Town of Winthrop : Record of Deaths 1907-1909, Part 9

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1907-1909 > Part 9


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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that 2hr died on the 2.7 h


day of January 1908, about 4 o'clock


A.M., or PAH., and that, to the best of my knowledge and belief, the cause of his death was as follows : Canery y Un Call (Fladder o Chutistima


Disease ? - Chief cause,


Centralinal Objemation Contributing cause, ..


Chief Cause,


Duration


Contributing cause, Al wi- 4 miles


M. D.


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


21 525 Bracon Ht


Tillery.


term


Face 27-1908


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1908.


CITY OF BOSTON.


FULL NAME Thomas Abbott


Registered No. 86.3


Place of Death l


Boston


Mass Charitable Eye & Ear Infirmary


and Residence S


Date of Death


Jan 27


1908.


Age


62


years .


3


months


4


.days.


STATISTICAL DETAILS.


SEX


COLOR


SINGLE, MARRIED, WID., DIV.


M


W


M


Maiden Name


Husband's Name


Birthplace


Milton (3 Pounds) . 10


Name of


Father John


Birthplace


of Father. Unknown


Maiden Name


Martha


Halfords


of Mother


Birthplace


Unknown


of Mother


Occupation


Barber


Informant


PHYSICIAN'S CERTIFICATE.


I HEREBY CERTIFY that I attended deceased during last illness,


from 1908, to .1908, that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows:


STRAR'S


PATRIBUS


,SITDE Primacy! (Duration)


Lepto-meningitis Diffuse?


DEFICE


36 hrst


BOSTONIA


A A.1822


·DONATA A.


N. MAS.S.


Contributory: Acute Otitis media with


(Duration)


Mastoiditis


2 .. most


(Signed)


T .J Shannahan


M.D.


Jan ... 28


1908


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


Place of BuriaWinthrop Cem Mass or removal


Undertaker


C R Bennison


Usual Residence


82 Sunnyside Av Winthrop


Filed


Jan 30


1908


A true copy.


Attest :


ErMSlenen


Registrar.


.


CIVITAT


CONDITAD.


TIS REGIM


BOSTON


Thomas abbott faw 2-1-1908


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


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Date of Death, Cun 28 Th


-1 190.8 ....


Name in full, Edward I. P. Reating


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


Sex, male Color visite


Condition,


Married


(Single, Married, Widowed or Divorced.)


Age, 34 Years, - Months, .. - Days. Occupation,


Residence, * 109 Buchanan


Ward,


Place of Death, 109 Buchanan


Place of Birth, Boston Mass


Date of Birth, -


Name and Birthplace John Keating - Ireland


of Father, Maiden Name and Birthplace of Mother,


May A. Wi Donough- Meland


Place of Interment,


Halu levons Malden


1.17, 9. Kelly


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston,


29 1908 .


Name and Age ?


Age, 39 years. of Deceased, Edward, is Keating.


I hereby certify that I attended deceased from


tam 28 1908, to fun?


190 8, that I last saw


day of 190 g, about 11 portocke that .. he died on the. 28'


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, Cancer of Stomach,


Contributing cause, Delated Showach


Chief Cause, .. 3 years


Duration Contributing cause,


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


alive on the 25


day of 190 .


M. D.


(White, Black, Mixed, Chinese, Indian, etc.) Letter Carrier


(State year, month and day.)


Exerand & P, Heating Jan 28-1908


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1908.


CITY OF BOSTON.


FULL NAME AlexandrH Gillis


Registered No ........ 1062 ......


Place of Death ¿


Boston .....


Relief ... Station


and Residence ....


Date of Death


Feb 1


1908.


Age


55


years


6.


months .. 2.days.


STATISTICAL DETAILS.


SEX


COLOR


SINGLE, MARRIED, WID., DIV.


M


M


Maiden Name.


Husband's Name.


Birthplace


Name of


Father


Peter ... Gillis


Birthplace of Father.


Scotland


Contributory : (Run over by a caravan (Duration)


Maiden Name


of Mother


Jessica ... Mckenzie


Birthplace of Mother Scotland


(Signed)


G B Magrath


M.D.


Fel903.


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


Informant


Place of Burial or removal. Mt Auburn Cambridge Mass


Undertaker W I .. Stokes


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:


IST PATRIBUS. SIT DE


RAR'S


Oedema of the brain and


Primacy ( Duration) MEFICE:


Lungs Hemorrhage and shock


BOSTONTA CONDITAAL.


