Deaths 1914-1916, Part 50

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


USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 50


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


Joseph Hamilton Jechaudron 2 FULL NAME


{If married or divorced woman ør widow give maiden name, also name of bysband.] @RESIDENCE Chelmsford.


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


& SEX


Male While-


5 SINGLE,


MARRIED.


WIDOWED


OR DIVORCE faireds


(Write the word)


16,50


(Month)


(Day)


17 I HEREBY CERTIFY that I attended deceased from


(Year)


abril


1916


Cinq, 16


6


to


If LESS than


[ day .........


... hrs.


that I last saw h.A.kas. alive on ...


aug . 15th


1916


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


The CAUSE OF DEATH* was as follows :


Cirrhosis


(Duration).


1


.... yrs.


.... mos.


....


... ds.


Contributory


(SECONDARY)


.... (Duration).


.... ds.


(Signed)


Umasa toward.


M.D.


aug. 18, 191


1916 (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).


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


Edrow lesmeting


Powell mais


DATE OF BURIAL


Aug. 19.


6


191


UNDERTAKER


ADDRESS


Walter Teshaus Cheliosford.


.


......


1916 (Year)


7 AGE


66. 6


.yrs.


.mos.


... ds.


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


OCCUPATION


(a) Trade, profession, or


particular kind of work


..........


Painter


(b) General nature of industry,


business, or establishment In


which employed (or employer).


9 BIRTHPLACE


(State or country)


loww bridge It


10 NAME OF


Samuel Richardson


11 BIRTHPLACE


OF FATHER


(State or country)


Jutland Ut.


MEDICAL CERTIFICATE OF DEATH


10 DATE OF DEATH


august


16"


......


....


(Month)


(Day)


· DATE OF BIRTH


feb.


4 COLOR OR RACE


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


195 Chelmsford


.........


39


....


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 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); Tubcr-


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," "Wcakness," 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.


-


MARGIN RESERVED FOR BINDING


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


3 SEX the 7 AGE 10 NAME OF FATHER PARENTS important. See instructions on back of certificate. 16 N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very ....


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


1 PLACE OF DEATH.


shehuard


(No.


Chelmsford


St. :


Ward)


196


(City or town.) .


Tlf 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.] @RESIDENCES


Chefunfund Gente Registered No.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


auch 19


1916 .........


(Month)


(Day)


(Year)


DATE OF BIRTH Dras


(Month)


(Day)


If LESS than I day ......... hrs.


.. mos ..


26 da.


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)


Cherryand


(Duration)


yrs.


mos.


ds.


Contributory ..


(SECONDARY)


Duration.


... yrs.


.. mos.


ds.


(Signed)


aug. 19 19


(Address).


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


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


At place


of death


yrs.


In the


.mos.


ds.


State ..


... yrs.


...


.mos.


ds.


Where was disease contracted,


If not at place of death ?.


Former or usual residence.


19 PLACE OF BURIALJOR REMOVAL


DATE OF BURIAL


aug 20 96


(Address)


Bulunand


Filed Ana 20, 1916 Edward . Bobbing


........


REGISTRAR


....


191


to


Cua, 19 1916


that I last saw hey alive on.


aux 19;, 1916.


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


The CAUSE OF DEATH* was as follows :


Entero colitis


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


Jenige, Il marchand Anty Y. color


M.D.


11 BIRTHPLACE OF FATHER (State or country) & Canada


12 MAIDEN NAME OF MOTHER Egiana Trambles


18 BIRTHPLACE OF MOTHER (State or country)


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant) Mathu.


Bertha Marchand


21.0


4 COLOR OR RACE


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


24


19/15~


(Year)


I HEREBY CERTIFY that I attended deceased from


20 UNDERTAKER A chichambault De


ADDRESS


438


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 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 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 occu- pation whatever, write None.


Statement of cause of death. - Name, first, the DIS- EASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite); Tuber-


culosis of lungs, meninges, 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- 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 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.


R. 15-8-'15. 100,000.


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 Lowell Mass. .(No .. Lowell Hospital


............. Ward)


197 Lowell


...........


(City or town.)


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


Henry nichols


2 FULL NAME


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


Chelmilore Centre, mais


MEDICAL CERTIFICATE OF DEATH


15 DATE OF DEATH


September 6


1910


(Month)


(Day)


(Year)


17


I HEREBY CERTIFY that I attended deceased from


191.


, to.


191.


.......


that I last saw h .............


alive on


191


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


m.


