USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1907-1909 > Part 3
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Elizabeth Wheeler
Gire state or country ; atso city, town, or county, if known
BIRTHPLACE
OF MOTHER
OCCUPATION
INFORMANT'S person giving stat ist jeut details NAME Charles A. Bugham. Pleasant Unitheraf.
ADDRESS 332 ( No.) (Street)
( Town or City)
PLACE OF BURIAL OR REMOVAL Woodlawn.
(Cemetery ) Everett, Masc
( Town of City, and State )
UNDERTAKER'S NAME
ADDRESS 40 Cross Somerville Marc
(No.)
( Street )
( Town or City)
PHYSICIAN'S CERTIFICATE
Ł
I HEREBY CERTIFY that I attended deceased during last, illness, from June 190.5 .to. AfM. IS- 1907: 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 :. multiple Carcinoma. ( DURATION)
Contributory : Carcinoma y Breast, Removed" Fab. 1904.
( DURATION ) DAYS
(Signed) France A Lillan 1
( Address )
M. D.
15 Princeton, E. Boston
(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
1-
190 Agent of Board of Health, appointed to issue burial permits Filed
190
City Clerl
ED
ME
LE
TVNOIL
MUNICIPAL
FOUNDED 1842
A CITY 1872. . STRENGTH
ESTABLISHED FULL NAME Elizabeth W. Brigham 332 Pleasant
Place of } Death
( Name of Hospital or Institution if any )
(No.)
(Strcet)
Winthrop Maro
Residence
Place of 1332 lacant (No.) (Street)
( Town or 'City and State)
Winthrop.
Somerville
Age
years
8
.
BIRTHPLACE OF FATHER 26
DATE OF BURIAL April 18. 190
RE
1/20 28
C
Cel: :: cette 7. Vingtaine / Caril 15, 190€- 1
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
? Valler Jennings
Place of )
Hospital Cottages for Children Balconville Mon Date of
Death *
S
Residence
6.8. Washington Are Winthrop Noord
.Age ..
14
.. years.
9 months. 6 days
STATISTICAL DETAILS
SEX
male
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME t HUSBAND'S NAME t
BIRTHPLACE #
Hyde Park Moss
NAME OF
FATHER
Edward 2. Jennings
BIRTHPLACE
OF FATHER$
no Wayne mains
MAIDEN NAME
OF MOTHER
May Evelyn Brockway
BIRTHPLACE
OF MOTHER $
Bradford ntr.
OCCUPATION Mons.
INFORMANT § HM. Papy
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from July 1 189 6000 to
May 3 1907. 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 : barabral Paralysis
since birth
(DURATION). .... . DAYS
Contributory :
(DURATION).
DAY8
(Signed)
Hartstrin WN Page
M.D.
May 3
Baldwinville hors
190.7 .... (Address).
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at
Place of Death ?
12 years
...
7.
months
6 days
Where was disease contracted,
If not at place of death ?..
Filed
.190 .....
Coled frusz
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
PLACE OF BURIAL OR REMOVAL II
Hyde Park
DATE OF BURIAL
may 4
190.).
UNDERTAKER
ADDRESS
Baldwinalle
.Registered No.
Death may 3
.1907
7 Halle Jennings may 3, 190 4
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH.
Winthrop BOSTON, MASS.
Date of Death, Way 5" 1907
Name in full, Eliza a. F. book
(If married or divorced woman give maiden name, also name of husband.)
Sex, Female Color, Arhite Condition, Didomed
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowcd or Divorced.)
Age, 74 Years, 8. Months, 29 Days. Occupation,
Residence, *. Winthropo mass Ward,
Place of Death, 15 Cottage Park Road
Place of Birth, Provincetime Mass Date of Birth,
(State year, mouth and day.)
Dwa, 6" 1832
Name and Birthplace Bater Riebom Whitman German Sandwich of Father,
mais
Maiden Name and 1 ann Jaros Holmes = Durbuy Macs
Birthplace of Mother,
Place of Interment,. Evergreen Lemmelens = Stoughton Mass Summer Efloyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston May 1 1907
Name and Agc \ of Deceased, Eliza a. F. Cook
Age, 74 years.
