Board of Health, Boston
Return of Death

Manual transcription from the death return form:

Decedent:
- Name in full: Ellen Gately
- Maiden name: Ellen Tenney
- Date of death: 25 February 1903
- Birth year as recorded: 1847
- Age: 56 years
- Residence: 75 Maywood St, Ward 21, Boston
- Sex: Female
- Conjugal condition: Widowed
- Widow of: Lawrence Gately
- Place of death: 75 Maywood St, Ward 21
- Place of birth: Ireland
- Name of father: Lawrence [surname unclear]
- Maiden name of mother: Bridget Cahill
- Birthplace of father: Ireland
- Birthplace of mother: Ireland
- Place of interment: Calvary

Physician's certificate:
- Date certified: 26 February 1903
- Name and age of deceased: Ellen Gately, age 56 years
- Date and place of death: 75 Maywood St, 25 February 1903
- Chief cause: Ch. Bronchitis
- Contributing cause: Fall from car (accidental)
- Duration of chief cause: 3 weeks
- Duration of contributing cause: 3 months

Notes:
- Manual transcription created from the cleaned repository PDF after citation-page stripping.
- The father's surname is not fully legible in the supplied image.
- The undertaker and physician address lines are only partly legible and were not normalized into the source record.