Deaths 1914-1916, Part 25

Author: Chelmsford (Mass.)
Publication date: 1914-1916
Publisher:
Number of Pages: 458


USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 25


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56


give maiden name, also name of husband.]


@RESIDENCE


Main Roadi Test Chelmsfor:


Registered No.


24


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED Widowed


(Write the word)


" DATE OF BIRTH


March


(Month)


(Day)


(Year)


If LESS than


I day .......


.. hrs.


mos. ds.


or ......... min. ?


8 OCCUPATION


(a) Trade, profession, or


particular kind of work


Retaired


Mill Operative


9 BIRTHPLACE


(State or country)


Ireland


11 BIRTHPLACE


OF FATHER


(State or country)


Ir: lund


Ireland


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


Mrs. Bridget Keenan


(Informant)


(Address) Main Rd, W. Chelmsford


Filed Mas 31, 1913. Huber E. Ellis .....


auch REGISTRAR


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


17 I HEREBY CERTIFY that I attended deceased from Mich 21, 1915 to. 19100 ......


that I last saw h alive on


Mch 28-


1915


and that death occurred, on the date stated above, at ...


m.


The CAUSE OF DEATH* was as follows :


Broncho. prea execute


.(Duration)


yrs.


....


Contributory ..


Semilly


(SECONDARY)


(Signed)


JEVarney


(Duration)


.. yrs.


....


................


mos.


ds.


MMM.D.


Mch 29, 1915 (Address)


18, Chilean food


* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.


18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).


At place


of death.


...... yrs.


.... mos.


In the


ds.


State ............ yrs. .


.... mos. ............ .


._ ds .............


Where was disease contracted, If not at place of death ? ............ Former or usual residence


19 PLACE OF BURIAL OR REMOVAL St. Patrick's


DATE OF BURIAL


7: 37


1915


20 UNDERTAKER


ADDRESS


176 Sicham So


Lowell.


1


.............


29


19/5


(Month)


(Day)


,


(Year)


....


MARGIN RESERVED FOR BINDING


1 PLACE OF DEATH


....


3 SEX


Mole


7 AGE


99


(b) General nature of industry,


business, or establishment in


which employed (or employer).


10 NAME OF


FATHER


12 MAIDEN NAME


OF MOTHER


PARENTS


1ª BIRTHPLACE


OF MOTHER


(State or country)


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


... yrs.


1


96 Cheleur and (City or wown.) ( --


...............


4 COLOR OR RACE


White


1.816


mos.


8


ds.


....


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, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who reccive 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 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 discase. 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 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.


WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.


3 SEX Male 6 DATE OF BIRTH 7 AGE 8 OCCUPATION (a) Trade, profession, or particular kind of work 9 BIRTHPLACE (State or country) 10 NAME OF FATHER 12 MAIDEN NAME OF MOTHER 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 --


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


1 PLACE OF DEATH


Lowell, Mass.


.. (No


Lowell Hospital


St. :


97


Lowell ...


......


(City or town.)


[if death occurred in a hospital or institution, give its NAME Instead of street and number.]


2 FULL NAME


Efthimios Koulos


20


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


Chelmsford, Mass.


Registered No. 304


MEDICAL CERTIFICATE OF DEATH


1915


(Month)


(Day)


(Year)


17 I HEREBY CERTIFY that I attended deceased from March 1,, 1915, to March 4, ........ , 1915 .... that I last saw him alive on ..... March 3. .


1915


and that death occurred, on the date stated above, at 5. 202.


The CAUSE OF DEATH* was as follows : Gastro-Enteritis


(Duration) ... yrs. mos. ds.


Contributory ...


(SECONDARY)


(Duration)


.... yrs.


.......


mos.


ds.


(Signed)


E. J. Clark


M.D.


Mar. 4 , 191 ...


5 (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 ....


In the


.yrs.


.. mos.


.ds.


Where was disease contracted, If not at place of death ?.


.... usual residence ... Former or ....


19 PLACE OF BURIAL OR REMOVAL Edspawgfretfrys.


DATE OF BURIAL


March 1. 1915


(Informant)


Manthos Koulos


(Address)


Chelmsford, Mass.


15 Filed_ Mar. 5,191 5


REGISTRAR


16 DATE OF DEATH


March 7.


4 COLOR OR RACE


White


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)Single


1


(Month)


(Day)


., (Year)


If LESS than


1 day ......... hrs.


-- yrs. .... 5 mos. ds. Or ......... min. ?


(b) General nature of industry, business, or establishment in which employed (or employer) ..


Lowell, Mass.


Manthos Koulos


11 BIRTHPLACE


OF FATHER


(State or country)


Greece


Constantina Stanoulos


13 BIRTHPLACE


OF MOTHER


(State or country)


Greece


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


20 UNDERTAKER


Peter H. Savage


ADDRESS


Lowell


Ward)


PERSONAL AND STATISTICAL PARTICULARS


---


MARGIN RESERVED FOR BINDING


....


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precise statemcut 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 ou 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 wheu 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 lias 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- BASE 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 (uever re- port "Typhoid pneuuiouia"); Lobar pneumonia; Broncho- pneumonia ("Pneumouia,". uuqualified, 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 (discase eausing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia,", "An- acmia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shoek," "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 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 4 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


important. See instructions on back of certificate.


PARENTS


11 BIRTHPLACE


OF FATHER


(State or country)


Chelmsford, Mass.