I hereby certify that I attended deceased from. Felly 3 .190 , to
May 5 1907, that I last saw
alive on the C Ha day of may 1907, that she died on the
day of may 1907, about 8 o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of. her death was as follows : Multiple abdominal Cancer
Chief cause,
Disease ? Contributing cause,
Chief Cause, .......... about 2/2 years
Duration Contributing cause,
* If an Institution, state how long an Inmate and previous residence.
M. D.
20 29 Eliza a. F. look May 29, 1907.
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, May 5"1907
Name in full, Lucina S. Reed
George W DD, Reed
(If married or divorced woman give maiden name, also name of husband.)
Sex, Female Color, White Condition, Mand
(White, Black, Mixed, Chinese, Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, 64 Years, ~ Months, ~ Days. Occupation,
Residence,* Dinthuop.
mace Ward, -
Place of Death, 24 Collage avenue
Place of Birth, Standled Plan.
Frederick. If, Sargent=
Unknown
Name and Birthplace of Father,
Melvina @ Hackett = Unknown
Maiden Name and 1 Birthplace of Mother, Place of Interment, Wordlawn Cemetery= Everett mare Suonare Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH ..
Thay 6th.
190%.
Name and Age
of Deceased,
Age,. 64. years.
I hereby certify that I attended deceased from Лидер 8 1905, to
190%, that I last saw her. alive on the .. fitthe day of thay. 1907,
fifte day of May. 1907, about 21.20 o'clock that died on the
I.M., w P.M., and that, to the best of my knowledge and belief, the cause of her death was as follows : Carcinoma literna. Chief cause,
Disease " Contributing cause,
Chief Cause, .. One year- new minithe
Duration
Contributing cause, Taux, I Staten the ..
* If an institution, state how long an lomate and previous residence.
21
Ognadarreel (State year, month and day.)
Date of Birth,
no 3/ Lucina S. and Imay 5, 1907
٩
[3.'06-37-LM.]
Permit No.
RETURN OF DEATH.
BOSTON, MASS.
Date Death,
May 15' 1907.
Name in full,
(If married or divorced woman give maiden name, also name of husband.)
Sex,
Color,
Condition,
(White, Black, Mixed, Chinese, Indian, etc.)
(Single- Married, Widowed or Divorced.)
Age, 28 Years,
Months 4
Days. Occupation,
Natile Maker
Residence,*
Ward,
Place of Death,
11 Notlage Park Road Nontrop
Place of Birth, Fait Boutin Date of Birth
(State year, month and day.) May 11'1879. Ireland
Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother,
Cajaberte R. Parte
Sneland
Place of Interment,
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, May 15 1902. ...
Name and Age! John 26 Stephenson
Age, 28 years. of Deceased,
I hereby certify that I attended deceased from 1 190 that I last saw
alive on the 14
1
he
190 ,about /So'clock his death A.M., or P.M., and that, to the best of my knowledge and belief, the cause of was as follows :
Disease ' S Chief cause, Typhoid Fever
Contributing cause,
Chief Cause, 2 mais
Duration Contributing cas .......................... (310 met calf M. D.
* If an Institution, state how long an Inmate and previous residence.
21
(may
day of 190),
that died on the 15 day of may
may 5 1907, to May 14
Richard
5
220 31 John W. Sipherson May 15 , 1907
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, Hilham Cagan
May 16. 1909.
Name in full,
Single.
(If married or divorced woman give maiden name, also name of husband.)
Sex, male Color, White Condition, Single
Age, 3% Na Years, 7 Months, Days. Occupation,
Residence,* Foot Banks Mars Ward, Winthrop
Place of Death, Fort Bank. mars.
(State year, month and day.)
Place of Birth,. Fransa Indra Date of Birth, Unknown
Name and Birthplace 1 Unknown
of Father, Maiden Name and Birthplace of Mother, > Muy".
Unknown
Junineu
Floyd
Place of Interment,.
145 Hemm Plet Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Mass. Bostan, may 16 1907
Name and Age ? of Deceased, William Gregan
Age, 34 22 years.
I hereby certify that I attended deceased from May 16 190%, to.
190 , that I last saw hun alive on the. 16' day of. may 190
that Pu
died on the 16 day of May 1907, about 4 .o'clock
Pm.
