USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1910-1911 > Part 32
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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 street, 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.
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 Chelmsford (No. Dalton Road St. :
Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No.
67
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE,
MARRIED
WIDOWED
OR · DIVORCED
(Write the word)
Marcel
6 DATE OF BIRTH .
any (Month)
10
(Day)
7 AGE
If LESS than
49 yrs. 2 mos. 10
ds
or ........ min. ?
8 OCCUPATION (a) Trade, profession, or particular kind of work
2nd Hand Bigshow Carpetes.
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE (State or country)
Hodstock New Brunswick
10 NAME OF FATHER
..
11 BIRTHPLACE OF FATHER (State or country)
Scotland
12 MAIDEN NAME OF MOTHER Thought Mattadgen
18 BIRTHPLACE OF MOTHER (State or country)
Scotland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
There Maknite
(Address)
16
Filed Oct. 21 1911 Edward J Robbing
- REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Oct.
19
1911
(Month)
(Day) (Year)
18162
17
I HEREBY CERTIFY that I attended deceased from
(Year)
Sept. 6
.... 1911, to
Oct. 19. 191
1 day,.
hrs.
that I last saw h.Las-alive on.
Oct.19
., 1917
and that death occurred, on the date stated above, at
m.
The CAUSE OF DEATH* was as follows :
Chronic
about
(Duration)
1 vrf. 6
mos.
ds.
Contributory (SECONDARY)
(Duration)
.. yrs.
mos.
ds.
(Signed)
Chuchu G. Scorina
-
M.D.
Oct. 2 2. 1911 (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
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
Forfactures Con
DATE OF BURIAL
Oct 22- 19/
....
20 UNDERTAKER
ADDRESS
Chelmsford
67
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband:] @RESIDENCE
MARGIN RESERVED FOR BINDING
important. See instructions on back of certificate.
PARENTS
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, Sur- 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.
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.
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
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Chelmsford Mass
(No.
St. :
Ward)
Registered No.
68
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
| 4 COLOR OR RACE
Female
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
16 DATE OF DEATH
Oct 24
191.1.
:
(Month)
(Day)
(Year)
6 DATE OF BIRTH
March
I9.
IgII
(Month)
(Day)
(Year)
7 AGE
.
yrs.
ds.
& OCCUPATION
(a) Trade, profession, or
particular kind of work
None
The CAUSE OF DEATH* was as follows : Otitis Media, leute Sobar
neumonia.
with
Encion, Brutitión
(Duration)
.yrs.
mos.
ds.
Contributory
(SECONDARY)
Duration
.yrs.
mos.
18
.ds.
Autun G. Scolma.
M.D.
(Signed )
Oct.25
4. 1911 (Address).
Chelmsford, mars.
* If death followed injury or violence the certificate of death must he 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
Edson
Cemetery
DATE OF BURIAL
Oct 27.
.,
1916
(Address)
Chelmsford Mass
15
Filed
Oct. 27, 191/ Edward Robimy
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
17
I HEREBY CERTIFY that | attended deceased from
Oct.6
Oct. 24.
191 /
....... ..... 1911, to
If LESS than
I day, .
.. hrs.
that I last saw her alive on
Cet 24, 91
and that death occurred, on the date stated above, at 1120 Pm.
or ........ min. ?
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
Chelmsford
Mass
10 NAME OF
FATHER
Carl A. Bishop
11 BIRTHPLACE
OF FATHER
(State or country)
Presque
Maine
12 MAIDEN NAME
OF MOTHER
Sylvia P Webster
13 BIRTHPLACE
OF MOTHER
(State or country)
Lebanon
N.H
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Carl
A/ Bishop
68
Chelmsford (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
Marion A. Bishop
"FULL NAME
{If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford
Mass
20 UNDERTAKER
bim. Young
ADDRESS
33 Prescottel
MARGIN RESERVED FOR BINDING
PARENTS
8
mos.
5
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) Salcs- 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- Coul mine, etc. Women at home, who are engaged in the duties of the household only (not paid Ilousc- keepers who receive a definite salary), may be entered as Housewife, Hlouscwork, 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 110 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 (tho 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- acmia " (mcrely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senilc," 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 septicemia," " 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 duc to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
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
1 PLACE OF DEATH
Chelmsford
Mass
(No
St. :
Ward)
Chelmsford (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME Sylvia A. Whitney
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford
Mass
Registered No.
