USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1910-1911 > Part 33
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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 Chelen ford Mars (No. Jungley aur
St. :
Ward)
fif death occurred in a hospital or institution, give its NAME Instead of street and number.]
Margaret as Itinvegan 2 FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
Dingley Our foto Chelisting Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female Midt
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Vingt
S DATE OF BIRTH
(Month)
(Day)
11
1965
(Year)
7 AGE
If LESS than I day, ...... hrs.
6
yrs.
4
mos.
22
ds.
or ....... min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
School Siel
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
ry) Inth Chelwex ford
PARENTS
12 MAIDEN NAME OF MOTHER Margaret Mi Cal
13 BIRTHPLACE OF MOTHER (State or country)
theland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
John Stunmegan etather
(Address)
Preglei aus
15 File nov. 4 1911Edward S. Robbing
REGISTRAR
16 DATE OF DEATH
november
3
(Month)
(Day)
19! \
(Year)
1 HEREBY CERTIFY that I attended deceased from Cect 16, 1916, to. V55 3, 1911. that I last saw hoy alive on Nous GtM., 1911. and that death occurred, on the date stated above, at ] P. m. The CAUSE OF DEATH* was as follows :
J. B. Meningitis
(Duration)
yrs.
mos.
ds.
Contributory (SECONDARY)
(Duration)
yrs.
mos. ds.
(Signed)
James
Mor 4
., 191.
(Address) no.
ford.
..
M.D.
* 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 PLACE OF BURIAL OR REMOVAL St. Jatings Ceneter
DATE OF BURIAL
19/
20 UNDERTAKER
ADDRESS
324 Mars 4 G
MARGIN RESERVED FOR BINDING
important. See instructions on back of certificate.
Cheluis ford Maas
(City or town.)
71
17
...
10 NAME OF
FATHER
11 BIRTHPLACE OF FATHER (State or country) Wieland relay
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, peritonacum, etc., Carcinoma, Sar- coma, etc., of. (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Mcasles ; 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 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 duc 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.
7 AGE PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very 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 /
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
PLACE OF DEATH 800. Chelmsford (No ....... 8 . Branlette
St. :
Ward)
Una moreton Thomas
Registered No.
72
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
He
4 COLOR OR RACE
1 5 SINGLE,
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word)
Widow
6 DATE OF BIRTH
(Month)
(Day)
1
(Year)
8 9
yrs.
mos.
ds.
or ........ min. ?
8 OCCUPATION at home
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
/10
Tracrette Me.
10 NAME OF
FATHER
hos houston
11 BIRTHPLACE
OF FATHER
(State or country)
oui Ayette me.
1
12 MAIDEN NAME
OF MOTHER'
13 BIRTHPLACE
OF MOTHER
(State or country)
full time. "
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informa
Ecard Suek
(Address) X Dinlettest
15 Filed Nov.11. 1911 Cavard S. Popli
REGISTRAR
17
I HEREBY CERTIFY that & attended deceased from
1911, t
Hov. 9
that I last saw hver alive on.
and that death occurred, on the dato stated above, at ....
.m.
The CAUSE OF DEATH* was as follows :
Lenility.
1
(Duration) .
... yrs.
.mos.
ds.
Contributory ..
Acute indigestion
(SECONDARY)
Co
F.G. Harney
(Duration)
.... yrs.
f.mos.
ds.
(Signed)
Arv. 9
........
1911 (Address).
Hol Chelmsford.
* 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 ..
12 PLACE OF BURIAL OR REMOVAL Edson
DATE OF BURIAL
MON, 11, 1911
20 UNDERTAKER
ADDRESS
6. It Malcon Iwill
72 no Chelmsford (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
manchester VI. It.
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
9.
(Month)
(Day)
191.1. (Year)
If LESS than
| day, ......
.. hrs.
(a) Trade, profession, or
particular kind of work ..
.M.D.
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, Loeo- motive engincer, 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., C'arcinoma, Sar- eoma, etc., of .... ...... ......... (name origin: "Cancer" is less definite ; avoid uso of "Tumor" for malignant neoplasms) ; Measles ; Whooping cough ; Chronie 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," ctc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," " Inanition," " Marasmus," " Old age," "Shock," "Uracmia," " 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 causo 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.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
...; Princeton
St. :.
Ward)
[If death occurred in a hospital or institution, give Its NAME instead of street and number.]
