USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1907-1909 > Part 14
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MAIDEN NAME OF MOTHER aurila Salle
BIRTHPLACE OF MOTHER $
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from .. 1900 190 ... to
oct 6ª 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 :
old age
(DURATION ) DAY8
Contributory :
A .... (DURATION) DAY8
(Signed)
Bir met calf
M.D
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 I
DATE OF BURIAL
180%- 9
0
..
190.'
UNDERTAKER
ADDRESS
* 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 marrled 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
.
Date of ¿
Coc.1 6
.190
Death
S
82 augusta Sadew Lindsay Cect 6-1908
14.'07.37-LM.|
Permit No.
Winthrop
RETURN OF DEATH.
BOSTON, MASS.
Date of Death,
(Oct 10" 1908
190
Name in full, Thomas a. Francis
.... .
(If married or divorced woman give maiden name, also name of husband.)
Sex, male .Color, White
Condition, maned
(White, Black, Mixed, Chinese, Indian, etc.) Credit Mange
Age, 40 Years,. Months, Days. Occupation,
Residence, *. Minitrope mass
Ward, ....
Place of Death, SH Highland avenue
Place of Birth, Botão mass
Date of Birth,
John Francis- Unknow
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Mary Stage-Orange@Hersey
Place of Interment,
Sumner Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Oct. 11th 190 ........
of Deceased, Thomas Q. Francis
Age,. 45 years.
I hereby certify that I attended deceased from. Oct. 2 1908, to .. Oct. gt
190 g, that I last saw Kim alive on the. ... day of Qct. 1908,
that died on the 10th
day of Oct. 190 8, about 6.45 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 :
Chief cause, binhosis
of the Lives
Disease Contributing cause,.
Chief Cause, .. suit years
Duration Contributing cause,. Thomas Etigte
· If an institution, state how long an inmate and previous residence.
Big.
M. D.
(Single, Married, Widowed or
Divorced.)
(State year, month and day.)
Name and Age ?
·
83 Thomas Frances 1
Olet 10-1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
Place of l
Death *
S
Death
Residence
139 Borrow. It Washet
Age
×
.years.
2
.. months.
.days
STATISTICAL DETAILS
SEX terraale
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME + HUSBAND'S NAME +
BIRTHPLACE #
NAME OF
FATHER
archog mueller
BIRTHPLACE OF FATHER# Constantinalle
MAIDEN NAME
OF MOTHER
Eletta. Shehand
BIRTHPLACE
OF MOTHER $
Rockland me
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from 190g ... to oct 10"- 190 .. 8, 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 : gastro Enteritis 1 Primary :
2week (DURATION).
.DAYS
Contributory :
.(DURATION) .DAY8
(Signed).
1
Biomedical
M.D.
oc/ 11 1908 (Address)
170 hundredest
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
. years ..
months.
3
days
Where was disease contracted,
at home Boundmest
If not at place of death ?
Filed
.190
Clerk
PLACE OF BURIAL OR REMOVAL II
DATE OF BURIAL
8
190.
ADDRESS
UNDERTAKER la 12 3.
* Clty 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 numbor.
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.
ALL NAMES TO BE IN FULL
...
.
Jan. Blanch, Miller
Registered No.
Date of l
Cect-1015
190
84 Laa Blanche miller Car 10-1908
[4.'07.37.I.M.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, Name in full, Manser vantes
(If married or divorced woman give maiden name, also name of husband.)
Sex, Cemalo Color, White Condition, (White, Black, Mixed, Chinese, (Single, Married, Widowed or Divorced.)
Indian, etc.)
Age, 43 Years, 2 Months,. /5 Days. Occupation, Residence,* Nohant Que Stinthrow Ward,
Place of Death, Nakary Live Skint froh
(State year, month and day.)
Place of Birth, tyre New York Date of Birth, Juli 28, 1869
John a Lawler, Que land
Mary a Sunny, CH) Ervenced. r
Place of Interment,
Name and Birthplace of Father, Maiden Name and Birthplace of Mother, Menaca, Efall., Diewer Ly, le Halter & riscoll. Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Oct. 12 1908
Name and Age
of Deceased, Many Lawler Age, 44 3years.
