USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1910-1911 > Part 8
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important. See instructions on back of certificate.
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
ashlynhan
mais,
12 MAIDEN NAME
OF MOTHER
Judía C. huW
13 BIRTHPLACE
OF MOTHER
(State or country)
I Cushion mars
THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
taihu
(Address)
no Chicago forel.
16 Filed .. 1/11/20, 1911
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
(Month)
(Day)
If
19| 7
(Year)
I HEREBY CERTIFY that I attended deceased from
Cina 15
191.00, to .
(Pr.c. 18, 1910.
If LESS than
I day ......
hrs.
that I last saw h ... . alive on
and that death occurred, on the date stated above, at
m.
The CAUSE OF DEATH* was as follows :
Verstemília
(Duration)
yrs.
mos.
ds.
Contributory
(SECONDARY)
.
10 (Duration)
... yrs.
. mos.
.......
ds.
J'y Laquo
1
M,D.
(Signed)
Ling 18.
, 1910 (Address)
110 Brauch 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
....... 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
Halthem marzo,
DATE OF BURIAL
(ing 20 1911
20 UNDERTAKER
1
ADDRESS
John C. Heinzbeck for middle It
223
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
PLACE OF DEATH
You've
6
(No Lerville
St .; -
.Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
" FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.]
nu Greene (Cicbert Mitchell)
@RESIDENCE
Registered No.
13/1
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Timale White
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
manuel
6 DATE OF BIRTH
8.
1818
17
..
(Monthy
(Day)
(Year)
7 AGE
32 yrs. 17 mos.
10 ds
or ....... min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
· (b) General nature of industry,
business, or establishment in
which employed (or employer).
at Home
9 BIRTHPLACE
(State or country)
1
Theword miars
1
10 NAME OF
FATHER
Oliva Mr Green
.
Lor el1
(City or town.)
Viola & mitchell.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
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 cngincer, 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 fercr (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, 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 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 canse 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 cansed 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, ctc.
108Foram
Sx
0
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
3 SEX Female 6 DATE OF BIRTH 7 AGE 8 OCCUPATION 9 BIRTHPLACE (State or country) PARENTS 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
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
E. Chelmsford .(No. .Gorham S.t. St. ; Ward)
2 FULL NAME Helen E. Donnelly [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Gorham St. E. Chelmsford
Registered No.
65
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED Single
(Write the word)"
Oct (Month)
22
(Day)
1908
(Year)
If LESS than I day. ....... hrs.
1 .yrs. .... 9 mos. 2.7
ds. or ........ min. ?
(a) Trade, profession, or
None
(b) General nature of industry,
business, or establishment in
which employed (or employer).
None
-
(Duration)
yrs.
mos.
ds.
Lowell
10 NAME OF
FATHER
Thomas Donnelly
11 BIRTHPLACE
OF FATHER
(State or country)
England
12 MAIDEN NAME
OF MOTHER
Mary E. Donohue
13 BIRTHPLACE
OF MOTHER
(State or country)
Lowell
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Thomas Donnelly
(Address)
E. Chelmsford ( Gorham St)
19 PLACE OF BURIAL OR REMOVAL St. Patrick's
DATE OF BURIAL
Aug. 21, 190
ADDRESS
Filed_
0
15 any. 20 1910 Edward &. Robbins
/ REGISTRAR
Contributory (SECONDARY)
(Signed) Carrero
Edward Le
(Duration)
... yrs.
mos.
ds.
eauf
M.D.
ank.20, 1910 (Address) 322 Manual
* 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
224
(City or town.)
{If death occurred in a hospital or institution, give its NAME instead of street and number.]
16 DATE OF DEATH august. (Month)
.... , 19 190 (Year)
(Day} }
17 I HEREBY CERTIFY that I attended deceased from Cnc 17, 1910, to. Cine. 19, 1910. that I last saw h En alive on and that death occurred, on the date stated above, at 11 4 hours The CAUSE OF DEATH* was as follows :
20 UNDERTAKER
MANDonough 108 Forham
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, Architeet, Loeo- 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 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, Ilousemaid, 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, Broneho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
eulosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- eoma, ctc., of. .. (name origin : "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles ; Whooping cough; Chronie valvular heart disease ; Chronie interstitial nephritis, ctc. The contributory (second- ary or intercurrent) affection necd not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broneho-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," "Hacmorrhage," " 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 septieaemia," "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.
