMES TO BE IN FULL
INFORMANT §
Place of
15 Washington Cover
Death
S
71 George P. Prior aug 29-1908.
COMMONWEALTH OF MASSACHUSETTS
Winthrop. Ma (CITY OR TOWN.)
FULL NAME
-trans
Place of l
Winthrop, Mass
Death *
Residence
"14 Taylor It
Age 27
.years.
.. months ..
days
STATISTICAL DETAILS
SEX
maly
COLOR
SINGLE, MARRIED, {
WIDOWED, OR
DIVOROED
Singles
MAIDEN NAME + HUSBAND'S NAME t
BIRTHPLACE #
Antigonieko ANY.
NAME OF
FATHER
By mi Eachau
(BIRTHPLACE
OF FATHER $
Port hood, Cape Breton
MAIDEN NAME
OF MOTHER
Mary higlevou
BIRTHPLACE OF MOTHER # Artigonich. ~ Ina Scotia
OCCUPATION
INFORMANT §
PLACE OF BURIAL OR REMOVAL II Holy Cross Loru
DATE OF BURIAL
1908
UNDERTAKER ADDRESS Strach V. malowry 350 tintop It
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from July 1 1908 ... to aug 30 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 : Philips Pulmarch,
(DURATION). . DAYS
Contributory :
(DURATION)
.. DAY9
(Signed)
M.D.
Suppe 1 1908
.(Address)
Winthrop Mars
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 calted for under "Special Information." If In a Hospital or Institution, give Its NAME Instead of street and number.
t In case of marrled or divorced woman, or widow. 1 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
RETURN OF A DEATH micacher
.Registered No.
Date of
freq 31"
190
Death
..
5
12 Tugues Mo: teachers - Cinq 31-1908.
14.'07.37.I.M. |
Permit No.
Winthrop ..
RETURN OF DEATH.
BOSTON, MASS. : Date of Death, aug-31 190 8
Name in full,
Ernest a mitchelle
......
(If married or divorced roman give maiden name, also name of husband.)
Sex, nale Color, pored.
Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, Years,.
Months, 18 Days. Occupation,
Residence,*
Mass ... Ward,
Place of Death, 12 Oakland Street
Place of Birth, 12 Oakland SI
(State year, month and day.)
Date of Birth, Ong 13' 19 cr
Name and Birthplace ) of Father,
adresous Mitchell= Besten
Maiden Name and Birthplace of Mother, S
florence 9, farrell - Boston
Place of Interment, Winther ellemeler
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Boston,
190
Name and Age
of Deceased, Event of Nutiluce Age, .... .years.
I hereby certify that I attended deceased from. Aug 25 1908, to Any 3108.
190 , that I last saw.
alive on the. 26 day of ary 190 Y,
that. he died on the 31 day of Any 1908 , about 12,30 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:
Disease Chief cause,
Iwantim
Contributing cause,
Low Vitality
Chief Cause,
........... Contributing cause, Low Vitatil
Duration
celwand 7, 9age M. D.
· If an Institution, state how long an Inmate and previous residence.
21
2 wks 6 days
Aug 31-1908
[4.'07.37-I.M.]
Winthrop
RETURN OF DEATH.
MASS.
Date of Death,
Vent, 3
190 g.
Name in full, .. Ellen
Burns
Sex, A. Color, W
(White, Black, Mixed, Chinese,
Condition,
(Single, Married, Widowed or
Divorced.)
Age, 70 Years, Months,
Days., Occupation,
Housemaid
Residence,* 54 Cliff ave Winthrop Mas Ward,
Place of Death 54 loff ave, Winthrop Mass.
Place of Birth, Ireland
Date of Birth,
Name and Birthplace ! Unknown.
of Father, Maiden Name and Birthplace of Mother, $
U6 wekenon
Place of Interment, Holy Cross Mal den
Thomas A. Lance Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH. Chelou Mexer. Boston .... Syp. 3- 190
190 8
Name and Age ?
of Deceased, Ella Burns - Age, 70 years.