SD. 1822


IVITATISR ATISREGOINE


DONATOLe . MAS.


to crush of thigh & leg


BO.STO


Occupation RealEstate


Usual Residence


Winthrop Mass - 34 Main


Filed


Feb 5


1908


A true copy.


Attest :


Eumylenen


Registrar.


PET


alexander He Gillis. feb-1-1908. 1


[3.'06 37-LM.]


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Date of Death, Getmary 2" 1908


Name in full, Charles Of, OrPin's


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


Sex, nale


Color, While-


Condition, Dédimer (Single, Married, Widowed or Divorced.)


Age, 74 Years, .. Months, 8 Days. Occupation,


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


Residence, *. Márthrop mass


Ward,


Place of Death, 34 Ser Pine Street


Place of Birth,


Charlestown Mass Date of Birth,.


(State year, month and day.)


(0c125"1833


Joseph Perkins = Malden Mask


Name and Birthplace of Father, Maiden Name and Sarah Faulkner- Malden mass


Birthplace of Mother,


Place of Interment,


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, Jeb. 4. 190 8


of Deceased, Chas. H. Pertina Age, 74 years.


I hereby certify that I attended deceased from


1908 , to


190 , that I last saw him alive on the ... 26 day of. 1908,


that Le died on the 22 day of 1908, about 2 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 : Mitral Stenosis


Disease Chief cause,


Contributing cause, Old age


Chief Cause, ... Indefinite


Duration Contributing cause, H.A Partir M. D.


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


121


Name and Age !


Charles 86. Ver Feb. 2-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Walter. S. Sampson


Registered No.


Place of 2


16 Ware Way Wanelook Mais


Date of


fiel 2


1908


Death


.years.


11


months. 11 .days


STATISTICAL DETAILS


SEX


nicole


COLOR


White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


Married


MAIDEN NAME 1 HUSBAND'S NAME 1


BIRTHPLACE +


lungatón Maso


NAME OF


FATHER


Benjamin


BIRTHPLACE


OF FATHER+


Rx Lupacon Mars


MAIDEN NAME


OF MOTHER


Sarah Bracefor.l


BIRTHPLACE


OF MOTHER #


Kaip con mars


OCCUPATION


INFORMANT §


Sono


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from. 2


1 190.7 ... to Feb. 2. 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 : Diabetes


Contributory : Quemonary Oudere 1


(DURATION).


13


. DAY8


(Signed)


2.J. Partes


M.D.


Jak. 4


.190 S .... (Address) ..


Hunchrop


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


Cedar Grove Dochala 4/5


190 .. 8


UNDERTAKER


C. Redanun


ADDRESS


* City or town, street and number, If any. If death occurs away from. USUAL RESI- DENCE, give facts called for under "Special Information." If In a Hospital or Institution, give its NAME Instead of street and number.


t in case of married or divorced woman, or widow. # State or country; also city, town or county, If known.


§ Name and address of person giving statistical details. Il Name of cemetery.


ALL NAMES TO BE IN FULL


Death *


S


Residence


CC


Age


673


.... . (DURATION) DAYS


12 Watter & Sauce jsou Feb- 2-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


FULL NAME Edward 2. Harding


Registered No.


58 DEutEr If. Hitchcok, mars


Place of Death


*


Date of Death


FEL Hur 1908


Age


years months days


STATISTICAL DETAILS


SEX


male


COLOR


white


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME +


HUSBAND'S NAME t


BIRTHPLACE #


NAME OF


FATHER


BIRTHPLACE


OF FATHER+


Hunden. DIE,


MAIDEN NAME


OF MOTHER


Martha T. it-inship


BIRTHPLACE


OF MOTHER #


OCCUPATION


Policeman (Retired)


INFORMANT § White, Bear, E, Harding


PLACE OF BURIAL OR REMOVAL II


DATE OF BURIAL Holy Cross Makes 58/ 7"


. 1908 190


UNDERTAKER


ADDRESS


Frank Di Matonay Ihraction


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from ٦٤3 190G ... to 7 th 4 1900, 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 : Mitral Insufficiency


(DURATION). DAYS


Contributory : acreta Gastritis


.( DURATION).


DAYS


(Signed)


M.D.


7-5 1900 (Address)


355 25 Entluces SV


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 "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.


R $ Name and address of person giving statistical details. Il Name of cemetery.


13 Edvard W. Harding Feb. 1-1908


[4.'07-37-LM.]


Permit No.


Winthrop RETURN OF DEATH. BOSTON, MASS.


Name in full,


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


Sex, Otemale


.Color, White


Condition,


(Single, Married, Widowed or


Divorced.)


Age, ~ Years, 1. Months,


Residence, *.


