USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 10
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Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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
1 PLACE OF DEATH
Lowell, Mass. (No.LOwell General Hospital St. : Ward)
John Koulos
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford, Center, Mass.
36
Registered No. 879
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4
(Month)
(Day)
191
(Year)
6 DATE OF BIRTH --
(Month)
(Day)
1 (Year)
7 AGE
If LESS than
I day, ........ hrs.
--
--
.yrs.
.mos, 10 .ds.
or ......... min. ?
16 DATE OF DEATH
June 22,
17
I HEREBY CERTIFY that I attended deceased from
June 1D
191 4 to ..
..... ,
June 22,
191 4
that I last saw h.j.m .... alive on June 22.
1914
and that death occurred, on the date stated above, at4. 4.55.
The CAUSE OF DEATH* was as follows :
Gastro-Enteritis
9 BIRTHPLACE
(State or country)
Lowell, Mass.
Contributory
(SECONDARY)
(Duration)
.........
.... yrs.
mos.
. ...
... ds.
(Signed)
Alfred M. Lemay
M.D.
Jun 22,
191.
.......
4
(Address) ..
Lowell Gen. Hosp
* 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
Edson Cemetery,
Lowell
DATE OF BURIAL
June 23, 1914
15 June 23,4 Filed 191.
REGISTRAR
36
Lowell
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
important. See instructions on back of certificate.
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Greece
12 MAIDEN NAME
OF MOTHER
Constantine Liatsis
13 BIRTHPLACE
OF MOTHER
(State or country)
Greece
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Grigorios Moulos
Chelmsford Center, Mass.
(Address)
20 UNDERTAKER
Peter H. Savage
ADDRESS
Lowell, Mass.
$ SEX
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word) Single
Male
8 OCCUPATION (a) Trade, profession, or particular kind of work.
--------
-
(b) General nature of industry, business, or establishment in which employed (or employer).
(Duration) . ............. yrs. ds. .mos.
10 NAME OF
FATHER
Grigorios Koulos
....
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to cach and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, c. g., Farmer or Planter, Physician, Compositor, Architeet, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial cmployments, 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 homc. 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 occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- LASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discase. Examples: Cerebro-spinal fever (the only defimte 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, ctc., Careinoma, Sar- coma, 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 (discase causing death), 29 ds .; Broneho-pneumonia (sccondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- acmia" (merely symptomatic), "Atrophy," "Collapse," "Comna," "Convulsions," "Dcbility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus,", "Old age," "Shock," "Uraemia," "Weakness,"· etc., when a definite disease can be ascertaincd as the cause. Always qualify all discases resulting from childbirth or miscarriage, as "PUER- PERAL septieacmia," "PUERPERAL peritonitis,", etc. State çause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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, ctc
4. Deaths under circumstances unknown, as A person found dead, ctc.
1
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Chelmsford
(No.
Bolden Cove Rd.
-
St. :
Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.}
2FULL NAME. Alice Marion Buckman.
alice My Stearme, This. E. Buckman
Registered No.
37
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
17
I HEREBY CERTIFY that I attended deceased from
Jan 22
1914, to June 27
1914
that I last saw ha. alive on.
June 27
... ,
1915
and that death occurred, on the date stated above, at 4 a.m.
The CAUSE OF DEATH* was as follows :
Cerebral embolosam
(Duration)
yrs.
mos.
5
ds.
Contributory ..
(SECONDARY)
(Duration)
.yrs.
mos.
ds.
(Signed)
Amara award-
M.D.
Jan 28, 19/2 (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 residonce.
19 PLACE OF BURIAL OR REMOVAL
Edson Cem. Sowell
DATE OF BURIAL
June 29.
1914
20 UNDERTAKER
Halter Perham
Perham
ADDRESS
Chelmsford.
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
white
5 SINGLE
MARRIED
WIDOWED,
Hemale
OR DIVORCED
(Write the word)
6 DATE OF BIRTH
(Month)
(Day)
7 AGE
63
5
8 OCCUPATION
at home
(a)' Trade, profession, or
particular kind of work
(b) General nature of industry,
business, or establishment in
which employed (or employer)
9 BIRTHPLACE
(State or country)
Lowill
10 NAME OF
FATHER
Edwin Steanne
11 BIRTHPLACE
OF FATHER
Mansfield Mark
(State or country)
12 MAIDEN NAME
OF MOTHER
Margaret Berrick
PARENTS
13 BIRTHPLACE
OF MOTHER.
Schwell
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Those Budu
important. See instructions on back of certificate.
(Address)
Chilinford
16
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
......
... yrs.
4
mos.
ds.
or ......... min. ?
Married
22 1851
(Year)
If LESS than 1 day ......... hrs.
Filed.
June 28, 1914 Edward Problema
REGISTRAR
37
- Chelmsford -
-
(Month)
(Бау)
1914
(Year)
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthifulness 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, 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," "Hacmorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all discases 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.