I hereby certify that I attended deceased from 1908, to Say 3 1905, that I last saw her alive on the. 2 1/2 day of. 190 8
The died on the 320
day of. 190 8, about 6,3%' 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, Certhenia
Disease Contributing cause, Propensione Servicios Quacnica
Duration
Contributing cause, Probably three years
M. D.
* If an Institution, state how long an lomate and previous residence.
13, Mark. One Chalan wake,
that
Chief Cause,
Permit No. 436
(If married or divorced)woman give maiden name, also name of husband.)
Indian, etc.)
(State year, month and day.)
Meller Humus
Sepet 3,1908.
5 .
3
[4-'07-37-I.M.]
Permit No.
RETURN OF DEATH. Winthrop BOSAN, MASS.
Date of Death, Left 4
Name in full, Geraldine Beenan
1908
(If married or divorced woman give maiden name, also name of husband.)
Sex, Color,
(White, Black, Mixed, Chinese, Condition,
(Single, Married, Widowed or
Divorced.)
Age, Years,. 3 Months, 19 Days. Occupation,
Residence, * 87 Washington ave, Winthrop
Ward,
Place of Death, 87 Washington are. Winthrop Mass.
Place of Birth,
Winthrop Mass.
Date of Birth,
Brendan Keenan Boston Mass.
Mary L. Sullivan Boston Mass
Place of Interment,
Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother, 5 Holy Cross Malden Thos. J. Lave
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Sept. 4 1908.
Name and Age ?
of Deceased, Geraldine seenan Age, 3 years.
I hereby certify that I attended deceased from.
July 26 1908, to sept 4
1908, that I last saw Bad alive on the. day of Sept 1908,
that died on the 4lt day of 1908, about! .... o'clock
her / death.
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of was as follows :
Disease 3 Chief cause, Toute meningitis
Contributing cause, . Gastro Enteritis
Chief Cause, 36 hours
Duration Contributing cause, 7 weeks
M. D.
* If an Institution, state how long an inmate and previous residence.
Indian, etc.)
(State year, month and day.)
Geraldine Rewan Septet, 1908
[4.'07.37-LM.]
Permit No.
Winthrop RETURN OF DEATH. BOSTON, MASS.
Syet 8 190 8 190
Name in full,
(If married or divorced woman give maiden name, also name of husband.)
Sex, male .Color Condition, manèd
Age, 81 Years, 2 Months 24 Days. Occupation,
(White, Black, Mixed, Chinese, Indian, etc.) Real Cetate
(Single, Married, Widowed or
Divorced.)
Residence,*
cineticof Mass
Hard,
Place of Death, 247, Main Street,
Place of Birth, Shellune el. &, Date of Birth, (State year, month and day.)
Name and Birthplace Į of Father,
Robert G. Ammin Skethere Of
Maiden Name and Bella Firth = Shelhume Ct. .
Birthplace of Mother,
Place of Interment, Winthrop, Cemetery Mantrofe mars
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Deuttrop Boston, Sept 10 1908
Name and Age ?
Age, 81 years.
of Deceased,
I hereby certify that I attended deceased from .. Saft 4 190 8, to Left 8
190 8, that I last saw the
.alive on the 8 day of Seft
1905.
day of Seft 190 8, about 1045 o'clock that died on the. 8
this death was as follows :
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of Traumatic Pneumonia
Disease S Chief cause,
Contributing cause,. Facture of rets collar boue
Forn Days
Chief Cause,
Duration
Contributing cause, There Say ....
M. D.
* If an institution, state how long an inmate and previous residence.
621
Date of Death, Samuel Grande Irvin
I
Samuel 4. Seven Sept 8, 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
Elizabeth 3. austin
Registered No.
Place of 1
Death
5
11 Reddy IL
Residence
Age
49
.years.
3
.months. 6 .day
STATISTICAL DETAILS
SEX
Female
COLOR
white
SINGLE, MARRIED, WIDOWED, OR DIVORCED
manuel
MAIDEN NAME +
Elizabet. B. Norton
HUSBAND'S NAME +
alexandra a. austin
BIRTHPLACE #
Farmington me
NAME OF
FATHER
Unknown
BIRTHPLACE
OF FATHER#
4
MAIDEN NAME
OF MOTHER
BIRTHPLACE
OF MOTHER +
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from may 1 Shefo. 9 1908 to 1908, that to the best of noy knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows :
Primary :
Remal Dropsy
3 mos
(DURATION).