Minttropo.


masz


Ward,


Place of Death, 35, Sea Fram Chenne


(State Year, month and day.)


Place of Birth Harttrop mars.


Date of Birth, Jan1"1908


Name and Birthplace of Father,


Henry m. Jacken


Maiden Name and Helena G. mo Sinnies Birthplace of Mother,


Place of Interment, Holy Cross Quetay, Shalden Dummer Floyd Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Printtrop Boston,


190 5


Name and Age ! of Deceased,


Barbara Jackan Age, mq years.


I hereby certify that I attended deceased from


190 , to


190 %, that I last saw


alive on the .. day of 1908


that died on the. day of 190 8, about 12 ... 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,


Marcamux


Contributing cause,


actors


Duration


Chief Cause, .... Contributing cause,


Saumon M.D.


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


Date of Death,. Santana Jackson


Otelmany 9" 1908


(White, Black, Mixed, Chinese, Indian, etc.) Days. Occupation,


barbara


Sac Reon


ex


4


-


1908


COMMONWEALTH OF MASSACHUSETTS


Vincent


(CITY OR TOWN.Y


FULL NAME


.Registered No.


Date of l feb 17 190 8 190


Death 1


5-


21


.months


.days


STATISTICAL DETAILS


White


Make


SINGLE, MARRIED, WIDOWED, OR DIVORCED


married


MAIDEN NAME +


HUSBAND'S NAME t


BIRTHPLACE # Nunchuof Mass


NAME OF FATHER albert Richardson


BIRTHPLACE


OF FATHER $


moultonlow Mitt


MAIDEN NAME


OF MOTHER


Obligat Tewksbury


BIRTHPLACE OF MOTHER $


OCCUPATION


INFORMANT §


PLACE OF BURIAL OR REMOVAL II


DATE OF BURIAL


Feb -20


190 8


UNDERTAKER


I.R.18 : 11 2min.


ADDRESS


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last 190.& .. to illness, from. Feb. 15 Feb. 17 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 : Garchie


(DURATION) 2 .. DAYS


Contributory :


(DURATION). ......... DAY8


(Signed)


Blimitar


M.D.


Feb. 20 1908 (Address). 17+ Wnullus Straget


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 "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 detalis. Il Name of cemetery.


ALL NAMES TO BE IN FULL


RETURN OF A DEATH albert Webster Rich


Place of


263 Winthrop Street


Death * S


Residence


Age.


04


.years.


-


albert Webster Richardem 7-6-17-1908


[3.'06 37-L.M.]


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Name in full, Susana


Date of Death, Telmary 19"1908 look


Susan , Amigas


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


Sex, Female Color, White (White, Black, Mixed, Chinese, Indian, etc.)


Condition, Hidemed


(Single, Married, Widowed or Divorced.)


Age, 77 Years, Months, 5 Days. Occupation, -


Residence, * Winthrope Wass


Ward,


Place of Death, 19 Or William & heel


Place of Birth, Paris Due Date of Birth,


(State year, month and day.)


Chamas Brigas =


Unknown


Name and Birthplace ? of Father, Maiden Name and Birthplace of Mother,


Sarah Hacker=


Unknown


Place of Interment, Findewoord Cemetery Stoneham Summer effond Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston Felly 20


1908


Name and Age ?


of Deceased, Susan P Cook


Age, 77 years.


I hereby certify that I attended deceased from Seft 1904, to Fely 19


190 ; that I last saw tur ......... alive on the 19 day of Fely 1905,


that yes- died on the. 14 day of Fely 1908,about 4 o'clock


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


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.


21


Winthropo


Susan . Look Feb-19-190 8


[3.'06 37-LM.]


Permit No.


RETURN OF DEATH. BOSTON, MASS.


Date of Death,.


March 3 "1908


Name in full, Ojaniet Jane Senge


Sex,


Female


Color White-


Condition,


Hidianed


(Single, Married, Widowed or Divorced.) 3


Age, 45 Years, 2 Months,


Residence,*


Nass


Ward,


Place of Death, 262 Orintenalo Street


Place of Birth, Chelsea Mass


Date of Birth,


Name and Birthplace \ Samuel Belcher = Chelsea Mass


of Father, Maiden Name and Mary a. Whiting: Whiting me


Birthplace of Mother, 5


Place of Interment,


Summer Ofloved


Undertaker.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston March 3


1908


Name and Age ?


of Deceased, Harriet Sauce


George Age, / S years.


I hereby certify that I attended deceased from.