12 MAIDEN NAME


OF MOTHER


Mary A. Cordick


13 BIRTHPLACE


OF MOTHER


(State or country)


Boston, Mass.


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


Father


(Address)


Chelmsford, Mass.


16 Filed


Mar. 16 5 Chin


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


8 SEX


Female


4 COLOR OR RACE


White


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


Single


16 DATE OF DEATH


March 15.


(Month)


(Day)


(Year)


6 DATE OF BIRTH


March 20


1898 |


(Month)


(Day)


(Year)


7 AGE


If LESS than


[ day, ........ hrs.


.. 1.6


.yrs. .11 mos. 2.2. ds.


or ......... min. ?


3 OCCUPATION


(a) Trade, profession, or


particular kind of work


School Girl


(b) General nature of industry, business, or establishment in which employed (or employer) ..


9 BIRTHPLACE


(State or country) chelmsford, Mass.


.. (Duration).


.............. yrs.


................ mos.


ds.


Contributory ..


(SECONDARY)


.. (Duration)


........


.... yrs.


... mos.


. ...............


ds.


(Signed)


Archibald R. Gardner


M.D.


Mar.


15., 191 5 (Address) Lowell, Mass.


* 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 ?. .... usuai residence .. Former or


19 PLACE OF BURIAL OR REMOVAL Chelmsford, Mass.


DATE OF BURIAL


Mar. 16


191


5


20 UNDERTAKER


J. A. Weinbeck


ADDRESS


Lowell


98


Lowell


(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]


2 FULL NAME


Fannie Blaisdell


[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Chelmsford, Mass.


Registered No.374


PERSONAL AND STATISTICAL PARTICULARS


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


Lowellm Mass. (No. Lowell Hospital St. : Ward)


26


191


.5.


17 I HEREBY CERTIFY that I attended deceased from March 9, 1918, to. Mar. 15, . 1915. that I last saw or alive on Mar. 15. ............. , 1915 ...... and that death occurred, on the date stated above, at a. m. The CAUSE OF DEATH* was as follows : Epidemic Cerebro Spinal Men- ingitis


....


10 NAME OF


FATHER


Ervin A. Blaisdell


....


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precise statement of oceu- 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, Architcet, 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) Groccry; (a) Forcman, (b) Automobile factory. The material worked on inay form part of the second statement. Never return "Laborer," "Forcman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborcr, Laborcr - Coal minc, cte. 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 gaill- 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, ctc. 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 faet may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no oceu- pation whatever, write None.


Statement of cause of death. - Name, first, the nis- CASE CAUSING DEATH (the primary affection with respeet 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," unqualificd, is indefinite) ; Tuber-


culosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- eoma, etc., of. ...... .. (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant ncoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection necd not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broneho-pneumonia (sccondary), 10 ds. Never report mcre symptoms or terminal conditions, such as "Asthenia," "An- acmia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Scnilc," etc.), "Dropsy," "Exhaustion," "Heart failure,"" "Hacmorrhage," "Inanition," "Marasmus,", "Old age," "Shock," "Uracmia," "Weakness," ete., when a definite discase can be ascertaincd 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 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 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.


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


...


.........


(City or town.)


{If death occurred in a hospital or institution, give its NAME instead of street and number.]


Harvard Duchene


2 FULL NAME


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


COLOR OR RACE


5 SINGLE.


MARRIED,


WIDOWED


OR DIVORCED


(Write the word)


* DATE OF BIRTH


0 (Month)


(Day)


(Year)


7 AGE


If LESS than 1 day ......... hrs.


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)


Lowell Mars


(Duration)


... yrs.


......


Contributory.


(SECONDARY)


Athing, Scobona


M.D.


(Signed)


apr.4


. 1915 (Address).


Chalus fond Man


........


* 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


In the


yrs.


mos.


.ds ...


....


Where was disease contracted, If not at place of death ?.


Former or usual residence ..


.


19 PLACE OF BURIAL OR REMOVAL


DATE OF BURIAL


......


1915


16 Filed.


aut. REGISTRAR


16 DATE OF DEATH


3


19152


...


(Month)


(Day)


(Year)


I HEREBY CERTIFY that I attended deceased from


Mar. 29.


.... 1915, to


apr. 3


1915


that I last saw h AM alive on


apr. 3


.1915


............ ,


and that death occurred, on the date stated above, at ................. m.


The CAUSE OF DEATH* was as follows : Certioval Harmonhay:


anterio Pacionalitis?


...........


mos.


7


ds.


10 NAME OF


FATHER


arthur Duchene


PARENTS


11 BIRTHPLACE


OF FATHER


(State or country)


Dr alban 4/f


12 MAIDEN NAME


OF MOTHER


Ida aubry


13 BIRTHPLACE


OF MOTHER


(State or country)


Farrell Meno


" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


(Address)


Sunt are


VADDRESS


738


20 UNDERTAKER A Archambault mer


99


1 PLACE OF DEATH


(No. Annetto tore


St. :


Ward)


Registered No.


2


7.


MEDICAL CERTIFICATE OF DEATH


22


-


.......


... yrs.


8 mos. 11


ds.


.........


......... yrş.


.. mos. ..............


ds.


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 applics 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 homc, 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 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," unqualificd, is indefinite) ; Tuber-


culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, ctc., 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 (discase 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 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.




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