I hereby certify that Iattended deceased from .. Dech 20, 1907, to Och 10 1
1900, that I last saw per alive on the. 10th
A day of Oct- 1908.
that She died on the 12th
" day of .. Oct- 1900 1900, about / o'clock
A.M., O and that, to the best of my knowledge and belief, the cause of
Disease ? Chief cause, .. carcinoma
Contributing cause,
Chief Cause, About one year.
Duration Contributing cause,. Francis Magun M& M. D.
her death was as follows :
* If an Institution, state how long an Inmate and previous residence.
... >1
Petrles 12, 190f
mary J. Lawler Oct12-1908
12-1-1900-0,000] J 429
COMMONWEALTH OF MASSACHUSETTS
CITY OF SOMERVILLE
RETURN OF A DEATH
Ellen avery
FULL NAME
Place of } Death 1
( Name of Hospital or Institution if any)
(No.)"
(Street)
Place of Residence
128 Irwin It
Winthrop
Age
69 years
Xmonths _days
(No.) (Street)
STATISTICAL DETAILS
SEX
COLOR
w
SINGLE, MARRIED, WIDOWER OR DIVORCED
ed
MAIDEN NAME
If a married or divorced woman, ou fridon
mahan
HUSBAND'S FULL NAME
Granville 0
BIRTHPLACE
Give state or country; also city, town, or county, if known
woodstock
1.03
NAME OF FATHER
BIRTHPLACE
OF FATHER
Gire state or country ; atso city, toin, or county, if known
MAIDEN NAME OF MOTHER
BIRTHPLACE OF MOTHER
Give state or country : also city, town, or county, if known.
OCCUPATION
Person giving statistical details
INFORMANT'S NAME Granville O avery
ADDRESS 28
(NO.)
(Street)
( Town or City)
PLACE OF BURIAL OR REMOVAL
Holywood Cem
DATE OF BURIAL cect 1) 1908
Brookline
( Town or City, and State )
UNDERTAKER S NAME Keating+ Withfull
ADDRESS
322 Cumberlike It Shalleste
mass
(No.)
(Street )
( Ton or city)
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from. Sept 15
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 : (If a soldier or sailor who served in the war of the rebellion both the primary and contributory causes of death must be given. )
Primary :
Pneumonia
Contributory ,
Pjo Thorax
( DURATION )
2
OAYS
(Signed
M. D.
( Address ) ..
(No.)
(Street)
(Town or City)
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents. Previous Residence How long at Place of Death ? Years, Months, Days
Where was disease contracted,
if not at place of death ?
Received
190 Agent of Board of Health, appointed to issue burial permits
Filed
190
City Clerk
TILL VUI WITH INK .- THIS IS A PERMANENT RECORD
ALL NAMES TO BE IN FULL
VES
ER
FREE
FOUNDED 1842.
A CITY 1872. ONAL STRENGTH
MUNICIPAL 42. ESTABLISHED A
J28 Irvin It
Registered No. sitter date of
Somerville
Death
Oct 15 190
( Town or Cityand State)
2 weeks
( OURATION )
98 Ellen avery Och 15, 1908
[4.'07-37.LM.]
Permit No.
RETURN OF DEATH.
rinttrop
BOSTON, MASS.
Date of Death, ... Det 24" 1908
Name in full,
Janela O. Samman
(If married or divorced woman give maiden name, also name of husband.)
Sex, Male Color, Othile Condition, married
(Single, Married, Widowcd or Divorced.y Age, 65 Years, ~Months, ~Days. Occupation,
Residence,*
Irántrop
mass Ward,
Place of Death, 23 Thornton Park
(State year, month and day.)
Place of Birth,
Otra Sentía Date of Birth,
Name and Birthplace of Father, Maiden Name and Birthplace of Mother,
Place of Interment,
Dupanier Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Drinitial Boston,
of Deceased, James E Mammon.