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
Thedeed
(3,8) /asx
...
(City or town.)
Tif death occurred in a hospital or institution, give its NAME instead of street and number.]
Stell Now Satra
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Highland avr. Forth Cheles ford Registered No.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
tecual hit
( 5 SINGLE,
MARRIED.
WIDOWED
OR DIVORCED
(Write the word)
Vingle
16 DATE OF DEATH
July
(Month)
(Day)
1914
(Year)
" DATE OF BIRTH
July X 19×4
(Month)
(Day)
(Year)
TAGE
If LESS than
1 day ......... hrs.
.... "
mos.
ds.
or
........ min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
(b) General nature of industry, business, or establishment in which employed (or employer) ...
9 BIRTHPLACE
(State or country)
Loth Chelmsford
PARENTS
12 MAIDEN NAME OF MOTHER atherm Harma ton ather
13 BIRTHPLACE
OF MOTHER
(State or country)
Queland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Javier a. Valmetrather
(Address thatland gut, North Cheluand
July 7, 1914 Gmail H Rotbank ....
REGISTRAR
....
17
I HEREBY CERTIFY that I attended deceased from
Sely 7, 1914
to.
July 7
1914
.....
that 1 last saw h
alive on
191.
and that death occurred, on the date stated above, at.
.m.
The CAUSE OF DEATH* was as follows :
Siel for
Still
(Duration)
ds.
.............. yrs ..
mos.
.......
... C
Contributory .. (SECONDARY)
.(Duration)
.mos.
....
ds.
(Signed)
Leon
Lage
M.D.
July 7, 1014 (Address) ryman Tochange
* 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
DATE OF BURIAL
20 UNDERTAKER
ADDRESÉ 324 MaxING
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
STANDARD CERTIFICATE OF DEATH
A PLACE OF DEATH In Theluce ford Pass (No)
Highland Wist.
...
Ward)
38
....
....
10 NAME OF
FATHER
James Q. Eaton
11 BIRTHPLACE OF FATHER (State or/country)
15 Filed_ 0
.....
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to cach 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, ctc. 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 - 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 oeeupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retircd, 6 yrs.). For persons who have no occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- EASE 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., Careinoma, Sar- coma, etc., of .. (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart discase; 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,", ctc., when a definite disease ean 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 provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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, ctc.
-
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK- THIS IS A PERMANENT RECORD.
3 SEX Demale 7 AGE 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 2
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Lowell. Mass.
(No
Lowell Hospital
St. :
Ward)
39
Lowell .....
(City or town.) Elf death occurred in a hospital or institution, give its NAME Instead of street and number.]
Myrtle M. Woodward
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
North Chelmsford, Masa.
Registered No.
931
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4
191.
............
(Month)
(Day)
(Year)
6 DATE OF BIRTH December 24 1911
(Month)
(Day)
(Year)
July 4
4
July 5
4
191.
....... , to
July
5
4
that I last saw her
alive on
191.
........
and that death occurred, on the date stated above, at.
5 P.
The CAUSE OF DEATH* was as follows : Epidemic Cerebral Spinal Meningitig
...
(Duration)
yrs.
mos.
ds.
Contributory ..
(SECONDARY)
.. (Duration)
.. yrs.
mos.
ds.
(Signed)
E. J. Clark
M.D.
July 6, 191 4 (Address).
Lowell Hospital
....
* 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
Riverside Cem. . Chelmstofgiy 6;
DATE OF BURIAL
ass.
(Address)
৳. Chelmsford, Mass.
16 Filed July 7, 1914
REGISTRAR
16 DATE OF DEATH
July 5,
White
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
single
1
If LESS than
1 day ......... hrs.
.. yrs.
6
mos.
12
ds.
........ min. ?
8 OCCUPATION (a) Trade, profession, or particular kind of work.
.........................................................................
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE (State or country) Concord, K. H.
10 NAME OF
FATHER
Otis Woodward
II BIRTHPLACE
OF FATHER
(State or country)
Bangor,
Me.
12 MAIDEN NAME OF MOTHER Catherine Walsh
13 BIRTHPLACE
OF MOTHER
(State or country)
Ireland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)_Catherine Woodward
1914
RTAKER
MD UNDERTAKER Weinbeck
ADDRESS
Lowell
4 COLOR OR RACE
17 I HEREBY CERTIFY that I attended deceased from
191
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation 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, ctc. Women at home, who are engaged in the duties of the household only (not paid House- kccpers 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. Carc 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 (rctired, 6 yrs.). For persons who have no occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- DASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discasc. Examples: Cercbro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pncumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, ete., Carcinoma, Sar- coma, etc., of. ........ (name origin: "Cancer" is less definite; avoid usc of "Tumor" for malignant ncoplasms) ; 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 aseertained 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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