Town of Winthrop : Record of Deaths 1910-1912, Part 3

Author: Winthrop (Mass.)
Publication date: 1910
Publisher:
Number of Pages: 956


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1910-1912 > Part 3


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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PHYSICIAN'S CERTIFICATE.


I HEREBY CERTIFY that I attended deceased during last illness,


from


1910, to


.1910, 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:


AR'S


Husband's Name


Maynard H Jordan


ITY


Birthplace


St John, N. B.


TVITATI


BOSTONIA


CONDITA A.


A. 1822.


(Signed)


H W Goodall


..... .M.D.


Feb .... 1.9. 1910


....


....


SPECIAL INFORMATION from Hospitals, Institutions, Transier.ts, or Recent Residents.


Undertaker


C R Bennison


Winthrop .


N


19 Мелкие дж.живелений Экв 20-1910


it should not haricinde the primary savona


forma


non the primary


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH Henderson


(CITY OR TOWN.)


FULL NAME


Place of l


Death *


Residence


#15 Giorno ant


Age.


.years ..


.months. days


STATISTICAL DETAILS


SEX female


COLOR


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME + HUSBAND'S NAME t


BIRTHPLACE #


NAME OF


FATHER


Franklin: a. Henderson


BIRTHPLACE


OF FATHER$


MAIDEN NAME


OF MOTHER


Eleanore. M. Moore


BIRTHPLACE


OF MOTHER #


Towarto out.


OCCUPATION


INFORMANT § Franklin. & Henderson


PLACE OF BURIAL OR REMOVAL !!


DATE OF BURIAL


2/23


1960


UNDERTAKER


ADDRESS


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from Sub. 19 190.0 ... to 2125 .196.6 .. , 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 : Peratura


Contributory :


(DURATION). .DAYS


(Signed)


(3. Hel ius


1


M.D.


26.23


190.0 ... (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 detalis. Il Name of cemetery.


FILL OUT WITH INK .- THIS IS A PERMANENT RECORD


ALL NAMES TO BE IN FULL


Registered No.


Date of Į


2/21


196 ℃


Death


1


(DURATION). .. DAYS


20


Henderson on Feb 21-1910


Farma


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


FULL NAME


Than I. Jordan


.. Registered No. ..........


Place of Death *


HO Hundont St Huittore Haus.


Date of Death


tek. 22-1910.


Age


81 years


8 months


2 days


STATISTICAL DETAILS


SEX


COLOR


SINGLE, MARRIED, WIDOWED, OR DIVORCED


MAIDEN NAME Ť mary L. Rud


HUSBAND'S NAME + David Gordon


BIRTHPLACE # Boothbay Marine


NAME OF FATHER


BIRTHPLACE


OF FATHER+


Boothbay Is.


MAIDEN NAME


OF MOTHER


BIRTHPLACE


OF MOTHER +


OCCUPATION


INFORMANT § Than nard H. Jordan.


PLACE OF BURIAL OR REMOVAL II Boothbay ME


DATE OF BURIAL 2-25 1900


UNDERTAKER


H.C. S rugas.


ADDRESS 2 Harmony


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from Jack. 16 1960 to Jef. 22 190.2.4 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 : Miture Regurgitation


auchma


Contributory : .. Indep.


(DURATION). DAYS


(Signed) Dr.g. Partes M.D.


Ich. 23 190 .. Q. (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 "Special Information." If in a Hospital or Institution, give Its NAME instead of street and number.


t In case of married or divorced woman, or widow.


# State or country ; also city, town or county, If known.


§ Name and address of person giving statistical detalls. || Name of cemetery.


ALL NAMES TO BE IN FULL


. (DURATION). ... DAYS


21 Mary D. Jordan. Tel. 22-1910


DAL na MARA on those macunalla


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1910.


CITY OF BOSTON.


FULL NAME


Samuel White


Registered No.


1886


Place of Death ¿


Boston


Mass. Homeo. Hospt.


and Residence S


Date of Death.


Feb. 24


1910.


Age


years


.months ... .days.


STATISTICAL DETAILS.


SEX


COLOR


M


W


SINGLE, MARRIED, WID., DIV. S


Maiden Name


Husband's Name


Boston


Birthplace


Name of


Father


Charles White


GIVITAT


BOSTONIA CONDITA A.