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of
Disease Chief cause, Gunshot wound of head .
Contributing cause, self inflicted.
Chief Cause,
Duration
Contributing cause,
Trest 9. Sliter
* If an Institution, state how long an Inmate and previous residence.
21
(Fort Banks) M. D.
his death was as follows :
(White, Black, Mixed, Chinese, Indian, etc.) Soldier
(Single, Married, Widowed or Divorced.)
32 Hilliane Sagen May 16. 1907
COMMONWEALTH OF MASSACHUSETTS.
RETURN OF A DEATH-1907.
CITY OF BOSTON.
FULL NAME George Handley
Registered No ..
.4.6.35.
Place of Death ¿ and Residence
Boston
Emergency Hospital
Date of Death
May 16
1907.
Age 7.8
years 1
months. 14 days
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
M
W
S
1907,
from 1907, 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 :
Maiden Name
S
RAR'S
T PATRIBUS, SIT DBIR
Uraemia.5 days
(Dura fo
CITY
Birthplace
Acton Mass
Name of
Abraham
Father
Birthplace of Father.
-Mass
Contributory : Enlarged Prostate
(Duration)
Maiden Name
Susan Winn
of Mother ..
Birthplace of Mother
Salem Mass
Occupation
Retired
May .. 16 .1907
SPECIAL INFORMATION from Hospitals, Institution:, Transients, or Recent Residents.
Usual Winthrop Mass
Filed. May ... 20 . . 1907.
A true copy Attest :
Registrar.
MARGIN RESERVED FOR BINDING.
Place of Burial or removal ...
So Acton Mass
Undertaker
Lewis Jones & Son
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
DEFICE:
BOSTONIA CONDITA AD
A. 1822
183+.
TA
B REGIMINE
S.
MASS.
(Signed).J .C. D Clark
M.D.
Informant
Husband's Name
8
George Sandley May 16, 190}
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH. BOSTON, MASS.
Date of Death, May 17" 190m
Name in full, James Gardner C
(If married or divorced woman give maiden name, also name of husband.)
Sex, Male Color White
Condition, Manied
(White, Black, Mixed, Chincse, Indian, etc.) US. Amspreder
Residence,* Winthrop mass
Ward,
Place of Death, 5, Cottage Park Road
Place of Birth,
Date of Birth,
moses affoll-
andover me
Gardner-OJosmich Mass
Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother, Place of Interment, Winthrop Cemetery Hintuito Mass Dimmer Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Dinthiol, Boston,
May 18 -
1907
Name and Age ! of Deceased, James Gardner abbato Age, 71 years.
I hereby certify that I attended deceased from.\ May 17 190 7 May 17
190 7 that I last saw him ... alive on the. 170h .. day of May (x: 1,90%,
that
him died on the 17. ... day of
1907, about: 3- 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, benebral Hemorrhage
Contributing cause, .
Chief Cause, 4 hours.
Duration Contributing cause, A. T. Roadon
* If an Institution, state how long an Inmate and previous residence.
East Boston: M. D.
21
(Single, Married, Widowed or
Divorced.)
Age, 71 Years, Months,
.Days. Occupation,
(State year, month and day.)
no 3 3 James Gardner abbott May 1 7, 1907
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH.
BOSTON, MASS.
Date of Death, ...
May 25, 1907
Name in full, William
(If married or divorced woman give maiden name, also name of husband.)
Sex, male. .Color White
Condition, Single
(Single, Married, Widowed or DR orced.)
Age, 22 Years, - Months,~ Days. Occupation,
Residence, *.
Foot Brands, Miars
Ward,
Place of Death, Fort Banks Mars.
2FT
(State year, month and day.)
Place of Birth,
Indian Ferritin
Date of Birth,
Unknown
Name and Birthplace ? of Father, Maiden Name and
Unten
Birthplace of Mother, ) I. Rever Mil. Cemetery. Place of Interment, Dunner estoyd) leston / tarlo Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
may 25. Boston, .. H. Banks Many
1907 .
Name and Age ?
of Deceased, William G. Brown
Age, 22 years.