. DAY8
Contributory :
Intervential Nephritis.
fear
.(DURATION).
.. DAY8
(Signed)
M.D.
0/0,10 1908 (Address)
SPECIAL INFORMATION only for Hospitals, Institutlons, 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.
ALL NAMES TO BE IN FULL
PLACE OF BURIAL OR REMOVAL !! Seft-11 Winchnot
DATE OF BURIAL
Soft 1115
8
190.
ADDRESS
UNDERTAKER CRBemma
Date of
Death
S
190
2
80 Elizabeth Bambus. Sept 9 - 1908
[4-'07-37-LM.]
Dad at 3. P.M.
Permit No.
RETURN OF DEATH. Winthrop BOSTON, MASS.
Date of DeathOK
Sept. 11
Name in full,
arthur a.
a.
Sullivan
(If married or divorced woman give maiden name, also name of husband.)
Sex,
Color,
(White, Black, Mixed, Chinese,
Condition,
Indian, etc.)
(Single, Married, Widowed or
Divorced.)
Age, ..... Years, 10 Months,. 21 Days. Occupation,
Residence,*
29 Washington ave, Winthrop
Ward,
Place of Death, 29 Washington Que. Winthrop Mass.
(State year, month and day.)
Place of Birth,
2. Boston Mass
Date of Birth,
Name and Birthplace ? of Father,
arthur a.
E. Boston Maso
Maiden Name and Birthplace of Mother,
Elever Cronin Charlestown Mass
Place of Interment, Holy Cross Malden
Phos. L. Jane
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
w willing Boston Seja 11 190 8 ....
Name and Age? arthur G. Sullivan
of Deceased, Age, 10/1 2years.
I hereby certify that I attended deceased from. Sep. 7 190 %, to Sijo. 11
190%, that I last saw lu
that died on the 11th
day of Sep.
day of Sejo 190 %
190%, about 3 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, Cholera in refactura
...
Disease Contributing cause,
Chief Cause, .. . . These days
Duration Contributing cause, ,
Edward ). Franyer
M. D.
· If an Institution, state how long an Inmate and previous residence.
alive on the 11th
1908.
17 archiv & Sullivan Sepr 11, 1908
[4.'07.37.L.M.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, zzer 13.
190 8
Name in full,
( Sicher -Mc Quarry - large
(If married or divorced woman give maiden name, also name of husband,5
Sex, Color,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, 41 Years, 3 Months, 17
Days. Occupation,
Residence, *. 125, argine
Ward,
Place of Death, 12 (auquel -
(State year, month and day.)
Place of Birth,
Date of Birth, May 31'1869 Thetow r. .
Name and Birthplace Angus
Maiden Name and Birthplace of Mother,
of Father, Thebs L. Andrews Frederickto F.B.
Place of Interment, Novalawn & Fit. Suerte mass. & & Brown. Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Name and Age
of Deceased, Lizzie B. Elder
Age, 41 years.
I hereby certify that I attended deceased from Cept. 10 1908, to. Sept. 17
1908, that I last saw her .alive on the. 17 day of September 1908, that the died on the 17 day of Deflimber 1908, about. 3 o'clock
.t.H.,or P.M., and that, to the best of my knowledge and belief, the cause of ... death was as follows:
Chief cause, .. Pulmonary Tuberculosis
Disease
Contributing cause, Cardiac failure
Duration
Chief Cause,
Three year
Contributing cause, One week
Mary Elizabeth Halsall M. D.
. If an institution, state how long an Inmate and previous residence.
1024 Bennington St. Bast Boston, mars.
Boston, September -17 190.8 ...
Condition, 16.
78 Lizzie R. Elder sobi is prog
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME
Elizabeth ...... Ann ..... Prescott.
Registered No.
Place of Death *.. 89 .... Cottage ... Avenue
Date of Death ....
September 24 I908
Age.