A.1822


Birthplace


of Father


Contributory : (


(Duration)


Maiden Name


Etta Swame


of Mother


Birthplace of Mother


Russia


J A Hayward


.M.D.


Feb.24


1910


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


Place of Burial


Woburn"Knights of liberty"


or removal.


Undertaker Jacob Stanotsky


Usual Residence


Winthrop(6 Waveway ave)


Filed


Feb.26


1910.


A true copy.


Attest :


ErMSlenen


Registrar.


MARGIN RESERVED FOR BINDING.


PHYSICIAN'S CERTIFICATE.


I HEREBY CERTIFY that I attended deceased during last illness,


from. 1910, to. 1910, 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:


ST


RAR'S


T PATRIBUS SIT DE


Lobar Pneumonia


Primacy (Duration) FFICE!


TISREGIMINE


18 30.


DONATA A.


Russia


BOSTON


MAS.S.


Scarlet fever - 6 days


(Signed)


Occupation.


Informant


CITY


3


70 ΜΠΑΤ 4Η


F


COMMONWEALTH OF MASSACHUSETTS


239


1


Winthrop


(CITY OR TOWN.)


FULL NAME


Serge K.


nuttall


!


.Registered No.


Date of l


Ich 24


.1980


Death S


Death *


5


Residence


4


.Age


65


.. years. ٠٦


.... months ...................... days


med Examinar


PHYSICIAN'S CERTIFICATE


SEX


Male


COLOR


White


SINGLE, MARRIED, WIDOWED, OR DIVORCED


Manuel


MAIDEN NAME +


HUSBAND'S NAME t


BIRTHPLACE #


Jobens M.B.


NAME OF FATHER William Nuttall .


BIRTHPLACE OF FATHER+


Halofor U.S.


MAIDEN NAME OF MOTHER Rebecca. Handan


BIRTHPLACE


OF MOTHER


If Johns n.B.


OCCUPATION


wilder


INFORMANT § wife


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. Il Name of cemetery.


PLACE OF BURIAL OR REMOVAL II


1


Glenwood Prevention


DATE OF BURIAL


frex 27


196.0


ADDRESS


UNDERTAKER CRBenquoi


| HEREBY CERTIFY that + 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 :


Poisoning by opium


(laudanum)


Suicidal


(DURATION) .. DAYS


Contributory :


(Signed)


Serge Burger brug


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


M.D.


190. (Address) Medina


Sifolklo.


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 ?


: 4


ALL NAMES TO BE IN FULL


RETURN OF A DEATH


Place of )


50 Main St.


STATISTICAL DETAILS


22


George 11. Hultall Feb- 24-1910 -


wwwanna the primary house of


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1910.


CITY OF BOSTON.


FULL NAME


Oscar G Berry


......


Registered No.


1913


Place of Death }


Boston


Eliot Hospt.


and Residence S


Date of Death


Feb. 25


1910.


Age.


45


years


6


months.


16 days.


STATISTICAL DETAILS.


SEX


COLOR


SINGLE, MARRIED, WID., DIV.


I HEREBY CERTIFY that I attended deceased during last illness,


.1910,


from 1910, to that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows:


RAR'S


PATRIBUS SITO


Primary: ) Porf. Duodenal ulcer - 9 dys


(Duration) EFIC E:


.... ........


.....


Name of


Father Marcellus D Berry


Birthplace of Father Bradford, Vt.


Maiden Name


Hannah A Evans


of Mother


Birthplace of Mother. Reading


(Signed) ................ M.J.Mixter ...... M.D.


Feb.25


....


.......


SPECIAL INFORMATION from Hospitals, Institutions, Transier.ts, or Recent Residents.


Informant.


......


Place of Burial


or removal.


Lynn


Usual Residence


Winthrop(68 Washington


St)


Feb. 28


Filed


1910.


Undertaker


W C Skaggs


.inthrop


PHYSICIAN'S CERTIFICATE.


Maiden Name -...


Husband's Name


Birthplace Reading


CITY


BOSTONIA CONDITAA


TISREGIMIT


ST


N


YATA A.1822


MAS.S. Contributory : ( Peritonitis - 9 days


(Duration)


Occupation. ...... Insurance


1910


A true copy. Attest : ErMSlenen


Registrar.