I hereby certify that I attended deceased from. May 21 1907 , to ... may 25/07
190 , that I last saw
alive on the 25. ... day of may 1907.
that he
died on the. 25 .day of may.
1907, about 9. 20 amo'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of huis death was as follows:
Disease Chief cause,
Cerebro Spinal Fever
Contributing cause, . (an injury to base of brain)
Duration Contributing cause,
Chief Cause,
* If an institution, state how long an inmate and previous residence.
Ernest J. Slater (Fort Banks) M. D.
21
(White, Black, Mixed, Chinese, Indian, etc.) Soldier
De 34 William a Brown May 25, 1907
4
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH
(CITY OR TOWN.)
FULL NAME
ogs . a. foxcrof
Registered No.
Place of
Wencherot Man
Death *
S
Residence
1
Age
65
.years ..
.months days
STATISTICAL DETAILS
SEX
Male
COLOR
avtute
SINGLE, MARRIED, WIDOWED, OR DIVORCED
MAIDEN NAME + HUSBAND'S NAME +
BIRTHPLACE # lechan Mars
NAME OF
FATHER
Yes. E. fixewft
BIRTHPLACE
OF FATHER$
MAIDEN NAME
OF MOTHER
Harnett. V Goodrich
BIRTHPLACE
OF MOTHER+
OCCUPATION
INFORMANT §
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, fron 1900 1903 ... to my 25 1907. 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 :
Jeurs
(DURATION). DAYS
Contributory :
TOUTATION ) ....... DAY8
(Signed)
Birulciel
M.D.
(Tuy 26 190) (Address).
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.
How long at Piace of Death ? years .................... ......... days months. ....
Where was disease contracted, If not at place of death ?
Filed
.190
Clerk
PLACE OF BURIAL OR REMOVAL II
DATE OF BURIAL
190
UNDERTAKER
C. Recensioni
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.
Death S
Date of ¿
May25
190
13
.
no 35-
May 25, 1801
[3.'06 37-LM.]
Permit No.
Winthropo
RETURN OF DEATH. BOSTON, MASS.
Date of Death, Way 27 " 1907
Name in full, Quey ann George
(If married or divorced woman give maiden name, also name of husband.)
Sex, Otimale Color While- Condition, Didon
(White, Black, Mixed, Chinese,
Indian, etc.)
(Single, Married, Widowed or Divorced.)
Age, 71 Years, 2 Months, .. 2 Days. Occupation,
Residence,* Printhrop Mask
Ward,
Place of Death, 79 Summit avenue
(State year, month and day.)
Place of Birth,. Harchile Mass Date of Birth,
March2y "1836
David Boynton-Ojavechile mass
Place of Interment,
Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother, Oficedate Chustery archive Mass Dumber Floyd Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Winthrop Boston,
May 28
1907.
Name and Age !
of Deceased, Lucy aun Logo Age, years.
I hereby certify that I attended deceased from Jan 1907,to May 28/
190 /, that I last saw her alive on the 24th day of may ..... 190 that. She died on the 274 day of May 1907 about 3 o'clock
J.K., or P.M., and that, to the best of my knowledge and belief, the cause death was as follows :
Chief cause, Career ma of abdomin
Disease Contributing cause,
Duration
Chief Cause,
Contributing cause, not known Jr. a. morrison M. D.
* If an institution, state how long an lomate and previous residence.
50 Princeton Dt. East/ 2motor
May 27, 190)
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH 1
FULL NAME
amelia
Lant
Place
Death * 1483 Stilen 28., Kruittrop
Residence
69 Candan 2% Bosti
Age.
45
.. years .. .
.. months .. .days
STATISTICAL DETAILS
SEX Jamale
COLOR negro
SINGLE, MARRIED; WIDOWED, OR DIVORCED
MAIDEN NAME Ť amelia Van V lake
HUSBAND'S NAME +
Frank Gank
BIRTHPLACE #
Ban Core Long Island
NAME OF FATHER augustus. Van Vlahe
BIRTHPLACE OF FATHER#
Orlen Bay Long bland
MAIDEN NAME OF MOTHER:
BIRTHPLACE OF MOTHER#
OCCUPATION
INFORMANT §
PLACE OF BURIAL OR REMOVAL II
DATE OF BURIAL
7
190.