......
190
Name and Age !
Age, 65 years.
I hereby certify that I attended deceased from ...... Seff. 19th 1908, to lat 2ylt
1908, that I last saw herin ... alive on the. 27th day of 1908
that he
died on the. 27H day of cech. 1908, about .. 3 o'clock
H.Hy or.P.M., and that, to the best of my knowledge and belief, the cause of
Chief cause, Acute Bright's Disease
Disease Contributing cause, Chief Cause, ...
A
Duration
Contributing cause, . A. B. Forman M. D.
* If an Institution, state how long an Inmate and previous residence.
his death was as follows:
1
(White, Black, Mixed, Chinese, Indian, etc.) Mining Genauer-
C James to Saumon
War 27-1968
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH Edward W Hudson
FULL NAME
Place of l
Death *
5
Residence
106 Summetave
Age
59
... years.
10
.months .. 2% .days
STATISTICAL DETAILS
SEX
male
COLOR
White
MARRIED,
MAIDEN NAME +
HUSBAND'S NAME t
BIRTHPLACE +
Boston Mass
NAME OF
FATHER
Robert Ekudson.
BIRTHPLACE
OF FATHER$
Quincy mass.
MAIDEN NAME
OF MOTHER
Clarissa Kenner
BIRTHPLACE OF MOTHER $ newyork ny.
OCCUPATION
Constable
INFORMANT §
Wife
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL
190.0
UNDERTAKER
ADDRESS
OF aunce Chelsea
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from .. oct 26 1905 to 27 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 : Fracture of ,Conical
Primary :
Vestebra
(DURATION) ONCE ..... DAYO
Contributory :
DURATION) ..... . DAY 8
(Signed)
M.D.
02/27 1908 (Address) 174 huntery St Wyther
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
24 hrs
years.
months.
. days
Where was disease contracted,
If not at place of death ?
accident Cost.
Filed
190
Cierk
* 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.
t State or country; also clty, town or county, If known.
§ Name and address of person giving statistical detalis. Il Name of cemetery.
Winthrop (CITY OR TOWN.)
.Registered No.
Oct. 27 908
Date of l Death S
cremation
mt. auburn.
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
Winthrop (CITY OR TOWN.)
FULL NAME
France
ille Lille
Registered No.
Place of ) 46 Nevada Sta Withof Mana
Death
Residence
Age
73
.years.
months.
days
STATISTICAL DETAILS
SAX
female
COLOR
white
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME Ť HUSBAND'S NAME t
BIRTHPLACE #
Brotón
NAME OF
FATHER
BIRTHPLACE OF FATHER$ New York State
MAIDEN NAME OF MOTHER Swear Piper
BIRTHPLACE OF MOTHER De Coton mais
OCCUPATION
intered
INFORMANT §
Fino Jane L'. Gits.
umów) 16 Morada St. Cinturato
PLACE OF BURIAL OR REMOVAL !!
DATE OF BURIAL
190
UNDERTAKER
Albaterman Sous
ADDRESS
Boston
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from Non 1905 .. to Nov 3 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 :
apoplatky
(OURATION)
. DAYS
Contributory :
.(DURATION). DAY8
(Signed)
Horace × Suma
M.D.
Winthrop
190 ...... (Address)
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 ?
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.
1908
Date of Nor.
4th
Death 1
90 Horace Gaulle Gifts 24-1908
[4.'07-37-1M.]
Win Thro Mans
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death,
Nov. 8
1908
Name in full, Stilllow Barton
(If married or divorced woman give maiden name, also name of husband.)
Sex, Female 0 (White, Black, Mixed, Chinese,
Mite
Condition,
Age,- Years, ~ Months, - Days. Occupation,
Residence, *..
35H Slowly It Gunther Ward,
Place of Death,
(State year, mouth and day.)