מנים


COMMONWEALTH OF MASSACHUSETTS


RETURN OF A DEATH


(CITY OR TOWN.)


FULL NAME


Mary Ellen Lerle


Registered No ..


Date of ¿


2/21


1910


Death


>5


6


months


15


.days


STATISTICAL DETAILS


SEX Female


COLOR


SINGLE, MARRIED, WIDOWED, OR DIVORCED


circon


MAIDEN NAME +


Wallace


HUSBAND'S NAME 1


Kev. Samuel. R. bitte


BIRTHPLACE# Mount Stealing Kunhuty


NAME OF


FATHER


Frugt. J. Wallace


BIRTHPLACE OF FATHER#


MAIDEN NAME OF MOTHER Marquette Romana


BIRTHPLACE


OF MOTHER #


OCCUPATION


INFORMANT § Miks. S. S. Whiting


PLACE OF BURIAL OR REMOVAL !!


DATE OF BURIAL 3/1 1960


UNDERTAKER


ADDRESS


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from. 2023 190 .....


07/27/980 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 : Promomed


(DURATION)


DAYS


Contributory :


(OURATION). DAYS


(Signed)


74 28 ,00.


(Address).


M.D.


SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents.


How long at Piace 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 statisticai details. ][ Name of cemetery.


FILL OUT WITH INK. - THIS IS A PERMANENT RECORD


ALL NAMES TO BE IN FULL


Place of l


40 Plummer SL


Death *


Residence


Cc


C-


Age


.years.


23 mary Ellen Little File. 27-1910.


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1910.


CITY OF BOSTON.


FULL NAME


Bertha Waity Scott


Registered No. 2047


Lass. Gen . Hospt.


Place of Death }


Boston


and Residence S


Mar. 1


39


3


19


Date of Death


1910.


Age


- years


.months.


.days.


STATISTICAL DETAILS.


SEX


COLOR


F


W


SINGLE, MARRIED, WID., DIV. S


Maiden Name


Husband's Name


Birthplace Woonsocket, R.I.


Name of


Father Edwin R Scott


Birthplace


of Father Blackstone


Maiden Name


Henrietta Abbott


of Mother


Birthplace England


of Mother


Occupation


Manicurist


Informant


......


Place of Burial


or removal


Woonsocket, R.I.


Undertaker


JA C Wightman


PHYSICIAN'S CERTIFICATE.


I HEREBY CERTIFY that I attended deceased during last illness,


1910, from 1910, 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:


ST


IT PATRIBUS


SITDE :Primaoy (Duration)


Gen . Poritonitis - 3 dys


SEFICE;


VITA


BOSTONIA CONDITA AD.


A.1822


DONATA A


Contributory : 3


Appendicitis - 6 mos


(Duration)


(Signed)


C R Motcalf


.M.D.


Mar.1


1910


SPECIAL INFORMATION from Hospitals, Institutions, Transier.ts, or Recent Residents.


Admitted to hospital Fob. 24,1910


Usual Residence.


Winthrop(15 Moore st)


Mar.3


Filed.


1910.


A true copy.


Attest :


Ermslenen


Registrar.


MARGIN RESERVED FOR BINDING.


183D. ISREGISSENE BOSTON. MAS.S.


RAR'S


CITY


COMMONWEALTH OF MASSACHUSETTS


1


2


Willnot. (CITY OR TOWNA


RETURN OF A DEATH


FULL NAME


Marianna Butieri Cristofori


Registered No.


Place of l


Death *


5


meliael Hospital


Residence


mars


Age


.. years ..


.. months. .. days


meli eramis


PHYSICIAN'S CERTIFICATE


SEX Female


COLOR


Wleite


SINGLE, MARRIED, WIDOWED, OR DIVORCED


widow


MAIDEN NAME +


mariana Butices


HUSBAND'S NAME +


Minghi Cristofori


BIRTHPLACE +


NAME OF


FATHER


BIRTHPLACE


OF FATHER$


Italy


MAIDEN NAME


OF MOTHER


BIRTHPLACE


OF MOTHER +


OCCUPATION


Servant


INFORMANT § alfloriano. Picana!