5I
... years. 6
.months
8
days
STATISTICAL DETAILS
SEX
female
COLOR
White
SINGLE, MARRIED,
WIDOWED, OR
DIVORCED
Married
MAIDEN NAME +
Elizabeth Ann Brown
HUSBAND'S NAME +
John Prescott
BIRTHPLACE #
Boston Mass
NAME OF
FATHER
Robert Brown
BIRTHPLACE
OF FATHER#
Ireland
MAIDEN NAME
OF MOTHER
Eliza Armstrong
BIRTHPLACE
OF MOTHER #
Ireland
OCCUPATION Housewife
INFORMANT §
John Prescott
PLACE OF BURIAL OR REMOVAL !!
Mt Hope Cemetery UNDERTAKER J. B. Levle &Son 560
DATE OF BURIAL
190.
Sept 26 1908 ADDRESS
Columbia Road
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from Aufu. 19 . 190 8 to Leh. 24 .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 Hemorrhage
.(DURATION).
5
OAYS
Contributory :
5 mrs.
(DURATION) . DAYS
(Signed)
M. D.
Sep. 24 1906 (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
* 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.
Dorchester
ALL NAMES TO BE IN FULL
-
Sept 2-4-1908.
[4.'07-37-LM.]
Permit No.
RETURN OF DEATH.
Printhop 4 BOSTON, MASS.
Deler 28 " 1908 S Date of Death, Darah S, Marden
Name in full,
George C. manden
(If married or divorced woman give malden name, also name of husband.)
Sex, Female .Color, White
Condition, Widowed
(White, Black, Mixed, Chinese, (Single, Marrled, Widowed or Indian, etc.) Divorced.) Age, 00 Years, Months, .... Days. Occupation,
Residence,* 19 Ocean View Street
Ward,
Place of Death, 19 Ocean View Steel
(State year, month and day.)
Place of Birth, Cash Machine me Date of Birth,.
Name and Birthplace ! Unknown
of Father,
Maiden Name and
Birthplace of Mother, Place of Interment, I cuithinal Cemetery Winthrop mas Summer Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Thenthrows Boston, Beletenter ....
1908
Name and Age !
of Deceased, Sarah'S murder Age,. 50 years.
I hereby certify that I attended deceased from. 1907 190 to
Sept 28
190 & that I last saw
alive on the. 28
day of Sujet 1908,
that died on the. 28 day of. Seft I.com.
1900, 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 : abdominal Cancer
Chief cause,
Disease Contributing cause, Theuritis
Duration
Chief Cause, 2 jours
Contributing cause, 2 year 3. 11met cal ) M. D.
* If an Institution, state how long an inmate and previous residence.
Sept 1 19 Sarah 'S Meander Seper 28, 1908
٤٠٠
1069
[6-'07-146. VM.]
(FOR POST-MORTEM EXAMINATIONS ONLY.)
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death,
act. 2, 1908
Name in full,
Jeanette Campbell (anna. Completi Dumont
Canklett
(If married or divorced woman give maiden name, also name of husband.)
Sex, Color, Vtuto Condition, Marie-
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Indian, etc.) Divorced.
Age,
31 Years,
7 Months, ..
21 Days. Occupation,
2
Residence,
Ward,
Place of Death, Great Hall, Winthrop Place of Birth,
(State year, month and day.)
Date of Birth,
Name and Birthplace \ of Father,
Maiden Name and Birthplace of Mother,
Louisi . R. Schultz-
Place of Interment,
CellBanca
Undertaker.
MEDICAL EXAMINER'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, nor.> 190
I hereby certify that I viewed the body of annacumple -
Name,
nette Camphill
DumontAge, 3 ) . years, who died on the. 2dl day of ... out. 190
and to the best of my knowledge and belief, the cause of her as follows:
death was Autopsy
Disease, Chief cause, Incineration consequent ou a Contributing cause, Confeagenten,
M. D.
2
Алена Самовей Oct 2, 1908
COMMONWEALTH OF MASSACHUSETTS
Writtento
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME Augusta Sadler Lindsey
.Registered No.
Place of )
Death *
S
L
Residence
22 ..
Age
93
.. years.
months .days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME + Cinquenta- d. Perry
HUSBAND'S NAME +
BIRTHPLACE#
NAME OF FATHER
BIRTHPLACE OF FATHER$ Holliston 222000
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