UNDERTAKER
ADDRESS
PHYSICIAN'S CERTIFICATE
1 HEREBY CERTIFY that I attended deceased during Tast
.190 Itttress, from 490 ..... 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 :
heart disease
(DURATION) DAYS
Contributory :
(DURATION) DAYS
(Signed).
Serge Bungno magrath
M.D.
May 27 1907 (Address). 274 Bryestas8
Jam Bester
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.
bruttuab - (CITY OR TOWN.)
Registered No.
Date of ¿ May 27 190
Death S
no 37
Imay 2%1207.
COMMONWEALTH OF MASSACHUSETTS
RETURN DEATH
Winthrop (CITY OR TOWNA
FULL NAME
Place of
1
Death *
483 Shirley
Residence
69 Cander SI Forlou Age
Thout. .Registered No. Date of ¿ At Winthrop. Death May 27 190
.years. months. .days
STATISTICAL DETAILS
SEX
COLOR
SINGLE, MARRIED, WIDOWED, OR DIVORCED
Widow
MAIDEN NAME +
Amelia VanVlaky
HUSBAND'S NAME + track Thank
BIRTHPLACE # Ilen Cont New York
NAME OF FATHER Augustus Var Vlaks
BIRTHPLACE OF FATHER# Outer Bay New York
MAIDEN NAME
OF MOTHER
Maria Weeks
BIRTHPLACE OF MOTHER# Flere Core New York
OCCUPATION
Taundress,
INFORMANT § Daughter
Sarah Elizabeth That
PLACE OF BURIAL OR REMOVAL I Alleborough May
DATE OF BURIAL May 31 190/
UNDERTAKER
ADDRESS
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 :
Contributory :
(DURATION) .. DAYS
(Signed)
M.D.
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
* 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. I| Name of cemetery.
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD
ALL NAMES TO BE IN FULL
(DURATION). ..... DAYS
Cassachusettsfind 191
Suffolk tet, then personally affared the wetten named Sarah
Thank and made oath that she is the daughter of the descased Amelia Thank and that the within's stalence are all hue
Preston 13 Churchill Join Click,
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH.
Winthrop
BOSTON, MASS.
1
Name in full,
(If married or divorced woman give malden name, also name of husband.)
Sex, malo Color White
Condition, Widmer
(White, Black, Mixed, Chinese, Indian, etc.) Retired
Residence, *
Winthrop
swaes
Ward,
Place of Death,
263
Main Street
Place of Birth,
Beton mass
Date of Birth,
Name and Birthplace Thomas Magee- Sortland
of Father,
Maiden Name and
Gammal Rogers.
Sortland
Birthplace of Mother,
Place of Interment, Winthrop Cemetery Hintenof mass Dumper Floyd Undertaker. 145. Human Street
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Minithe Boston,
190%
Name and Age ?
of Deceased, 1 Edward Noget
Age, 84 years.
I hereby certify that I attended deceased from aquie 9 1909, to June 12
1907, that I last saw alive on the. 11 day of June 190%, that died on the. 12 day of 1907, about ... 2, 30o'clock
A.M., or P.H., and that, to the best of my knowledge and belief, the cause of his death was as follows : Chronic Valvula Heart Disease
Chief cause,
Disease Contributing cause, .
Chief Cause, Several years
Duration Contributing cause,
M. D.
· If an institution, state how long an inmate and previous residence.
June 12"1907
Date of Death, Edward Nuages
(Single, Married, Widowed or Divorced.)
Age, 84 Years, ~Months, 24 Days. Occupation,
(State year, month and day.)
almica Parksbury June 12,1907.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH isaac 1 all.
FULL NAME
Registered No. ......
Place of Death *
495 Pleasant It Winthrop Mass
Date of Death
Amb 16.19.7
Age.
80
years
8
months
10
STATISTICAL DETAILS
SEX
male
COLOR
white
-SINGLE, MAANMED,
WIDOWED, OR
MAIDEN NAME t HUSBAND'S NAME t
BIRTHPLACE #
Sandwicha spass
NAME OF
FATHER
Salt
BIRTHPLACE
OF FATHER#
andwich spass
MAIDEN NAME OF MOTHER Eunice Clark.