I HEREBY CERTIFY that I attended deceased during last


Fitness, 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 :


multiple burno o


12x, ad x 3d digans


0


ofacci dental org (DURATION)


DAY8


Contributory :


(DURATION).


.. DAY8


(Signed)


Junge Burgon Manuel


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


* 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 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 statisticai 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 Plymancato


DATE OF BURIAL


Mar qIX


19g.a.


UNDERTAKER


ADDRESS Kulturof


Death


Date of l


mar 2 08


190 ℃


STATISTICAL DETAILS


2.5 mariana Butieri Cristofori man . 7-1910


[1-'09-37-XXXM.]


Winthrop mass


Permit No.


RETURN OF DEATH. BOSTON MASS.


the


Date of Death,.


marsh ?? 19 Q


Name in full, maria.


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


Sex, Females Color, Soluté


Condition,


Stidlow


(Single, Married, Widowed or Divorced.)


Age, 80 Years, Years, Months, .. Days. Occupation,


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


Residence, *


Daunbar CE


Ward,


Place of Death, 2 Familiar CE


Place of Birth,


Ireland Date of Birth,.


(State year, month and day.)


Name and Birthplace ) not shown


... of Father, Maiden Name and 1


Birthplace of Mother, Salvarat EnElEry- Bastão Place of Interment,


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


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


Boston, ..


Mar. 9


19/0


Name and Age ? Maria J, Henderson


Age, 85 years.


I hereby certify that I attended deceased from. apr. 1909, to mar 5


19/0 , that I last saw lier alive on the fifth


day of. 19/0,


that died on the Dereult day of luar.


1910, 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 : Qlironie interstitial repliritis


Disease ? Chief cause,


Contributing cause,. Gangrene of the


Duration


Chief Cause, Cine year


Contributing cause, Two weeks


Edward . Tranger - M. D.


PHYSICIANS BEFORE STATING CAUSE OF DEATH ARE REQUESTED TO SEE THE OTHER SIDE OF THIS BLANK.


of Deceased,


LIST OF INDEFINITE TERMS WHICH SHOULD BE AVOIDED IN GIVING CAUSES OF DEATH.


Acute gastritis. State cause. Was it due to some irritant poison ?


Ascites.


Name disease causing ascites. See "Dropsy."


Asphyxia.


How? Was it accidental? If so, state fully the nature of the accident. If by gases or poisonous vapors, give particulars. Was it a case of "overlying" (child) ? What disease caused this condition ?


Asthenia. A practically worthless statement. See "Debility." What was the cause?


Atrophy. What caused the atrophy? Was it tuberculous wasting (phthisis) ? Was it syphilis? What organ or part atrophied ?


Blood poisoning.


Do you mean septicemia, syphilis, or any other definite Was it disease? If septicemia, what was the cause? puerperal ?


Chronic~ pneumonia.


Congestion of lungs.


Was it acute bronchitis, broncho-pneumonia, or lobar- pneumonia? If so, state definitely. Was it passive or hypostatic congestion ? If so, name disease causing the condition.


Convulsions.


What caused the convulsions? Were they epileptic, puerperal, or caused by diarrhea or enteritis (infants) ? Name the disease in which the convulsions occurred. "Convulsions" are mere symptoms and should not be given as equivalent to a proper statement of cause of death.


Debility.


What caused the debility? Name the acute or chronic disease. Debility might follow typhoid fever, diph- theria, tuberculosis, Bright's disease, and a host of other causes. The return is worthless and should never be made.


Dentition.


What was the disease causing death of the teething child? "Dentition" is not a proper cause of death, and, like "infantile" and "old age," does little except to mark the approximate age of decedents.


Dropsy.


Name the disease in which the "dropsy" occurred.


Dyspepsia. Was there organic disease of the stomach or other organs? If so, name the disease causing death.


Eclampsia. Give cause of convulsions. Were they puerperal ?


Edema of lungs. Give cause. See "Congestion of lungs."


Gastric fever.


A worthless return. Was it acute gastritis (q. v.) or some


definite form of fever, as typhoid, malarial, etc .?


General paralysis.


If extended paralysis resulted from cerebral hemorrhage, the cause should be given and the expression "general paralysis" should be avoided. "General paralysis" should be written only for "general paralysis of the insane," or paretic dementia, and the statement of the fact of insanity should always be included.


