USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1912-1913 > Part 2
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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.
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 Chelmsford
(No
St. :
Ward)
fIf 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 husbaud.] @RESIDENCE
Sarah C. Dan ?
Leander W Bisbee
Registered No.
8
Chelmsford.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
Widower
6 DATE OF BIRTH
(Month) (Day)
(Year)
7 AGE
If LESS than
1 day, ........ hrs.
77
... yrs.
mos.
.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)
Maine
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
Maine
12 MAIDEN NAME OF MOTHER Unknown
13 BIRTHPLACE OF MOTHER (State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Herbert Bisbee
(Address)
Chelmsford
18 Filed Tel. 6 , 1912 Edward X. Collins
.....
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Februar
(Month)
(Day)
(Year)
1834
17
I HEREBY CERTIFY that I attended deceased from
nov. 8th
1911, to.
Jan 26 00
1912
that I last saw her alive on
Jan. 26th
191 2
and that death occurred, on the date stated above, at 5Pm.
The CAUSE OF DEATH* was as follows :
Dry gangrene of the feet
(Duration)
2
mos.
ds.
Contributory.
5000
emmotor
Citaxia
(SECONDARY)
(Duration)
.... yrs.
mos. .. ds.
Umaretoward
M.D.
... 1912 (Address).
.....
* If death followed injury or violeuce 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
Edson Gemeten feb 6
1912.
30 UNDERTAKER
ADDRESS
ofTrescott St
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
94 Chelmsford tetton toyn!)
Sarah 8. Bisbee
3 SEX
Female White
191Z
......
.. yrs.
10 NAME OF
FATHER
Unknown
(Signed)
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," "Forcman," " 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 Ilousc- 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 bo 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: Mcasles (disease causing death), 29 ds .; Broncho-pncumonia (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," " Marasmns," "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 septicacmia," " 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. Suddon deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to bc due to Alcoholism. etc.
4. Deaths under circumstances unknown, as A person found dead, 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
PLACE OF DEATH Boston Road ( No Chelmsford Center St. : Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME
Hugh P Graham
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Chelmsford Center
Registered No.
9
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
white
! 5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
single
6 DATE OF BIRTH
(Month)
(Day)
1
(Year)
7 AGE
6
yrs.
mos.
ds.
or ....... min. ?
8 OCCUPATION
(a) Trade, profession, or School Boy
particular kind of work.
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
Lowell Mass
10 NAME OF
FATHER
Henry Graham
11 BIRTHPLACE OF FATHER (State or country) Ireland
12 MAIDEN NAME OF MOTHER Elizabeth Brady
13 BIRTHPLACE
OF MOTHER
(State or country)
Ireland
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address) Bester Grad Cheluscho Cante
16 Filed Fel 9, 1912 Edward J. Robbing
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Fcb.
1912
(Month)
(Day)
(Year)
17
I HEREBY CERTIFY that I attended deceased from
Jan. 29
.... , 191.2 ... , to
Fil. 7 4
1912
C
that I last saw him .. alive on
46.700
1912
and that death occurred, on the date stated above, at // a.m
The CAUSE OF DEATH* was as follows :
Pentaxitis
(Duration)
yrs.
mos.
6
ds
Contributory. (SECONDARY)
(Duration) . yrs.
.mos.
ds
Amara toward
M.D.
(Signed)
Fil. 7
.. 1912 (Address).
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.
. 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 Patricks Cemetery
DATE OF BURIAL
Feb 9th/ Ig
20 UNDERTAKER
ADDRESS
95
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
F
:
PARENTS
If LESS than
1 day,.
...... hrs.
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative hcalthfulness 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) Forcman, (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 ccrebro-spinal meningitis ") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tubcr-
eulosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- eoma, 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- 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 Commmwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
I PLACE OF DEATH North Chelmsford. (No. Sherman
St. : Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
Barbara & Holgate. 2FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE No. Chelmsford.
Barbara& Harrison. John Holgate.