69
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
14 COLOR OR RACE
Female
White
6 DATE OF BIRTH
I849
(Month)
(Day) (Year)
7 AGE
62 ... yrs. ... 3 ........ mos. .... 27 ds.
or ........ min. ?
8 OCCUPATION
(a) Trade, profession, or particular kind of work ..
At
Home
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
Walcot Vt.
10 NAME OF
FATHER
alvah
Whitney
11 BIRTHPLACE OF FATHER (State or country)
Vermont
12 MAIDEN NAME OF MOTHER
Idris
Richardson
13 BIRTHPLACE
OF MOTHER
(State or country)
Fairfax
Vt
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mrs
Edgar P. Barclay
(Address)
Lowell
Mass
16
Filed Oct. 29, 191 Edward, Robbins
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
October
27.
191
(Month)
(Day)
(Year)
17
I HEREBY CERTIFY that I attended deceased from
July 22
Och 26
... , 191/, to
- 191/ .....
:
If LESS than
[ day. ....
hrs.
that I last saw her alive on.
OCR 26
191/
and that death occurred, on the date stated above, at 1 2:30 am.
The CAUSE OF DEATH* was as follows :
Valvular Strach Desene
(Duration)
yrs.
mos.
ds.
Contributory (SECONDARY)
(Duration)
yrs.
mos.
ds.
(Signed)
Ock 27
...
191 / ....... (Address)
Attual, Leolina.
* 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.
In the
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
DATE OF BURIAL
Uct-29.
1911
Edson Cemetery
20 UNDERTAKER
b.m. Horng
ADDRESS
33 Rescott of
T
MARGIN RESERVED FOR BINDING
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
69
M.D.
PARENTS
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word) Single
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 bo 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 "Epidemie cerebro-spinal meningitis") ; Diphtheria (avoid usc 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
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.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
2 FULL NAME 3 SEX Male 6 DATE OF BIRTH 7 AGE 8 OCCUPATION 9 BIRTHPLACE (State or country) 10 NAME OF FATHER 12 MAIDEN NAME OF MOTHER PARENTS important. See instructions on back of certificate. (Address) 15 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 (a) Trade, profession, or particular kind of work
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH no Chelinford (No
Fax
William Elmer Low
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
St. no Chelmsford
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
white
5 SINGLE,
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word
finale
00/1
17
(Yeaf-)
If LESS than
1 day, ........
hrs.
.yrs. mos. ...
or
......
min. ?
(b) General nature of industry, business, or establishment in which employed (or employer) ..
no chelmsford
Elmer
11 BIRTHPLACE OF FATHER (State or country)
Laconia N. H.
Aussell
13 BIRTHPLACE OF MOTHER (State or country)
England
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Muss Juno E. Hadley
nochelista
Filed Oct. 30, 191) Edward . Robbing
REGISTRAR
16 DATE OF DEATH Oct (Month) 29 (Day)
191 / (Year)
I HEREBY CERTIFY that I attended deceased from
Oct. 23
1911 to
Del. 29
...
1911.
that I last saw him alive on
01.26
191
and that death occurred, on the date stated above, at 8 P. m
The CAUSE OF DEATH* was as follows :
Convulsions
Cause sunknown.
The church was born bemali
(Duration)
.. yrs.
mos.
7
.ds.
Contributory
(SECONDARY)
.(Duration)
.... yrs.
mos.
ds
JE Varney
M.D.
(Signed)
Oef.30
., 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.
mos.
ds.
State
yrs.
In the
mos.
ds
Where was disease contracted, if not at place of death ?.
Former or usual residence.
19 AGE OF BURIAL OR REMOVAL
side
DATE OF BURIAL Oct 30191
ADDRESS DOUNDERTAKER e m. Eastman 24 Hacksoust.
70 Chelmsford (City or town.)
St. ;.
... Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
70
Registered No.
MEDICAL CERTIFICATE OF DEATH
Oct (Month)
(Day)
27 ds.
Lucy
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 Ilouse- 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 (ncver 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," "Collapsc," "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.
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