USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 5
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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
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.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
Thompson farmy st .:
East Chelmsford (City or town, Ward) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
Stillborn Langliton
2 FULL NAME
[If married or divorced woman or widow
give maiden name, aiso name of husband.]
@RESIDENCE
East Chuchusford
Registered No.
16
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
March
(Month)
10
1914 ....
(Day)
(Year)
....
17
I HEREBY CERTIFY that I attended deceased from
Man. 10, 1914, to
...
that I last saw h ............. alive-on.
19
and that death occurred, on the date stated above, at 1
m.
The CAUSE OF DEATH* was as follows :
(Duration) ...
· ds.
............ yrs.
......
......
Contributory ... (SECONDARY)
........
(Duration)
.......... yrs.
mos.
ds.
(Signed)
1.
M.D.
Makerz, 1919 (Address) 895 quelie-30
* 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 Sto. well man.
DATE OF BURIAL
mar. 13,
20 UNDERTAKER
Deo . W. Eastavars
ADDRESS
363 Bridgest
1 PLACE OF DEATHO East thilunsford (No 4 COLOR OR RACE 5 SINGLE, MARRIED WIDOWED, OR DIVORCED (Write the word) 3 SEX male white DATE OF BIRTH (Month) (Day) AGE $ OCCUPATION (a) Trade, profession, or particular kind of work, (b) General nature of Industry. business, or establishment in which employed (or employer) ... 10 NAME OF FATHER 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 ... .............. y.s. mos. ds.
1
(Year)
If LESS than
I day, ........ hrs.
or ......... min. ?
9 BIRTHPLACE
(State or country)
Earth Chilisford Mass
Stephena. Laughton
11 BIRTHPLACE
OF FATHER
(State or country)
fowall. Mars.
12 MAIDEN NAME
OF MOTHER
Georgiana Welch
13 BIRTHPLACE
OF MOTHER
(State or country)
Unity U. H
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Stephen a Langliton
(Address)
East Cheks ford
15 Filed Mar. 12 1956 Edward SRLbuis __ _ REGISTRAR
PERSONAL AND STATISTICAL PARTICULARS
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation is very important, so that the relative healthfulness of various pursuits ean 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," "Dcaler," 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 occu- pation whatever, write None.
Statement of cause of death. - Naine, 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, etc., Carcinoma, Sar- coma, etc., of ............ .(name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ctc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- aemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," ctc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uracmia," "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.
1
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.
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
17
....
(City or town.)
[If death occurred in a hospital or. institution, give its NAME instead of street and number.]
Registered No. 17
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE
Mal Splite
5 SINGLE
MARRIED
WIDOWED
OR DIVORCED
(Write the word)
0
8 DATE OF BIRTH
(Month) (Day)
1
(Year)
7 AGE
8.5,
......... ...... yrs. mos. ds.
or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work.
Ofetire
(b) General nature of industry, business, or establishment in which employed (or employes) ...
9 BIRTHPLACE (State or country) Maine
PARENTS
11 BIRTHPLACE OF FATHER (State or country) Mains
12 MAIDEN NAME OF MOTHER
13 BIRTHPLACE OF MOTHER (State or country)
Maine
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address) Hlubocelord
16
Filed. Mar. 16, 1916 Edward Willing
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from Mar 11, 1914, to Mar 13, 19/14 that I last saw h Umalive on Mar 13, 1914 and that death occurred, on the date stated above, at / / A.m. The CAUSE OF DEATH* was as follows : Prostatic Hubert of his ....
.(Duration)
9
.... yrs.
.mos.
ds.
Contributory ..
(SECONDARY)
(Signed)
Q.V. Wells
...
(Duration)
.yrs.
mos.
...
ds.
M.D.
Mar14, 1914 (Address) Westford 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.
ds.
State
.yrs.
In the
ds.
.mos.
.......
Where was disease contracted,
If not at place of death ?. .... Former or usual residence ... e .....
19 PLACE OF BURIAL OR REMOVAL
Valiich
DATE OF BURIAL
Mar 16 94
XO Powell est Lochan
important. See instructions on back of certificate.
1 PLACE OF DEATH
STANDARD CERTIFICATE OF DEATH São Chelmsford
-St. Ward)
Ssauce
Johnson
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
PERSONAL AND STATISTICAL PARTICULARS
16 DATE OF DEATH
Mar.
(Month)
13
(Day)
1914/
(Year)
...
....
10 NAME OF
FATHER
V
...
If LESS than
! day, ........ hrs.
1
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 (6) 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 ('AUSING 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.
