Report on registration, presented to the Quarantine and Sanitary Convention, at its fourth annual meeting, held in the city of Boston, June 14, 1860 / by Edwin M. Snow.

  • Edwin Miller Snow
Date:
[1860?]
Catalogue details

Licence: Public Domain Mark

Credit: Report on registration, presented to the Quarantine and Sanitary Convention, at its fourth annual meeting, held in the city of Boston, June 14, 1860 / by Edwin M. Snow. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    RETURN OF A DEATH. CITY OF *- 1. Date of Death? ?cuulo*J£ 10, f#bO. 2. Name in full? ^aitt&tt JSfiaLLon. fj6LcLficj4.x 8 Age? ' 33 Years. J. Months. 1S Days. 4. ( Place ) Street and No.? SB /^'^cj^-^Jt^eL ] of [ 5. (Death?) Ward? V. 0 (5. Sex? ........... 7. Color? 8. Condition ? !). Occupation?. ...... Id. Where Born? 11. Father's Name? . . . . 12. Mother's Name? 13. Birthplace of Parents? 14. Where Buried? /w. ^/CL—jUfLJle of g&eajt-g&i ^Ccj t s rJ^ccJi e.^, J3*ttc.U-tcLen.ee> ^J'ctrn.es. j3fictLLc.it. ^EciLt'tSCt j3>ClLLcJT.. Fa. /PteLctncL. Mo. JIL. gf. JVe^njxn. ^entete.itty, ^Jpctrrtes j3ftctLLc.n, Informant. N. B.—At Nos. 4 and 5, give the -place where the person died. At No. 8, state whether married or single, widow or widower. At No. 13, state the country in which each parent was born: PHYSICIAN'S CERTIFICATE. Date of Death? J>cttLLtcti^u. 10, 18 bO. Name ? ^attt&ct jSftctLLcm. ^Lctif-ei^. Disease? 1. Primary, ^an&ftm/tttcn. 2. Secondary. J^nettntanlct. Duration of Disease? 1. J ntaitt/ts. 2. Idcti/s. ^fctntes. ^f£itnteit, Physician. J certify that the above is a true return, to the best of my belief. SphLtift /WctLLej£, Undertaker.