Place of Birth,
Date of Birth,
Name and Birthplace ) of Father, Maiden Name and Birthplace of Mother,
Svar Blancy
Place of Interment, It Bundet
Zhul Pfotillo 0 Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, 200.9 1908
Name and Age ?
of Deceased, Stillborn Buntien. Age, .. years.
I hereby certify that I attended deceased from 72.8 1908, to.
190 , that I last saw .. Man alive on the 8 day of 1905.
that .. the died on the. 8 day of. 1908, about 8 .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,
Disease Contributing cause,
Duration
1
Chief Cause, .. Contributing cause, I/ P. Voici. M. D.
· If an institution, state how long an inmate and previous residence.
Indian, etc.) Matter
(Single, Married, Widowed er Divorced.)
Electrician
Manlow Ahoo 8, 1908
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
FULL NAME
5 milford fulham
Registered, No.
×
3)Fair Vario IL Hfrischrok, Dass.
Place of Death *
Date of Death
1 200 18 1908
Age
5
. years.
months
.. days
STATISTICAL DETAILS
SEX maly
1
COLOR
Debito
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME + HUSBAND'S NAME t
BIRTHPLACE #
-
Winthrop, Mas
NAME OF if Leonard Fulham
BIRTHPLACE
OF FATHER +
Boston
MAIDEN NAME
OF MOTHER
mary E, Barrett
BIRTHPLACE
OF MOTHER $
Brotou
OCCUPATION
- -
INFORMANT §
10
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from Lut 10
190,., ... to 0 15 16 1905, 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 :
60
(DURATION) DAYS
Contributory :
(DURATION). 60 DAYS
(Signed) Vor.1815 199 ... (Address)
M.D.
SPECIAL INFORMATION only for Hospitals, Institutions, Translents, or Recent Residents.
Former or Usual Residence
How long at
Place of Death ?
.Days
Where was disease contracted, If not at place of death ?
Filed
190
Clerk
PLACE OF BURIAL OR REMOVAL !!
Holy Cross Walden
DATE OF BURIAL
For 19 50.8
UNDERTAKER
ADDRESS
H' rank of maloney frauthrop her Name of cemetery.
* 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.
92 Wilfred Julhover Nov 18, 1908
[4.'07-37.L.M.|
Permit No.
RETURN OF DEATH. BOSTON, MASS. windtutman. Date of Death, 0100 19 th 190 0
Name in full, Hannah. I.H.
Cadauno
Wider of le 2020les ad ans
{If parried or divorced woman give maiden name, also name of husband.)
Sex,
female Color,
(White, Black, Mixed, Chinese, Condition, Wichern
(Single, Married, Widowed or Indian, etc.) Divorced.) Age, 82 Years, 10 Months, 19 Days. Occupation,
Residence, *.
140 Clif Cena
Place of Death, 140
Place of Birth,
Becameil ME Date of Birth,
1825
(State year, month and day.) Name and Birthplace Urlhai M1. Hace Umumikille of Father, Maiden Name and Birthplace of Mother, Harriett Hoyco Brunswick the
Place of Interment,
Colico
2.
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Wintheoh hasa hover. 22 190 8 .
Boston,
Name and Age ? Hanmah In . adam Age, ... 82 years.
of Deceased,
I hereby certify that I attended deceased from. hou. 1 1908, to hou. 17
1905, that I last saw her alive on the. 17 day of ... how. 190€.
that she died on the. 19th hou 1908, about 3.45 o'clock her day of A.My or P.M., and that, to the best of my knowledge and belief, the cause of death was as follows : Heart failure
Chief cause,
Disease Contributing cause, O la age-
Duration
Chief Cause,
Contributing cause,
ThomasKligott
M. D.
· If an institution, state how long an inmate and previous residence.
92 Hereford -Tuchover Nov 18, 1908
[4.'07.37. I.M. ]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, 2100 19 th 190 190 0
adarus
Name in full, Hannah .D.H.
of & webber ad ans
(If piarried or divorced woman give maiden name, also name of husband.)
