USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1910-1911 > Part 30
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Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners :
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the strcet, or one supposed to be due to Alcoholism, etc.
4, Deaths under circumstances unknown, as A person found dead, etc.
WRITE PLAINLY, WITH UNFADING INK- THIS IS A PERMANENT RECORD.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH East Chelmsford (No Carlisle L.
39. Erst Chelmsford
(City or town.)
Tlf death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME
anna Gilmore Quina
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Erhan Ir. East Chelmsford
Registered No.
59
PERSONAL AND STATISTICAL PARTICULARS
3 SEX unal
4 COLOR OR RACE
Alt
ang
-
(Day)
7 AGE
If LESS than
I day, ........ hrs.
13
11
mos.
ds.
or ........ min. ?
& OCCUPATION
(a) Trede, profession, or
particular kind of work.
Whoat Sind
(b) General nature of industry,
business, or establishment in
which employed (or employer).
student
9 BIRTHPLACE
(Stato or country)
East Cheluisford
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
Ireland
12 MAIDEN NAME OF MOTHER
13 BIRTHPLACE OF MOTHER (State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address) Cast Chilistard
15 any 16, 191 Edward Stabbing
- REGISTRAR
MEDICAL CERTIFICATE OF DEATH
(Month)
(Day)
1911 17 I HEREBY CERTIFY that I have investigated the (Year) death of the deceased.
The CAUSE OF DEATH* was as follows :
Cestil This Land ofBrain
accidental
(Duration)
.... yrs.
mos ..
ds.
Contributory .. (SECONDARY)
(Duration) .
............. yrs.
.. mos.
ds.
Funees,
M.D.
(Signed)
aug. 15, 199 (Address).
160 Remeneck /2.
MEDICAL EXAMINER
* State the DISEASE CAUSING DEATH, or, in deaths from VIOLENT CAUSES, state (1) MEANS of INJURY; and (2) whether ACCIDENTAL, SUICIDAL or HOMICIDAL.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
... yrs.
mos.
ds.
State
yrs.
In the
mos.
ds ..
Where was disease contracted, if not at place of death 7.
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL St Pating Center
DATE OF BURIAL
aug 16
1918
20 UNDERTAKER
ADDRESS
16 DATE OF DEATH aug. 14 1911 (Year)
6 DATE OF BIRTH
(Month)
.yrs.
D SINGLE,
MARRIED,
WIDOWED
OR DIVORCED
(Write the word)
St. :
Ward)
MARGIN RESERVED FOR BINDING
10 NAME OF
FATHER
John P. Jim
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery ; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return " Laborer," "Foreman," " Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia ; Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of .. (name origin: "Cancer" is less . definite; avoid use of " Tumor" for malignant neoplasms) ; Measles ; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), " Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," " Inanition," "Marasmus," " Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS state MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, Or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train - accident ; Revolver wound of head -homicide ; "Poisoned by carbolic acid - prob- ably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis tetanus) may be stated under the head of "Contributory."
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
1
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH South Chelmsford IN.
St. :
Ward)
Elf death occurred in a hospital or institution, give its NAME instead of street and number.]
Hortenos & Hard
2 FULL NAME [If married or divorce woman or widow give maiden name, also name of husband.] @RESIDENCE Sauch Chelmsford
Registered No.
60
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Formale Hthata
5 SINGLE, MARRIED, WIDOWED. OR DIVORCED (Write the word)
Marked
'16 DATE OF DEATH Ana 28
(Month)
(Day)
191.
(Year)
| HEREBY CERTIFY that I attended deceased from 17
191
to
Ang. 2391
that I last saw h &r. alive on Aug /23, 196 and that death occurred, on the date stated above, at 7 m. The CAUSE OF DEATH* was as follows :
yrs.
mos.
ds.
(Duration)
Contributory. (SECONDARY)
.(Deration) ..... yrs.
.mos.
ds.
(Signed)
Autun 4, Scotone
M.D.
Au 4.29, 1911 (Address).
Chelmsford Mars
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
In the
of death
. yrs.
mos.
ds.
State ...
... yrs.
mos.
ds
Where was disease contracted, If not at place of death ?.
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL 82 Patrick
DATE OF BURIAL
aug 31
1916
(Address)
220 Fletcher St
15
Filed
aun 31. 191/ Edward J. Rolling
REGISTRAR
.
If LESS than I day, . hrs.
26
yrs.
mos. 1 .ds.
or. min. ?
8 OCCUPATION at Home
(a) Trade, profession, or particular kind of work
(b) General nature of industry, business, or establishment in which employed (or employer) ..
9 BIRTHPLACE (State or country)
well Tmare
10 NAME OF FATHER Potuti
11 BIRTHPLACE OF FATHER (State or country)
Linkou
PARENTS
12 MAIDEN NAME OF MOTHER Elisabart Helch
13 BIRTHPLACE OF MOTHER (State or country)
Unkown
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Carne " March
ADDRESS
20 UNDERTAKER
Higgins Beos 415 Laurence 11
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate. N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
+ COLOR OR RACE
6 DATE OF BIRTH
(Month)
(Day)
1 (Year)
7 AGE
....
MARGIN RESERVED FOR BINDING
MEDICAL CERTIFICATE OF DEATH
60
(City or town.)