Heart failure.


What disease caused the "heart failure"? The heart always "fails" before death from any cause. Be par- ticularly careful that deaths from diphtheria, tubercu- losis, etc., are not so reported. If organic heart disease is meant it should be so stated.


Hemorrhage of lungs.


Was this not due to pulmonary tuberculosis? If so, the primary cause should be reported without fail.


Hypostatic congestion.


Name the disease causing the passive or hypostatic con- gestion.


Imperfect nutrition.


State name of disease causing imperfect nutrition. follow some disease? If so, give name of disease.


Did it


This is a particularly pernicious term and is responsible for a multitude of worthless certificates. It sounds as if it meant something definite, but, in the majority of cases, it does not. What disease caused the inanition? Was it syphilis, tuberculosis, cholera infantum? If inability to take food, state cause.


Infantile asthenia. See "Asthenia." The term "infantile" adds no precision to an indefinite statement.


Infantile atrophy. See "Atrophy."


Malassimilation.


What disease caused the malassimilation ?


Malnutrition.


What disease caused the malnutrition ?


Marasmus. What disease caused the "marasmus" ? Was it due to tuberculosis, syphilis, or cholera infantum? State fully, as this return in itself is practically worthless for compilation.


Meningitis. Was it epidemic cerebro-spinal meningitis? If so, write exactly in this form. Did it follow scarlet fever, pneu- monia, or some acute infection? If so, name the pri- mary disease. Was it traumatic? If so, state the nature of the violence which caused the meningitis. Was it tuberculous meningitis?


Nephritis. Was it acute or chronic? If acute, occurring in the course of some disease, name the disease causing death.


Old age. This is not a satisfactory return. The influence of age is shown by the statement of age in years, months, and days. To this the statement of "old age" as a cause of death adds nothing of value. Name the disease to which the old person succumbed.


Peritonitis. What was the cause of the peritonitis ? "Idiopathic peri- tonitis" should be rarely returned. Was it puerperal or traumatic? In the latter case, state mode of injury.


Pernicious anemia. If any definite cause can be assigned for the anemia, it should be reported. Anemia due to tuberculosis, syph- ilis, etc., should be returned under the primary disease.


Pneumonia.


Specify definitely whether broncho-pneumonia or lobar-


pneumonia. If sequel to influenza, state that fact.


Pyemia. What caused the pyemia? Was it puerperal or trau- matic? If traumatic, state nature of accident causing injury.


Senile asthenia. See "Old age" and "Asthenia." death.


Give disease causing


Senile atrophy. See "Old age" and "Atrophy." State disease causing


death.


Senile decay.


See "Old age." State disease causing death.


Senile decline.


See "Old age." Name the disease, if any, that caused the


decline.


Senile marasmus. See "Old age" and "Marasmus." Name disease causing death.


Shock. What caused the shock? If from injury, state nature of accident. If from surgical operation, state disease or injury requiring the operation.


Surgical


operation.


Surgical shock.


B


Always state the disease or injury requiring operation. Unless the operation was improper or unskilfully per- formed, it should not be given as the primary cause of death.


Teething. Name the disease affecting the teething child. See "Den- tition."


Toxemia. Was this acute or chronic poisoning due to some external agent? Was it auto-intoxication, due to poisons gen- erated in the body by disease? If so, state the name of the disease.


Tuberculosis. State organ affected. Do not fail to state as pulmonary tuberculosis if lungs were affected. .


Tumor.


Was it a cancer? Whether a cancer or tumor, do not fail


to specify organ or part of body affected.


Typhoid condition.


Avoid this term as it is likely to be mistaken for typhoid


fever.


Was the primary disease typhoid fever or pneumonia ?


Typhoid pneumonia. Typho-malarial fever. Was it typhoid fever? Was it malarial fever? A mix- ture of these diseases rarely occurs, the great majority of cases of so-called "typho-malarial fever " being noth- ing more nor less than typhoid fever.


Inanition.


Was this not pulmonary tuberculosis?


UNDERTAKER'S RETURN


of Wrathof


To the Board of Health of the City of Worcester


Date of Death


March 8


Name Denise Pourtue


Maiden Name.


