USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 34
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9 BIRTHPLACE
(State or country)
Chelmsford mars
PARENTS
12 MAIDEN NAME
OF MOTHER
Lelie, Spaulding
13 BIRTHPLACE OF MOTHER (State or country) Beverly it
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Me A, le Guene
(Address) Chelius fond. mais
16 Filed. Seht 2, 1915 Edward J. Rolfas
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
aug. 31
Month)
(Day)
195
(Year)
I HEREBY CERTIFY that ! have investigated the death of the deceased.
If LESS than 1 day, .. hrs. The CAUSE OF DEATH* was as follows :
arterio - 2denses
(Duration)
.mos.
ds.
Contributory.
Prostatic Hypertrophy
.. yrs.
(SECONDARY)
(Duration) .. yrs.
.mos. .ds.
(Signed)
F. theys
M.D.
aug 31, 1915 (Address) 1611 Nemark 1
MEDICAL EXAMINER
* State the DISEASE CAUSING DEATH, or, in deaths from VIOLENT CAUSES, state (1) MEANS of INJURY; and (2) whether ACCIDENTAL, SUICIDAL or HOMICIDAL.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
In the
At place
of death.
yrs.
mos.
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 Huetachino Gen.
DATE OF BURIAL
Left V 1915
20 UNDERTAKER
Wallin Julian
ADDRESS
Elulus fond
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
St. ,.
Ward)
132 Chelmsford (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
17
10 NAME OF
FATHER
Henrie Byan
Teurig
11 BIRTHPLACE! OF FATHER (State or country)
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 cascs, 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 cxamples: (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- keepcrs 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 Nonc.
· 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, 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. For VIOLENT DEATHS state MEANS OF INJURY and qualify as ACCI- DENTAL, SUICIDAL, or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoned by carbolic acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., scpsis tetanus) may be stated under the head of "Contributory."
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.
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
APLACE OF DEATH
Lowell Mars
(No Lowell General Hospital St.
Ward)
'Lowell (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
ann, Elizabeth Byam
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
South Chelmsford Mass
Registered No. 60
PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH
SEX
14 COLOR OR RACE
demale/ White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
( Write the word)ungle
1887
(Month)
(Day)
7 AGE
If LESS than
1 day, ......... hrs.
28 yrs. 5
..... yrs. .....
..... "
mos.
20
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)
Chelmsford Mass
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Chelmsford Mass.
12 MAIDEN NAME.
OF MOTHER
Jennie Parland
13 BIRTHPLACE
OF MOTHER
(State or country)
Gratos Conn
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
mother
(Address)
So. Chelmsford mars
16 File Sept. 2, 195 kepler Flynn
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
(Year)
Que, 20
195 to august 29 1915
that I last saw her alive on
11/ 2995
and that death occurred, on the date stated above, at a. m.
The CAUSE OF DEATH* (was as follows :
Hemorrhage from the stomach
.... (
(Duration)
... yrs. .....
..... mos.
.. ds.
Contributory
laperation 4 days before for
Chris Lependicitis and Gallstones ..... yrs. .,mos. ds.
(Signed)
Fruit Martin
M.D.
aug 31.
1912
(Address) ..
Lowell Mast
* 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).
In the
At place
of death
.yrs.
.... mos. .........
... 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
Hart Fond
Cemetery
So, Chelmsford Mass
DATE OF BURIAL
Sept. 1
1912
20 UNDERTAKER
Walter Perham
ADDRESS
Chelmsford.
1991
....
(Month)
(Day)
(Year)
" DATE OF BIRTH
March 10
16 DATE OF DEATH
august
81
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
133
10 NAME OF
FATHER
George & Buam
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation is very important, so that the relative liealthfulness 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 enginecr, Civil engincer, 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- kcepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At sehool 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 (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, peritoneum, etc., Careinoma, Sar- eoma, etc., of. (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic 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 .; 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 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 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
Clulunsford MakesNo ...
Month road
St. :
Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
' FULL NAME
(Many any Mcmahon mee M Enancy)
[If married or divorced woman or widow
give maiden name, also name of, husband,
@RESIDENCE
North Road, Chelaw ford (Mass.
Patrick mc mahon
Registered No.
61
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female While
+ COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
married
· DATE OF BIRTH
185g
(Month)
(Day)
(Year)
TAGE
If LESS than
1 day. hrs.
١
.. mos.
.. ds.
or-min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
ar france
(b) General nature of industry,
business, or establishment In
which employed (or employer) ...