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
important. See instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Chelmsford, Mass. (No. 1067, Chelmsford ...........
St. ;..
............... .Ward)
Chelmsford (City or town.) [if death occurred in a hospital or institution, give its NAME instead of street and number.]
2FULL NAME Sarah J. Churchill [If married or divorced woman or widow give maiden name, also name of husband.] Sarah J. Picker -- Richard Churchill
@RESIDENCE 1067 Chelmsford St.
Registered No.
18
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
Thite
5 SINGLE,
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word)
Widowed
· DATE OF BIRTH
(Month)
(Day)
1
.
(Year)
TAGE
If LESS than
1 day .......... hrs.
83. ............. yrs. .mos. ds.
of ......... 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) ....
.(Duration)
... yrs.
..........
.............. mos.
. ...
ds.
Contributory ..
(SECONDARY)
(Duration)
........
... yrs.
.mos.
ds.
(Signed)
Howard Hewitt
M.D.
March 2/ 1914
(Address) Mymano 9
* 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.
DATE OF BURIAL
Mar. 27, 1914.
Edson Cemetery
20 UNDERTAKER Jag Saunders
.
......
19 PLACE OF BURIAL OR REMOVAL
(Informant)
William C. Stanley
(Address)
15 Filed Mar. 23 1914 Edward Robbing
REGISTRAR
16 DATE OF DEATH
(Month)
2.1
(Day)
191.4
....
17
I HEREBY CERTIFY that I attended deceased from
Marche /7, 1914, to
March 21
. 1914
....
that I last saw hun alive on
March 1 9, 1916
and that death occurred, on the date stated above, at 59
..... m.
The CAUSE OF DEATH* was as follows :
Einchal Harmanslags
....
.
9 BIRTHPLACE
(State or country)
New Hampshire
-
- ==-- Ricker
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
N.H.
12 MAIDEN NAME
OF MOTHER
Unknaon
13 BIRTHPLACE OF MOTHER (State or conntry)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
....
10 NAME OF
FATHER
....
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
-
18
ADDRESS Lowell, Mass
4 COLOR OR RACE
.
(Year)
Granisch
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 apphes 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, Architect, Loco- motive engincer, 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 necdcd. 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," "Dcaler," ctc., without more precise specification, as Day laborcr, Farm laborer, Laborcr - Coal mine, etc. Women at home, who are engaged in the dutics 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 faet 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: Cercbro-spinal fever (the only definite synonym is "Epidemie cerebro-spinal meningitis"); Diphtheria (avoid usc of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualificd, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, cte., 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 nced not be stated unless im- portant. Example: Mcasles (discase causing death), 29 ds .; Broncho-pneumonia (secondary.), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- acmia." (mercly 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 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- posurc, 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.
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
1 PLACE OF DEATH
South Road
St. :
Ward)
Elf death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
....... (Month)
(Day)
(Year)
7 AGE
If LESS than
1 day ........ hrs .!
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)
about I week.
.(Duration)
.. yrs.
mos.
ds.
Contributory (SECONDARY)
.. (Duration)
..... yrs.
mos.
ds.
(Signed)
Anhang, colori)
M.D.
22/02/1914 (Address).
* If death followed injury or violence the certificate of death must be made ont by the Medical Examiner.
48 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR REGENT 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
(Informant)
(Address)
Efterhand Gente.
Filed_
16 mm. 23 1914 Edvard YrRating ............
REGISTRAR
....
.....
94 (Year)
(Month)
(Day)
DATE OF BIRTH
8
-
or ......... min. ?
I HEREBY CERTIFY that I attended deceased from
March 16, 1914
..........
March 22, 1914
that I last saw h.dr. alive on.
.
March 22 1914
...
and that death occurred, on the date stated above, at ///km.
The CAUSE OF DEATH* was as follows :
Solar Pneumonia
10 NAME OF
FATHER
Javis 6. Black
11 BIRTHPLACE
OF FATHER
(State or country)
Faurers hr
PARENTS
12 MAIDEN NAME.
OF MOTHER
0
18 BIRTHPLACE OF MOTHER (State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
19
....
(City or town.)
Mary B.
Black
thefunfarce Genel Registered No. 1 MEDICAL CERTIFICATE OF DEATH
19
5 SINGLE
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word)
16 DATE OF DEATH
1 Mach 2.2
20 UNDERTAKER Auch angli and The
DATE OF BURIAL A cch 23 1914
ADDRESS
738
MARGIN RESERVED FOR BINDING
... yrs. ..........
mos. 14 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 ueeded. 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 laborcr, 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, 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 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 pueumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonacum, 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," ctc.), "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:
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