USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 4
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The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
PLACE OF DEATH Chemspool Mas no Chemsfred Mans (d)
Walter Larkin
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
To chemsford Mass Church Sistered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE
3 SEX
Male White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
6 DATE OF BIRTH
. .
(Month)
(Day)
-
(Year)
7 AGE
If LESS than i day .......... hrs.
... yrs.
... 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) ...
ouch Ineumon
(Duration)
.. yrs.
mos.
ds.
9 BIRTHPLACE
(State or country)
no chumfre
PARENTS
12 MAIDEN NAME OF MOTHER Margaret Fumiga
ungan
18 BIRTHPLACE
OF MOTHER
(State or country)
ho chemsford
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
John Ranking
(Address)
I no shamefood
15 Feb. 24, 1914 Edward . Rolling
REGISTRAR
16 DATE OF DEATH
(Month)
23
(Day)
191 4
(Year)
17
I HEREBY CERTIFY that ! attended deceased from
Tab. 23 94
to
Hab. 23 1914
that I last saw ha alive on
fire 23, 1914
and that death occurred, on the date stated above, at ....
m.
The CAUSE OF DEATH* was as follows :
Contributory
(SECONDARY)
(Duration) _..
0
... yrs.
.mos.
ds,
(Signed) di
turn & Scolonia
.....
M.D.
Fico. 24, 1914 (Address)
Chicken ford war.
* 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 placo
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 Allatricks
DATE OF BURIAL
.... 1
Why It Seems To yuham
12
(City or town.), [If death ogourred fin a hospital or institution, give its NAME Instead of street and number.]
12
.....
....
10 NAME OF
FATHER
John Larken
11 BIRTHPLACE
OF FATHER
(State or country)
no Chemfund
..........
MARGIN RESERVED FOR BINDING
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of oeeu- 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," ctc., without more precise specification, as Day laborer, Farm luborer, 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 domestie 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 "Epidemie 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, ete., 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 intereurrent) 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- acmia" (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," ctc. 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, cte.
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
......
Chelmsford Centre (No.
........................
.... Boston ...... R .......··················........********
St. :
Ward)
13
Chelmsford. (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2FULL NAME.
Orlando J. Cass.
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford Centre
Registered No. 13
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
White
{ 5 SINGLE,
MARRIED, Married
WIDOWED,
OR DIVORCED
(Write the word)
16 DATE OF DEATH
Feb.
28
191.
4
(Month)
(Day)
(Year) 1
6 DATE OF BIRTH
30
1837
(Month)
(Day)
(Year)
' AGE
If LESS than
I day ......... hrs.
76
.......... yrs ..
.. mos.
..... ds.
or ......... min. ?
$ OCCUPATION
(a) Trade, profession, or
particular kind of work.
Farmer
(b) General nature of industry,
business, or establishment in
which employed (or employer).
* *
9 BIRTHPLACE
(State or country)
Vermont
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Verment
12 MAIDEN NAME
OF MOTHER
Shaw
13 BIRTHPLACE
OF MOTHER
(State or country)
"ferment
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Selden Caas
Seas/art. Maine
ADDRESS
15 Mar. 5, 1914 Edward & Robbing Filed.
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
..........
....?
that I last saw h.f.m. alive on.
Feb. 27 /
1914
and that death occurred, on the date stated above, at 3Pm.
The CAUSE OF DEATH* was as follows :
Myocarditis
.(Duration)
/
.yrs.
.mos.
ds.
Contributory .....
senile
.........
(SECONDARY)
(Duration)
.. yrs.
... mos.
ds.
(Signed)
Annarstoward
.........
M.D.
Arch. 2 1914 (Address) Chelmsford, 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).
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
DATE OF BURIAL
10 NAME OF
FATHER
John Cass
17 I HEREBY CERTIFY that I attended deceased from
+16.27
Feb.28%
.... 1914
, 191.4, to.
29
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
Male
(Address)
Chelmsford Centre
20 UNDERTAKER
Wm. H Saunders, 12 Hund St
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, Architeet, Loco- motive engincer, 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) 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," cte., without more precise speeifieation, as Day laborer, Farm laborer, Laborer - Coal mine, ete. Women at home, who are engaged in the duties of the household only (not paid Housc- 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 Scrvant, 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. - Namc, first, the DIS- EASE CAUSING DEATH (the primary affection with respcet to time and eausation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemie ecrebro-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, ctc., Carcinoma, 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 .; 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,". "Shock," "Uraemia," "Weakness,", etc., wheu a definite disease can be ascertained as the causc. 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 strcct, or one supposed to be due to Alcoholism, ctc
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.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B .- Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Lohofffor Chelmsfordentre XNo.
St. : Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME Manwell M. Delasta
[If married or divorced woman or widow give maiden name, also name of husband. @RESIDENCE Cherlafinal Centre
Registered No.
14
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
4 COLOR OR, RACE
While
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
( Write the word)
Baby
1913
...
(Month)
(Day)
..
(Year)
7 AGE
If LESS than
1 day ......... hrs.
3
... mos.
-
-
... ds.
or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work.
at hence
(b) General nature of industry, business, or establishment in which employed (or employer).
-
9 BIRTHPLACE
10 NAME OF
FATHER
Do. V. Decosta
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
12 MAIDEN NAME
OF MOTHER/
Rosse augustateixeira
13 BIRTHPLACE
OF MOTHER
(State or country)
azon Flanel
"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Hor Da Velost
(Informant).
) ......
(Ades) Chemillard Center
15 Filed Mar. 2. 1914 Oderard . Bobbing
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
March 2
(Month)
(Day)
1914
17 I HEREBY CERTIFY that I attended deceased from AFelway 2894 to March 2 191
4
that I last saw hun alive on ..
Feb 28
1914
and that death occurred, on the date stated above, at ...
m.
The CAUSE OF DEATH* was as follows :
gastro enteritis (cute)
1
.(Duration)
.yrs.
nos 3 cuezas
Contributory
Promemoria (Broncho)
(SECONDARY)
(Duration)
.yrs.
mos.
(Signed)
Marshall 5. Alicia
M.D.
march 2, 1914 (Address) 617 westford SK.
* 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.
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 It Patriche
DATE OF BURIAL
Mac 3, 194
ADDRESS
20 UNDERTAKER
Lohnt. Olinwell as Gorham
....
(Year)
6 DATE OF BIRTH
Dec
yrs.
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 inaterial worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager,""Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia ; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc , Carcinoma, Sar- coma, etc., of. (name origin: "Cancer" is less definite ; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example : Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " 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 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.
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
1 PLACE OF DEATH Chelmsford .(No. Dallo Road
St. : Ward)
(City or town.) [if death occurred in a hospital or institution, give its NAME instead of street and number.]
2FULL NAME anna Graham Colline
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
annaS. Berrich, John Collins
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female white
4 COLOR OR RACE
15 SINGLE
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
widno
6 DATE OF BIRTH Cect
(Monthı)
27
1834
(Day)
(Year)
7 AGE
If LESS than
1 day ......... hrs.
79
.... yrs.
4
mos.
6
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)
Sowell, Index Village
PARENTS
12 MAIDEN NAME
OF MOTHER
Margaret Herring
13 BIRTHPLACE
OF MOTHER
(State or country)
Boston
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mas ST. Steam
(Address) Center
15 Filed March 7 1914 Edward , Potom
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Mich
4
(Month)
(Day)
1914
(Year)
17
I HEREBY CERTIFY that I attended deceased from
Fab. .
1914, to.
mch. 4
... 1914
..........
that I last saw her alive on
mch. 3
and that death occurred, on the date stated above, at 7 Pm.
The CAUSE OF DEATH* was as follows :
Myocarditis
1
(Duration).
.. yrs.
mos.
ds.
Contributory
Bronchitis
.....
(SECONDARY)
8
ds.
(Signed)
amara Stoward
M.D.
nich. 7, 1914 (Adress) Chelmsford Mars
* 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,
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 Riverside Com
DATE OF BURIAL
March 7 1914
20 UNDERTAKER Maler Perhan
ADDRESS
Chelmsford
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
10 NAME OF
FATHER
Hermanas Berrick
(Duration)
... yrs.
mos.
11 BIRTHPLACE OF FATHER (State or country) Sermany
Chelmsford 15
....
Registered No. /3
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative licalthfulness of various pursuits can be known. The question applics to each and every person, irrespective of age. For many occupations a singlo word or term on the first line will be sufficient, c. g., Furmer 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 necded. 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. Comen 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 usc of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia ; Broneho- pneumonia (" Pneumonia," unqualified, 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 neoplasms) ; Measles; Whooping cough; Chronie 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 " (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 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 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, a A death upon the street, or one supposed to be due to Alcoholism, etc.
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