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery ; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more preciso specification, as Day laborer, Farm laborer, Laborcr - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Ilousewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retircd, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and canisation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup ") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of .. . (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles ; Whooping cough ; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example : Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (mcrely symptomatic), " Atrophy," " Collapse," "Coma," " Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," " Heart failure," "Haemorrhage," " Inanition," "Marasmus," " Old age," "Shock," "Uraemia," " Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posurc, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholisni, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
1
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE, OF DEATH
L Forth Chele ford (No ... Nightand ders
.
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Mal
4 COLOR,OR RACE
Ahit
6 SINGLE,
MARRIED,
WIDOWED
OR DIVORCED
(Write the word)
Married
6 DATE OF BIRTH
-
(Month)
(Day)
1849
(Year)
7 AGE
1.2
1
1
yrs.
mos.
or ........ min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
operation
(b) General nature of industry
business, or establishment in
which employed (or employer) ...
Avallen Mill
Wollen
Intestinal Jums
.(Duration)
2 yrs.
.mos.
ds.
Contributory
(SECONDARY)
.. (Duration)
.yrs.
mos.
..........
ds.
(Signed)
Ind . . ..
A
M.D.
3
191 .... ... (Address).
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
yrs.
In the
mos.
ds.
State
.yrs.
.....
mos.
ds ..
Where was disease contracted, if not at place of death ?.
Former or usual residence.
19 PLACE OF BURIAL OR REMOVAL It.Takinga Country nul
DATE OF BURIAL
Veb t' 3.
1917
(Address)
Highland un
16 Filed.
Self-2 191 Edward J. Robbing
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
191 .......
If LESS than
I day ........
hrs.
that I last saw him alive on.
1911 ...
and that death occurred, on the date stated above, at 8 am.
The CAUSE OF DEATH* was as follows :
9 BIRTHPLACE
(State or country)
Ireland
10 NAME OF
FATHER
Satuy Larkin
PARENTS
11 BIRTHPLACE OF FATHER (State or country) Inland
12 MAIDEN NAME OF MOTHER Mary Higgins
13 BIRTHPLACE
OF MOTHER
(State or country)
Cheland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Uhimas M. Laibe
Um
Chelunsford 6/
Ward)
John J. Tanken Vr
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
Highland avr Forth Chelusoford
Registered No.
61
16 DATE OF DEATH
Septi
191
(Month)
(Day)
(Year)
20 UNDERTAKER
ADDRESS
important. See instructions on back of certificate.
ds.
-
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery ; (a) Foreman, (b) Automobile factory. The material worked on inay form part of the second statement. Never return " Laborer," " Foreman," "Manager,""Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Ilouse- keepers who receive a definite salary), may be entered as Ilousewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, tho DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup ") ; Typhoid fever (nover rc- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) : Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of. (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasmns) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," "An- aemia " (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," " Debility " ("Congenital," "Senile," etc.), " Dropsy,""Exhaustion," "Heart failure," "Haemorrhage," " Inanition," " Marasmus," " Old age," "Shock," "Uraemia," "Weakness," ctc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas Poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal Abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found deud, etc.
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Lavell mars
(No.
It achio Horst
Clarence It (1)
, praque
62
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
"male
4 COLOR OR RACE
While.
5 SINGLE,
MARRIED,
WIDOWED
Married
OR DIVORCED
( Write the word)
8 DATE OF BIRTH
Oct.
1846
17
(Month)
(Day)
(Year)
7 AGE
64
11 . 16.
ds.
... yrs.
.mos.
Or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Laboral
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE (State or country) Iwill "Mars.
10 NAME OF
FATHER
6
Thomas upraare
PARENTS
II BIRTHPLACE
OF FATHER
(State or country)
Charlestours May.
12 MAIDEN NAME OF MOTHER Saffronia Hubbard
13 BIRTHPLACE
OF MOTHER
(State or country)
1 Winchester nie
14 THE ABOVE IS TRUE TO THE BEST/OF MY KNOWLEDGE
(Informant)
(Address)
21 Chester 21.
15 14. 23. 1911
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Sup.
(Month)
(Day)
21 1911
(Year)
I HEREBY CERTIFY that I attended deceased from
191.
to
191
.. .
that | last saw h ...........
alive on
191
and that death occurred, on the date stated above, at.
m.
The CAUSE OF DEATH* washas follows :
accident( + M.
. R.R.)
/ (Duration) !!
yrs. .... / mos.
ds.
Contributory ...
Fracture of Skull ICan't + tax)
(SECONDARY)
3
(Duration)yrs.
mos.
.ds.
(Signed)
1. 1 mugs med Ex m.b.
JA, 22 1911 (Address)
160 Mummach 21
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR
RECENT RESIDENTS).
At place
of death.
yrs ..
mos.
ds.
State.
In the
mos.
ds.
yrs.
Where was disease contracted, if not at place of death ?.
Former or usual residence.
19 PLACE OF BURIAL OR REMOVAL
DATE OF/BURIAL
Privéide Com. Na torinoand 04. 2001
20 UNDERTAKER
6. m. Yring
ADDRESS, 33 Prescale et,
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
62
Lowell
St. : Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also namc of husband.]
@RESIDENCE
no thelangford Mars,
-
If LESS than
I day ......... hrs.
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially iu industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery ; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager,""Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborcr- Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wagcs, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonyın is "Epidemic cerebro-spinal meningitis ") ; Diphtheria (avoid use of "Croup ") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritoneum, etc., Carcinoma, Sar- coma, etc., of. ...... (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles ; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless in- portant. Example : Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " All- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," ctc.), "Dropsy," "Exhaustion," "Heart failure," " Haemorrhage," "Inanition," " Marasmus," " Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
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