Betty Waterhouse arerhouse give maiden name, also name of Kushiand.] Betty Bower. Isaac Water house @RESIDENCE No. Chelmsford.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Nov.
(Month) /
(Day) 13. 191.1. (Year)
I HEREBY CERTIFY that I attended deceased from
nov 8
1911, to 2202 03
1911.
If LESS than 1 day, ..... . hrs. that I last saw her alive on ... por 13 191./, and that death occurred, on the date stated above, at. 2. 30 /,m. The CAUSE OF DEATH* was as follows :
Organ is dream of head.
hand wich ale (Duration)
. .... yrs.
mos. 10 ds.
Contributory (SECONDARY)
(Duration)
yrs.
mos.
ds.
(Signed)
JE Van ey
nos 63. 1
....... .
1911 (Address).
2 Chil um fal
M.D.
* 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.
DATE OF BURIAL
19 PLACE OF BURIAL OR REMOVAL Riverside North Chelms for
metern Nov, 16, 191.
ADDRESS
20 UNDERTAKER Gro. M.Healey. 79 Branch Dr.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
I PLACE OF DEATH no. Chelmsford (No. 2 FULL NAME [If married or divorced woman op fyldow 3 SEX 4 COLOR OR RACE Female. White. 7 AGE & OCCUPATION (a) Trade, profession, or 9 BIRTHPLACE (State or country) England. PARENTS 18 BIRTHPLACE OF MOTHER (State or country) England, 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 particular kind of work At Home. Non
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Widowed.
6 DATE OF BIRTH
July 23
(Monthy
(Day)
(Year)
66
yrs.
3 mos
.mos.
21
ds.
or ....... min. ?
(b) General nature of industry,
business, or establishment in
which employed ( or employer) ..
At Home.
10 NAME OF
FATHER
George Bower.
11 BIRTHPLACE OF FATHER (State or country) England
12 MAIDEN NAME
OF MOTHER
Hannah Ambler.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Herbert Waterhouse
(Address) No. Chelmsford, Mare,
16 Filed Nov. 14, 1911 Edward & Robbing
REGISTRAR
;
;
.
17
18400
73 No. Chelmsford.
Registered No.
~ 3
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 (d) 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.
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
PLACE OF DEATH no. Chelmsford ( No Highland Ave
Dorothy E. Clark.
2 FULL NAME. [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Highland Ave, Dr. Chelmsford.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Females White.
+ COLOR OR RACE
5 SINGLE
MARRIED,
WIDOWED,
OR DIVORCED
( Write the word)
Single.
6 DATE OF BIRTH
Sept.
(Month)
(Day)
7 AGE
yrs.
... mos.
24
ds.
& OCCUPATION
(a) Trade, profession, or
particular kind of work
None.
(b) General nature of industry,
business, or establishment in
which employed (or employer).
None
9 BIRTHPLACE
(State or country)
No. Chelmsford, Mask,
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Englands
12 MAIDEN NAME
OF MOTHER
Ethel M. Joy.
18 BIRTHPLACE OF MOTHER (State or country)
England.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informan
+) Harry S. Clark,
(Address)
No. Chelmsford.
15
Filed. Nov. 15, 1911 Edvard. Robbing
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
1.91
.... , to
por 14, 19/.
If LESS than [ day. ....... hrs. that I last saw h ~~ alive on. nur por 14. 19%. and that death occurred, on the date stated above, at 2-4 m. or ....... min. ?
The CAUSE OF DEATH* was as follows :
sheene brown wrinkle
- 112
mos.
ds.
(Duration)
yrs.
Contributory .. (SECONDARY)
(Duration) yrs.
mos.
ds.
7 E ramey
M.D.
(Signed)
Nur 15
191
(Address).
n chanfang
* 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.
Elmwood CEM
esteteraz.
Methuen, Masa.
DATE OF BURIAL
Nov. 16. 19%.
20 UNDERTAKER
Geo hotealey,
ADDRESS
79 Branch St.
74
No. Chelmsford (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
St. :
Ward)
Registered No.
74
16 DATE OF DEATH Nov 15.
(Month)
(Day)
19!/,
(Year)
22. 1911.
(Year)
MARGIN RESERVED FOR BINDING
10 NAME OF
FATHER
Harry D. Clark
-
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 (retircd, 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 (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) ; Mcasles ; 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.
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