Fily27 1908, to


190; that I last saw hun alive on the 2 dl


day of March 1903,


that died on the 3dl


day of march


190%; about. 2 o'clock


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


Chief causc,


Disease Contributing cause, Gener


Chief Cause,


Duration Contributing cause, 5 days


M. D.


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


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


(White, Black, Mixed, Chinese,


Indian, etc.)


Days. Occupation,


2


(State year, month and day.)


Harriet Sauce George March 3-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


Neutrop (CITY OR TOWN.)


FULL NAME


Natalie Blauch Sears


Registered No.


Date of March 3.


.1908


Residence


00


30


.. years.


9


8


months.


.days


STATISTICAL DETAILS


SEX female


COLOR, 1


White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME t Natalie Blanche Polestar


HUSBAND'S NAME +


Paul Sears


BIRTHPLACE #


New Gloucester. ME.


NAME OF


FATHER


Joseph M. Pallister


BIRTHPLACE


OF FATHER#


Freeport. me.


MAIDEN NAME


OF MOTHER


Kellie S. Hunnewrel


BIRTHPLACE


OF MOTHER #


Durham. ME.


OCCUPATION


INFORMANT


My. Kellie S. Pallister


49 Pics Av. Winthrop man.


mother


PLACE OF BURIAL OR REMOVAL !!


Feco Gloucester ME.


DATE OF BURIAL


march 6.


....


190 8


UNDERTAKER


m. F. Rodgers


ADDRESS


malden. mars.


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from 1907 to /Me/ / 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 :


(DURATION).


... DAY8


Contributory :


.(DURATION).


. DAY 8


(Signed)


P. D. Conroy


M.D.


190 ..... (Address).


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


How long at


Place of Death ?


years


months.


....


. days


Where was disease contracted,


If not at placo of death ?


Filed


190.


Clerk


* City or town, street and number, If any. If death occurs away from USUAL RESI- DENCE, glve facts called for under "Special information." If in a Hospital or Institution, give Its NAME Instead of street and number.


t In case of married or divorced woman, or widow. * State or country ; also clty, town or county, If known.


§ Name and address of person giving statistical dotalis. Il Name of cemetery.


Place of 1


Death *


49 Pico Avz. Winthrop. mass


Age


Death


1


18 natalie Blanche Sears March 3, 1908


COMMONWEALTH OF MASSACHUSETTS


72


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Henry


J. Schell


Registered No. ......


Date of ¿


Death .


march 5 1908


Residence


Temple


avenue


Ag 53 .years. months. .. days


STATISTICAL DETAILS


PHYSICIAN'S CERTIFICATE


SEX


Male


COLOR


avtute


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME Ť


HUSBAND'S NAME t


2


BIRTHPLACE ¢ Cologne Germany


NAME OF


FATHER


Mitchell S check


BIRTHPLACE OF FATHER+


MAIDEN NAME OF MOTHER


BIRTHPLACE


OF MOTHER +


OCCUPATION


Lupt. U.S. Construcción Dalla


INFORMANT §


Filed


190


Clerk


PLACE OF BURIAL OR REMOVAL W


DATE OF BURIAL


Izran-10- 1908


UNDERTAKER


ADDRESS


I HEREBY CERTIFY that + attended deceased during last


iHnees, from. 190 ..... to ..... ............................ 90 ....... 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 :


Multiple injuries


Caused by being Strunck and run


DAYS Contributoryan railroad Chans .


(DURATION). DAYO


(Signed)


George Burgen magritte.


M.D.


190 .... (Address).


Suffolk to. 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 ?.


....


* 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, givo 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.


Place of )


Death *


S


winthrop


١٠


19 Henry & Scheel Mar 5- 190 8


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1908.


CITY OF BOSTON.


FULL NAME Willis A D Hadley


(alias William)


Registered No. 2145


Place of Death l Boston


South Station, Room 290


and Residence S


Date of Death


Mar 6


1908.


Age


40


. years .


3


months.


19


.days.


STATISTICAL DETAILS.


SEX


COLOR


SINGLE, MARRIED, WID., DIV.



W


M


Maiden Name. .............


ST


R. AR'S


CITY


-Primacy (Dura trò () DEFICE!


BOBTENIA


CONDITAA.


Name of Father. Horace Hadley


BO.STO


Birthplace of Father


Maiden Name


of Mother Susan E Blair


Birthplace of Mother.


Dresden Me


(Signed)


Geo . B.Magrath


M.D.


Mar .... 6


1908


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


Place of Burial or removal


Winthrop "Winthrop Cem"


Usual Residence


Winthrop


Undertaker


Sumner Floyd


Filed


Mar 9


1908


A true copy.