Registered No. 10
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female. White
4 COLOR OR RACE
5 SINGLE,
MARRIED
WIDOWED, Married.
OR DIVORCED
( Write the word)
16 DATE OF DEATH
Feb.
(Month)./
(Day)
13.
.... .
1912
(Year)
6 DATE OF BIRTH
May
(Month)
(Đáy)
16
1864
(Year)
7 AGE 47 yrs. 8 mos. 28
mos.
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).
At Home.
me.
9 BIRTHPLACE
(State or country)
England.
PARENTS
(State or country)
England,
12 MAIDEN NAME
OF MOTHER
Mary Haleall.
13 BIRTHPLACE
OF MOTHER
(State or country)
England.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
John Holgate
(Adress) No. Chelmsford.
16
Filed.
Feb. 14, 1912 Edward. Robbing
REGISTRAR
17
1 HEREBY CERTIFY that I attended deceased from
Samy 15
1912, to.
Inky 13
1912
.....
....
that I last saw be alive on
......
Jeky 13
1912
and that death occurred, on the dato stated above, at. 2.30 Pm
The CAUSE OF DEATH* was as follows :
Organic desease/ Kidney
.(Duration)
... yrs.
/
mos.
ds.
Contributory .. (SECONDARY)
.(Duration)
.yrs.
mos.
ds.
(Signed)
7 E Jamey
M.D.
Jaby 13
1912 (Address).
n. Chefhun few
* 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 dlsease contracted, If not at place of death ?..
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL DATE OF BURIAL Riverside Cemetery. No. Chelmsford, Macc, Hel, 18, 1912.
DO UNDERTAKER
gro. Madealey.
ADDRESS
79 Branch &X.
96
No. Chelmsford (City ortown.)
MARGIN RESERVED FOR BINDING
10 NAME OF
FATHER
John Harrison.
11 BIRTHPLACE
OF FATHER
If LESS than
1 day ......... hrs.
MEDICAL CERTIFICATE OF DEATH
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 enginecr, 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 sccond 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 ; 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- 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.
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 South Chelmsford (No
Chelmsford
....
St.
Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.1
Registered No.
11
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
white
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
Widowed
6 DATE OF BIRTH
april
3
1838
(Month)
(Day)
. (Year)
7 AGE
If LESS than
I day, ........ hrs.
83
yrs. 10
mos.
/2~ ds.
........ min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Retired
(b) General nature of industry,
business, or establishment in
which employed (or employer).
Tanner
9 BIRTHPLACE
(State or country)
Norway
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Norway
12 MAIDEN NAME
OF MOTHER
Siri Skjerbak
13 BIRTHPLACE
OF MOTHER
(State or country)
norway
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Nro Hans Johnson
(Address)
Sochelitend
16
Filed
Fill 17, 1912 Eherand J. Bobbing
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
(Month)
(Day)
191 2
(Year)
17
1 HEREBY CERTIFY that | attended deceased from
Jul. 2
.... 1912 to
tab. 15,
1912
that I last saw h Mnalive on
Feb. 15,
1912
and that death occurred, on the date stated above, at 10 Pm.
The CAUSE OF DEATH* was as follows :
Epidemie Influenza-
acute Bronchitis
about
(Duration)
15
ds.
yrs.
mos.
Contributory (SECONDARY)
... (Duration)
.. yrs.
mos.
ds.
(Signed)
Autres. Scopona
M.D.
Tab. 15 1912 (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 PLACE OF BURIAL OR REMOVAL Hart Pond Com
DATE OF BURIAL
Heb 18
1912
20 UNDERTAKER Walter Perham
ADDRESS Chelmsford
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
Ceux Bruun
2 FULL NAME
{If married or divorced woman of widow
give maiden name, also name of husband.]
"RESIDENCE So Chelestore
97
10 NAME OF
FATHER
Christen
Bruun
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 husiness 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, 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, ctc. 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 inere 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 childhirth or miscarriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
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