Sex


Color


Married, Single or Widowed


Age


65


Years


Months


Days.


Name of the Physician


Whether 56 2.


Residence of the Deceased, No ..... 21


[{2 }- WinStreet


Occupation


Husband's Name.


Place of Death, No.


Place of Birth


Father's Name


Father's Birthplace.


Mother's Maiden Name


Birge


Mother's Birthplace


Place of Interment


Date of Burial


ничего 10


Information given by -


Signature of Undertaker


Dated at Worcester, this.


10 cts


day of.


quar


19/0


Physician's Certificate of the Cause of Death.


Date of Death,


March 8.


1910,


Name and Sex of Deceased,


Place of Death


Disease or


Primary


No. 20 Nafatura Do Manchego many Initial Regurgitateon)


Duration of*


Cause of Death


Contributory


Epicpay


Duration of


Uncertain


I certify that the above is a true Return, to the best of my recollection and belief.


Name and Professional Title, . d-4. Vorce?


Street Marchisep, 200xx.


Residence, No. 5Gr


Dated at Worcester, this.


0


day of Mark


19 /".


[ Be very particular to fill all the Blanks.]


* Reckoned to the time of death.


Approved,


Board of Health.


Daniel Donahue


Cemetery


May 8 - 1910


Daniel Douche


the cause should be given and the expression "general


Unless the operation was improper or unskilfully


1


operation.


1. 1 . 40 ----- 1


COMMONWEALTH OF MASSACHUSETTS.


RETURN OF A DEATH-1910.


CITY OF BOSTON.


2294


Registered No.


Place of Death ¿


Boston


Boothby Hospt.


and Residence S


Date of Death


Mar. 9


1910.


Age


35


3


. months


13


.days.


STATISTICAL DETAILS.


SEX


COLOR


F


SINGLE, MARRIED, WID., DIV. I.I


I HEREBY CERTIFY that I attended deceased during last illness,


from 1910, to .. 1910, 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


Folsom


John & Thompson


Husband's Name


Carmel, Me.


Birthplace


Name of


Oliver J Folsom


Father.


Birthplace Blue Hill, Me.


of Father


Maiden Name Elizabeth A Clapham


of Mother


Carmel , LIo.


Birthplace of Mother.


Occupation


iTone


Informant


......


Place of Burial


Epring, T.H.


or removal.


Undertaker AT Lastman .Co.


PHYSICIAN'S CERTIFICATE.


PATRIBU


Primacy (Duration)


Post-Opr. shock - 20 hrs


FFICE!


BOSTONIA CONDITA AD.


A.182


BOSTO


· MAS.S.


Contributory : 2


Opr.Uterine fibroid -


(Duration)


(Signed)


D D Scannell


M.D.


Mar. 9


1910 .................


SPECIAL INFORMATION from Hospitals, Institutions, Transier.ts, or Recent Residents.


Usual Residence


Winthrop


Filed


Mar 10


1910.


A true copy.


Attest :


ErMSlenen


Registrar.


STRAR'S


CITY


ITATIS


18 3D. ISREGIMINE DONATA A.


N


. years


FULL NAME


Ruth A Thompson


COMMONWEALTH OF MASSACHUSETTS


1389


RETURN OF A DEATH


FULL NAME


Elionos a. Beach.


Registered No.


Place of Death *


58 Buchanan St. Huithrole Center


Date of Death


Fuch 13.


Age


/ ... years


4 months


15 days


STATISTICAL DETAILS


SEX


COLOR


W


SINGLE, MARRIED, WIDOWED; OR DIVOROED


MAIDEN NAME Ť


HUSBAND'S NAME +


BIRTHPLACE #


NAME OF FATHER Edgar Beach


BIRTHPLACE OF FATHER novascotia


MAIDEN NAME OF MOTHER


BIRTHPLACE OF MOTHER# Clicaux. DeC.


OCCUPATION


INFORMANT §


PLACE OF BURIAL OR REMOVAL I!


Hintprof~ Com.


DATE OF BURIAL Unch 15 1900


UNDERTAKER ADDRESS IS. C. Skaggs It enmond


PHYSICIAN'S CERTIFICATE


I HEREBY CERTIFY that I attended deceased during last illness, from mar 6 196Q .... to June 18 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 :




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