BIRTHPLACE
OF MOTHER #
Br
estes spass.
OCCUPATION
1 wore.
INFORMANT §
C.V. Hat
PHYSICIAN'S CERTIFICATE
1 HEREBY CERTIFY that I attended deceased duri illness, from. A/M.2.3 1907 to June 16 that to the best of my knowledge and belief death occurred date stated above, and that the CAUSE OF DEATH was as f Primary : Probably Cancer
.......... (DURATION).
Contributory :
Age
(DURATION).
(Signed)
A.B. Somman
.. June 20-1907 (Address)
Nuithol 6.
...
SPECIAL INFORMATION only for Hospitals, Institutions, Tr or Recent Residents.
Former or
Usual Residence
How long at
.. Place of Death ?
Where was disease contracted, If not at place of death ?..
Filed
190
PLACE OF BURIAL OR REMOVAL !!
Winthrop Ciru.
DATE OF BURIAL
June 18
... 190.
UNDERTAKER es:
ADDRESS Boston
* City or town, street and number, If any. If death occurs away from USUA DENCE, give facts called for under "Special Information." If in a Ho: 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.
MARGIN RESERVED FOR BINDING ALL NAMES TO BE IN FULL
FILL OUT WITH INK .- THIS IS A PERMANENT RECORD
no to
suac & Hall Au at Jane 1.69.91
[3.'06 37-LM.]
Permit No.
RETURN OF DEATH.
Winthrop BOSTON, MASS.
Name in full, leatherine
Date of Death,. 1me/8"1901 Elizabeth Whelpeley
(If marrled or divorced woman give malden name, also name of husband.)
Sex, Ofemale Color,
Merita
Condition,
Hioned
(White, Black, Mixed, Chinese, (Single, Married, Widowed or Indian, etc.) Divorced.)
Age,
86 Years, 10 Months, 10 Days. Occupation,
Ward,
Residence,*
Winthrop. Mass
Place of Death, 58 Thornton Park
Cruq 81820
(State fear, month and day.)
Place of Birth,
Greenwich N. B, Date of Birth ...
Qua 8"1820
James Gelyva-Greenwich WB
Name and Birthplace ! of Father, Maiden Name and Elizabeth Thain Greenwich 2 B
Birthplace of Mother, )
Place of Interment,
J'enpenary Depozit" Rie Vomb
Quince floyd
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Hinthurt Boston,
June 19
1902.
Name and Age ? Catherine Elizabeth Cheffley. Age, 86 years.
of Deceased,
I hereby certify that I attended deceased from June 9 190 , to June 18
190), that I last saw hur alive on the 17 day of June 190%
that. she .died on the 18 day of June 190 7, about ...... 5 o'clock
A.M., or P.M., and that, to the best of my knowledge and belief, the cause of. her death was as follows : Cerebral apoplexy. Henriplegia
Chief cause,
Disease Contributing cause, ..
Chief Cause, .. .....
hive day
Duration Contributing cause, . Ejohnson M. D.
* If an Institution, state how long an Inmate and previous residence.
Catherine Elizabeth helply. June 18, 1907
COMMONWEALTH OF MASSACHUSETTS
Winthrop
MITT Of TOWN.)
FULL NAME
Zamest
Musset
Place of )
125 Cliff Que
Death *
1
Residence
125 Cliff ave Hanthrop
Age
63
.. yeats
2
.months 18 days
STATISTICAL DETAILS
SEX
Male
COLOR
white
SINGLE, MARRIED,
WIDOWED, OR
pHOnOES
Manied
MAIDEN NAME Ť
HUSBAND'S NAME +
BIRTHPLACE+
Mondon Doubs France
NAME OF FATHER Jean Baptiste Animato.
BIRTHPLACE OF FATHER$ Mondon Doubs France
MAIDEN NAME OF MOTHER Hanne Baptiste Caney
BIRTHPLACE
OF MOTHER}
Cubrial Davis France
OCCUPATION Hotel Kuchen
INFORMANT'S
Hanut Anewiset
PHYSICIAN'S CERTIFICATE
I HEREBY CERTIFY that I attended deceased during last illness, from .. June .190.7 .. to
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