MARGIN RESERVED FOR BINDING
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 West Chelamfad. (No
225 Chefmylad. (City er town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
St. :
Ward)
Ellen Ostardund- Ellen. Petterson
2 FULL NAME.
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Nest Chelmsford
Married Carl Osterlund
Registered No. 66
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Farmala.
4 COLOR OR RACE
ghita
5 SINGLE,
MARRIED.
Married
WIDOWED,
OR DIVORCED-
( Write the word)
6 DATE OF BIRTH Geht 25
1876
1
(Month)
(Day)
(Year)
7 AGE
34
... yrs. mos.
ds.
or ........ min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
Housewife
(b) General nature of industry,
business, or establishment in
which employed (or employer).
9 BIRTHPLACE
(State or country)
Sweden
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
20
Sweden.
12 MAIDEN NAME
OF MOTHER
Inkom
13 BIRTHPLACE
OF MOTHER
(State or country)
Queden.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Carl. Osterlund
(Address)
15
Filed
Bug. 21, 1910 Canard Y Bobbing
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH auquel- 21
(Month)
(Day)
1910
(Year)
I HEREBY CERTIFY that I attended deceased from 17
191
to
Quand: 21, 1918.
If LESS than
I day,
hrs.
that I last saw h alive on.
ancora. 21, 190
and that death occurred, on the date stated above, at 10,55 m.
The CAUSE OF DEATH* was as follows :
Puerperal Convulsiones
about 9 hours.
(Duration)
yrs.
mos. ds.
Contributory
(SECONDARY)
(Duration) yrs.
mos.
ds.
(Signed)
JE Varney
M.D.
arejad 22 1910 (Address)
2. Chercontrol.
* If death followed injury or violenee 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
DATE OF BURIAL
West Chelonadead Can Wait Chelo vord. Camita Aug. 23, 1910
20 UNDERTAKER
David & Greig
ADDRESS
Werteord- Mars
10 NAME OF
FATHER
& Hellerson
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, Arehiteet, Loeo- 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 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, 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, Broneho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
eulosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sur- eoma, etc., of. ........ .. (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronie valvular heart disease ; Chronie interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broneho-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 causc. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septieaemia," " 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, F'ulls, 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
I PLACE OF DEATH Grafton Colony , the Worcester State asylum; 0
FULL NAME James W. Dum.
[If married or divorced woman or widow give maiden name, also name of husband] @RESIDENCE meet thelong ford- mall.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
mal
4 COLOR OR RACE
2
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
6 DATE OF BIRTH
-
(Month)
(Day)
1867
(Year)
7 AGE
43
... yrs. 3 . mos. 27 ds.
or ........ min. ?
8 OCCUPATION
(a)' Trade, profession, or
particular kind of work
mule Shimmer
(b) General nature of industry,
business, or establishment in
which employed (or employer).
Cotton mill
9 BIRTHPLACE
(State or country)
Chelmsford mall.
10 NAME OF
FATHER
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
heland
12 MAIDEN NAME
OF MOTHER
- -
-
13 BIRTHPLACE
OF MOTHER
(State or country)
Theland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Euferibrer M.D.
(Address)
16
Filed. Que, 10, 1910 Eduris a Hard
REGISTRAR
17
:
1910.
that I last saw ha alive on any ?
..
and that death occurred, on the date stated above, at /1-20 cm.
1910,
The CAUSE OF DEATH* was as follows :
acute Cardiac Dilatation
Intestinal Nephritis.
(Duration)
.yrs.
mos.
ds.
Contributory Chien
mi Dimentico
(SECONDARY)
(Duration)
.yrs.
(Signed)
EV. Scribner HLori Hick
mos.
ds.
M.D.
Que. 7. 1910 (Address) Worcester Maer
* 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 ...
3 yrs. 7 mos. 3
...
in the
State 43 yrs. 2 mos. 47 ds.
Where was disease contracted, If not at place of death ?.
Former or
sual residence ....
N Chelmsford maz
19 PLACE OF BURIAL OR REMOVAL Lowell, Mael.
DATE OF BURIAL Que- 10, 1910
ADDRESS
20 UNDERTAKER
So. Sección Sambo Marcela Mars
,
(City oftown.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
1
6
X
Registered No.
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
aug
(Month)
7.
(Day)
-
191 0
(Year)
I HEREBY CERTIFY that I attended deceased from
£
1907, to ang
...
If LESS than
[ day, ........ hrs.
MARGIN RESERVED FOR BINDING
--
226
Ward)
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 (6) 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," " All- 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.
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