Attest :


ErMSlenen


Registrar.


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 :


T PATRIBLE, SIT DEX


Natural causes, prot.


Husband's Name ..


Birthplace Dresden Me


Heart Dis. (no autopsy)


188D. ATA A. 1822 TISREGIMINE .DONATA A MA'S S.


Contributory : ( (Duration)


Occupation.


R ... R ... Brakeman


Informant


Millis A.W. Hadley


MALTOR Mar 6-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME Sarah, H. Seymour


Registered No.


38/11.


Place of ¿


DI Vane 4? Ihave Qu'


Date of l


Mar 9


190


Death * 5


Residence


Age


76


years.


3


months.


.days


STATISTICAL DETAILS


SEX terras


COLOR


SINGLE, MARRIED,


WIDOWED, OR


DIVORCED


manual


MAIDEN NAME + Sarah. K. Shower


HUSBAND'S NAME +


John : H. Promove


BIRTHPLACE +


Brandon OT


NAME OF


FATHER


BIRTHPLACE


OF FATHER$


MAIDEN NAME


OF MOTHER


Parche Knowhow Theh. 9


BIRTHPLACE


OF MOTHER $


OCCUPATION


.


INFORMANT §


Low


PLACE OF BURIAL OR REMOVAL II


Cleveland This


DATE OF BURIAL


190 ...


ADDRESS


PHYSICIAN'S CERTIFICATE


| HEREBY CERTIFY that I attended deceased during last illness, from Mch. 6 1908 ton.2. 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 : acute Indigestion


(DURATION) DAYe


Contributory :


antrag


(DURATION). DAYS


M.D.


(Signed)


1902 .... (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 detalis. || Name of cemetery.


UNDERTAKER


8


Death


1


20 Sarah K. Seymour Mar 9- 1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH Redman


(CITY OR TOWN.)


FULL NAME


archer


Registered No ...


Place of }


Wenchenet Mars Washington Lave


Death *


3


Residence


Age


24


.years.


months.


.days


STATISTICAL DETAILS


SEX


male


COLOR


SINGLE, MARRIED, WIDOWED, OR DIVORCED


Single


MAIDEN NAME +


HUSBAND'S NAME +


Z


BIRTHPLACE #


Lansdown Out


deeds 00


NAME OF


FATHER


Joseph. P. Redmond


BIRTHPLACE OF FATHER$ Escol "ont


MAIDEN NAME


OF MOTHER


Elizabeth Hodgeio


BIRTHPLACE


OF MOTHER


London Only


OCCUPATION


Click


INFORMANT §


tucher


PHYSICIAN'S CERTIFICATE


.. to I HEREBY CERTIFY that I attended deceased during last illness, from mar 6


190. Mar. 11. 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 : Dipituturia


(DURATION) .... OAYO


Contributory :


Aspitia Pneumonia


(OURATION) ..... / ... .DAY8.


(Signed)


M.J. Parão


M.D.


Mar. 12 1908 (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 (


Lansdown Cent


DATE OF BURIAL


May 13


8


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, glva 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 glving statistical detalls. Il Name of cometery.


190


Death


1


Date of l


Mar 10


8


...


21 arthur Reduan Mar 10-1908


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Louisa. 22 20 ob/


Registered No.


Place of Į


Death *


S


Frost Banks Wenchut


Death


1


.. years


10


months. .days


STATISTICAL DETAILS


SEX


COLOR


White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


widow


MAIDEN NAME t


HUSBAND'S NAME t


David O. De TRf.


BIRTHPLACE ¢


Udano. New York State


Jefferson Co


NAME OF


FATHER


Stephen B. Wright


BIRTHPLACE


OF FATHER *


Decifield mais


MAIDEN NAME


OF MOTHER


Hannah . Kellogg


BIRTHPLACE


OF MOTHER $


Hartford Com


OCCUPATION


INFORMANT §


PLACE OF BURIAL OR REMOVAL II


adams 2. 1.


DATE OF BURIAL


Mar 14


8


190.


UNDERTAKER


ADDRESS


Wonchung


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from Jisb. 24th. - 1908 to 12864.11 .. 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 : Primary :


Hus li full in wassering, on Myb. 2 3-08


(DURATION). 17 DAYS


Contributory :


Old age hand geweest wolnoman


(OURATION). ... 0AY8 ...


M.D.


(Signed)


2


1908 (Address).


7% Davies, Insan


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 "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.


Il Name of cemetery.


Date of l Mar 11 8


190


Residence


1.


11


Age


82


22


J


Juan 11-190 8




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