Sex, female Color,
(White, Black, Mixed, Chinese, Condition,
(Single, Married, Widowed or Divorced.) r
Age, 82 Years, 10 Months, 19 Days. Occupation,
Residence, *.
140 Olup as a
Place of Death, 140 Clofare
Place of Birth, Becameik ME Date of Birth,
(Statc year, month and day.) 1825
Name and Birthplace ?
Pirchair 11. Hall Oumitilha
of Father, Maiden Name and 1 Harrett Hoyco Brunswick the
Birthplace of Mother,
Place of Interment,
Calico
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Wintheog hosa how. 22 190.8.
Name and Age ! Hanmah In. adamo
Age, 82 years.
I hereby certify that I attended deceased from hou. 1 .. 1908, to. 17
190S, that I last saw her alive on the. 17 day of ... how 190€.
that she died on the 19th day of 1908, about 3. 45 o'clock
A.My or P.M., and that, to the best of my knowledge and belief, the cause of
Disease
Contributing cause, O la age -
Chief Cause,
Duration Contributing cause,. Thomas& gott. M. D.
· If an institution, state how long an Inmate and previous residence.
Boston,
of Deceased,
hou
her death was as follows : - Chief cause, Heart failure
Indian, etc.)
Hannah In. asaus Mor19,1908
[4.'07.37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Ir citrofo
Date of Death, Stillhm datant (Flanagan) Name in full,
(If married or divorced woman give malden name, also name of husband.)
Sex, male Color Ophile Condition,
Quelem Infant
(White, Black, Mixed, Chinese,
Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, C Years, Months, Days. Occupation,
Residence,*
H12 Shirley Sheet
Ward,
Place of Death, !! 11
1.1 .....
(State year, month and day.)
Place of Birth, 1) 11
Date of Birth,
Charles a. Flanagan-Boston
Name and Birthplace ? of Father, Maiden Name and Lillian S. Fraizer Vara Sentia
Birthplace of Mother,
Place of Interment,
Hinterop Cequeley
@unner@Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Minttrop
Boston
Nov 22
1907
Name and Age?
of Deceased, Still- Gom
Age, 0 years.
I hereby certify that I attended deceased from. o Non 22 1908, to samme lote
190 , that I last saw? never saw alive on the.
day of. Non 22 190 F,
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: Stile.com
Disease s Chief cause, Contributing cause,
Chief Cause, Stic- som
Duration
Contributing cause, Edward Fe Ereje M. D.
* If an Institution, state how long an inmate and previous residence.
21
Flanagan 2022, 1908
[4.'07-37-LM.]
Permit No.
RETURN OF DEATH.
Scrittura
DOSTON, MASS.
Date of Death,. OVN 23" 190 8
Name in full,
Edward L. Clank
(If married or divorced woman give maiden name, also name of husband.)
Sex, male .Color, White
Condition, married
(Single, Married, Widowed or Divorced.)
Age, 57 Years, 2. ..... Months, 2.5 Days. Occupation,
Residence,*
Place of Death,
69 Sargent Street
Place of Birth,. Cambridge Mase Date of Birth,
(State year, month and day.)
Name and Birthplace \ Thomas blank- Glascon- Scotland
of Father,
Maiden Name and Mary Manon - Liverpool - England
Birthplace of Mother,
Place of Interment,
Winthrop Cemetery
Sunny Floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,
nov 23 '
190 8.
Name and Age ?
of Deceased, Edward & Clark
Age, 57 years.
I hereby certify that I attended deceased from Nov. 2/1908, to 200. .
190 , that I last saw
alive on the. 21. day of 2200 1908,
that the died on the
day of 190 , about 6 o'clock
A.M., op P.M., and that, to the best of my knowledge and belief, the cause of. death was as follows :
Disease Chief cause,
Cerebral Hemorrhage
Contributing cause, Puedan on
a
Chief Cause, 5 anos
Duration
Contributing cause, 3 days.
H.R. Porter M. D.
* If an Institution, state how long an Inmate and previous residence.