The CAUSE OF DEATH* was as follows :


l'ecident


1 Thrown from motorcycle by reason of breaking of front (fork) A.(Duration) . .... ys. ..... mes. ds.


Contributory ...


Ruptureof Intestine


LOLCONDARY)


peritonitis


.. (Duration).


.yrs.


.mos. ds.


(Signed)


I. V. meigo)


M.D.


Sept. 1. 19/2. (Ade


. (Address).


Lowell


......


* 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


Green Cem, Carlisle Mansept. 10


191 6


20 UNDERTAKER


ADDRESS


walter Perham Chelmsford


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


4 COLOR OR RACE


white


male


$ SINGLE,


Single


le


MARRIED,


WIDOWED,


OR DIVORCED


& DATE OF BIRTH


may


21


....


(Month )


(Day)


(Year)


3 AGE


If LESS than


I day ........ hrs.


22 yrs. 3


........


mos.


16


ds.


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


& OCCUPATION


milkman


(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)


Carlisle mass


10 NAME OF


FATHER


Clarence G. nicholl


11 BIRTHPLACE


OF FATHER


(State or country)


Carlisle Mass


12 MAIDEN NAME


OF MOTHER


Sarah E. Dutton


PARENTS


18 BIRTHPLACE


OF MOTHER


Lowell mass


(State or country)


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very


(Informant)


mother


important. See instructions on back of certificate.


(Address)


Chelmsford et. Mass


N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


.....


1294


Filed 1


16 Sept. 11


REGISTRAR


...


Registered No.


1326


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precisc 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, Architeet, 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," ete., 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. 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 busiuess, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persous who have no occu- pation whatever, write None.


Statement of cause of death. -- Name, first, the DIS- EASE CAUSING DEATH (the primary affcetion 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, peritonaeum, ete., Careinoma, Sar- coma, 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, ctc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broneho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- aemia" (merely symptomatie), "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 diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis," ete. 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, ete.


2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.


3. Sudden deaths of persons not disabled by recognized" discase, as A death upon the street, or one supposed to be duc to Alcoholism, ete


4. Deaths under circumstances unknown, as A person found dead, etc.


R 18, 3-'16. 10,000.


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.


....


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


2 FULL NAME


& SEX


' COLOR OR RACE


W.


7!


' DATE OF BIRTH


(Month)


7 AGE


62


& OCCUPATION


(a) Trade, profession, or


particular kind of work


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


(b) General nature of Industry,


business, or establishment in


which employed (or employer) ........ ++++++++


& BIRTHPLACE


(State or country)


PARENTS


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very


.........


.... yrs. ...


3


mos.


5 SINGLE,


MARRIED.


WIDOWED,


OR DIVORCED7


(Write the word)


Bale


vd 1854


(Day)


(Year)


20


ds.


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


10 NAME OF


FATHER


Edwin Stearns


11 BIRTHPLACE


OF FATHER


(State or country)


Walhole Mass


12 MAIDEN NAME


OF MOTHER


Margaret Berick


13 BIRTHPLACE


OF MOTHER


Middlesex Village.


"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE POLICY


(Informant)


Fred a Butteros


(Address)


Cliclunsford, mas


15


Filed ...... Sept 11, 191 6 Edward De Politie


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


10 DATE OF DEATH


Sept.


9


......


(Month)


(Day)


(Year)


17


I HEREBY CERTIFY that I attended deceased from


aluca 13 1916 to Sept. 9.


....


.....


1916.


If LESS than


i day .........


........ hrs.


that I last saw h &M alive on


.... 1916


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


.m.


The CAUSE OF DEATH* was as follows :


Pelvic


-carcinoma=


.(Duration)


................. 08. .. ds.


Contributory


(SECONDARY)


2


(Duration) ...


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


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


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


(Signed)


Anhue J. Deabona


M.D.


Sept, 10.


., 1916 (Address).


Chelesforel, mais.


......


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


Isual residence.


19 PLACE OF BURIAL OR REMOVAL


DATE OF BURIAL


Edron Canceling Sept 12


Lowell


6


191


20 UNDERTAKER


Waller uban


ADDRESS Chelmsford


MARGIN RESERVED FOR BINDING


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


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


Golden Core Road


... (


Estella . Jutters)


[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE delwestend- mars


Tired a Bultas


42


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


Chelmsford 198


St. :


Ward)


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


1916.


......... ,


....


....


Sikt q'


at home


....


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


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 linc 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, Laborcr - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- kccpers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. 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 (rctired, 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 discase. Examples: Ccrcbro-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 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," "Scnile," 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, ctc.




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