Invalid
Away
I HEREBY CERTIFY that I attended deceased from Cinq 11, 1915, to Sehit 7, 1915 that I last saw her alive on Sehst 5, 1995 and that death occurred, on the date stated above, at ...
8:30 Pm. The CAUSE OF DEATH* was as follows :
Chimie Rheumatism
9 BIRTHPLACE
(State or country)
) Chelmsford mais
mal Contributory ....
Chronic Neplusitis
(Duration) 20
yra.
.... mos.
. .........
ds.
....... (SECONDARY)
(Duration).
..... „yrs.
.mos. ds.
(Signed)
Jan
M.D.
Sept 8 05 (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
In the
of death.
... yrs.
........... mos.
mos.
ds.
ds.
State.
............. yrs.
Where was disease contracted, If not at place of death ?. .......
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
(Address)
Thelineford masSt Patricks Cand Sulph 1095
15
Filed ...
Seft. 8 1915 Edward Stalling
REGISTRAR
.....
1311 Chelmsford
.....
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See Instructions on back of certificate.
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Ireland
12 MAIDEN NAME
OF MOTHER
(Many MG Granul
13 BIRTHPLACE OF MOTHER (State or country) Theland
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Patrick , Mi Machen
ADDRESS
20 UNDERTAKER Surge B. Mit Senna Lowell Mari
.... .
191 4 (Year)
16 DATE OF DEATH
Sept
3
(Month)
(Day)
MARGIN RESERVED FOR BINDING
10 NAME OF
FATHER
6
.....
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- motivc 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 arc engaged in the duties of the household only (not paid Housc- kecpers 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 Nonc.
Statement of cause of death. - Namc, first, the DIS- EASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the saine disease. Examples: Ccrebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid usc 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 usc 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," "Senilc," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite discase 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.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
$ SEX Female TAGE 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 Commonwealin of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
.....
No Chezosfora
(No.
Shaw Ave
St. :
Ward)
....
2 FULL NAME
Rosaline A. "cCarthy
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Shaw Ave. No chelmsford
Registered No.
62
PERSONAL AND STATISTICAL PARTICULARS
+ COLOR OR RACE
white
1 5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED Ilcl ℮
(Write the word)
· DATE OF BIRTH
Dec
4
1914
(Month)
(Day)
If LESS than
1 day ........ hrs.
.yrs.
9 .... mos. ds.
or ......... min. ?
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH
Suff-
16
1915
(Month)
(Day)
.... (Year)
17 I HEREBY CERTIFY that I attended deceased from
(Year)
Jeff-12, 1915, to.
211-16
1915.
that I last saw h .............
alive on
Jul1-16
1915
...... and that death occurred, on the date stated above, at 8pm. The CAUSE OF DEATH* was as follows :
Centero-colitis
(b) General nature of industry.
business, or establishment in
which employed (or employer) ....
None
9 BIRTHPLACE
(State or country)
Lomell
.. (Duration)
............... yrs.
................ mos ..
7
ds.
Contributory
(SECONDARY)
......
....
«.(Duration).
............... yrs.
..... mos. ................ dr.
................
JEVany
M.D.
(Signed)
Jeff-16
1915 (Address) 2. 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).
In the
At place
of death ..
.... yrs.
mos. ....
.. ds.
State ............ yfs.
.........
.. mos.
. ........... .. ds .........
Where was disease contracted, If not at place of death ?.
Former or usual residence ... ......
19 PLACE OF BURIAL OR REMOVAL Judson N.H.
DATE OF BURIAL
Jest 18. 1915
(Address)
No. chelmsford
Filed Seft 17 1915 Godward S Nothing
REGISTRAR
135
10 NAME OF
FATHER
Patrick Mccarthy
11 BIRTHPLACE
OF FATHER
(State or country)
Ireland
12 MAIDEN NAME
OF MOTHER
Rose McCaffrey
1$ BIRTHPLACE
OF MOTHER
(State or country)
Ireland
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Patrick Mccarthy
10
$ OCCUPATION
(a) Trade, profession, or
particular kind of work .............................................
None
....
....... (City or town.) [If death occurred in a hospital or institution, give its NAME Instead of street and number.]
ADDRESS
20 UNDERTAKER
tohar 2. Undmange 76 Gorham
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 eases, 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) 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 specifieation, 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 serviee for wages, as Servant, Cook, Housemaid, ete. If the occupation has been changed or given up on aeeount 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- EASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same diseasc. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemie eerebro-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, ete., of .. ...................... (name origin: "Caneer" 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 ean be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis," ete. State eause 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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