21
(White, Black, Mixed, Chinese, Indian, etc.) Superintendent
Ward,
Nov 23, 1908
-
[4.'07-37-LM.]
Miel care Friday ani
Permit No.
RETURN OF DEATH.
Winthrop
BOSTON, MASS.
Date of Death,. @Nor 25 190.8
Name in full, Hattie Vilorech
(If married or divorced woman give maiden name, also name of husband.)
Sex, Female Color,
Arte
Condition,
Hidomed
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, 69 Years,
Months, 20 Days. Occupation,
Residence,*
Winthrop mare
Ward,
Place of Death,
140 Horcleide avenue
(State year, month and day.)
Place of Birth,
Walden &1
Date of Birth,
Name and Birthplace } Unknowme
of Father,
Maiden Name and Irene Heath= Stanstead Ca
Birthplace of Mother,
Place of Interment,
Summerleblond Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Boston, nov 26-
1908
Name and Age Hatten. breech Age, 69 years.
of Deceased,
I hereby certify that I attended deceased from. May 1908, to nov 25.0
190 0, that I last saw he .. alive on the. day of nov - 190S.
day of. hou- 1905, about ........ o'clock that .... died on the 25th
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of
Disease - Chief cause, Chronic Diffuse, nephritis Contributing cause, .. Chronic Mitral. Insufficiency
Chief Cause,. one cca. +
Duration
Contributing cause,. one year + It Ethay don M. D.
· If an Institution, state how long an Inmate and previous residence.
-
of her death was as follows :
Levis Sanderson 2200 25/1908.
COMMONWEALTH OF MASSACHUSETTS
RETURN
Catharine 6. Tien
(CITY OR TOWN.)
FULL NAME
Place of l
Death *
Residence
Sauce
Age.
36
2
.years
.months.
.days
STATISTICAL DETAILS
SEX Gunals
COLOR
Ithete
SINGLE, MARRIED WIDOWED OR -DIVORCED.
MAIDEN NAME + HUSBAND'S NAME+
BIRTHPLACE#
Roxbury Mans
NAME OF
FATHER
BIRTHPLACE
OF FATHER#
Crecloud
MAIDEN NAME
OF MOTHER
Many Similly
BIRTHPLACE
OF MOTHER +
OCCUPATION
INFORMANT §
Wand Sal. Bata
PLACE OF BURIAL OR REMOVAL II Wir Benedict.
DATE OF BURIAL
nor 30
190 ..
8.
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from Car 18 190S ... 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 : Pulmonary Lubuculares
abans 11 years
(DURATION). .DAYS
Contributory :
.(DURATION) .. ... DAYS
(Signed)
M.D.
nov 28 90 8 (Address)
Binetwap mas
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.
FILL OUT WITH INK. - THIS IS A PERMANENT RECORD ALL NAMES TO BE IN FULL
UNDERTAKER
ADDRESS
Registered No.
Date of l
nor 27
190
8
Death
98 Catherine Ekweg Nor 27, 1908
[4.'07-37.L.M.|
Permit No.
RETURN OF DEATH. BOSTON, MASS. Nonchal Mer,
Date of Death, 200 23 190 . Whittier
Name in full,
L
(If married or divorced woman give maiden name, also name of husband.)
Sex, Male Color, white Condition, L
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.) 2 Age, X Years, X Months,
Residence,* 94 Lincoln
Place of Death,
Place of Birth, Le
Date of Birth, ..
200231909
Name and Birthplace ! of Father,
Enque. @ Whitter Burton Max. 3
Maiden Name and Olivia Fi Marshall Bostonchan,
Birthplace of Mother,
Place of Interment,
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, 22020. 25 - 190 € ..
of Deceased, Holictier Age, 0 years.
,2253. 23.
I hereby certify that I attended deceased from. EL 1908 , to .
190 , that I last saw Tem alive on the. 23, day of
.190 8
that .. -I -died on the. 23. day of 190 8, about 7 .o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of. death
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