USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 6
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1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be duc to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
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 Church
.... ,
Frederic H Blodgett
2 FULL NAME.
[If married or divorced woman of widow give maiden name, also name of husband.] @RESIDENCE
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Viale Write
4 COLOR OR RACE
1 5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Widowed
· DATE OF BIRTH
TH /Ana 30 1843
(Month)
(Day)
(Year)
, AGE
70 Vs. 6 mos. 22
ds.
........ yrs ...
or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Hammer
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(Sta
10 NAME OF
FATHER
- HildenichWBladget
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME OF MOTHER Hotely B.
13 BIRTHPLACE OF MOTHER (State or country} Weettrial
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
fryformant)
Rehh & Blodgett.
(Address) Watthan
16 Filed Play, 25, 1914, Edward Skalbins
REGISTRAR
-
20 C
(City or town.)
St. ;
.. Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No. 20
16 DATE OF DEATH
Mich
(Month)
22
191 4
(Year)
(Day)
17
I HEREBY CERTIFY that I attended deceased from .
much 18
1918, to Mel 22
191 X
that I last saw her alive on.
.1918
and that death occurred, on the date stated above, at 8.30 Pm.
The CAUSE OF DEATH* was as follows :
Branche. Generación
-
1
(Duration)
.... yrs.
.mos.
.. ds.
4
Contributory
organic diversi? Hechatip
(SECONDARY)
.(Duration) .
mos.
.......
ds.
(Signed)
JE Varney
M.D.
, 1914 (Adress) H. Chiliantal
* 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
DATE OF BURIAL
follelustro Mai25 914.
20 UNDERTAKER
ADDRESS
fot Wembeck Macher in
.......
1
If LESS than
1 day ......... hrs.
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, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But iu 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, Laborcr - Coal mine, etc. 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 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 DEATHI (the primary affection with respect to time and causation), using always the same accepted term for the same discase. Examples: Cercbro-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-
Blodgett
culosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- coma, etc., of. .(name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant ncoplasms); Mcasles; 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 (discase causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- aemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus,", "Old agc," "Shock," "Uraenia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicacmia," "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, 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
no Chemsfund Mario
C1 PLACE OF DEATH
To chemsad
................... V
Sill Bon ) James Murphy
21
(City or town.) &s death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAMEC [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
Youts Chimsind Mask
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
33EX
Hale White
5 SINGLE MARRIED. WIDOWED, QR DIVORCED (write the word)
6 DATE OF BIRTH
(Month)
(Day)
.
(Year)
7 AGE
If LESS than ! 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) ...
9 BIRTHPLACE
(State or country)
try orth Chemsford
(Duration)
.. yrs.
mos. ds.
Contributory. (SECONDARY)
.(Duration)
.yrs.
mos.
„ds.
(Signed)
7 E Varney
....
M.D.
* 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
mos.
ds .............
Where was disease contracted, If not at place of death ?.
Former or usual residence ..
-
19 PLACE OF BURIAL ØR REMOVAL
DATE OF BURIAL
St Patricks Mar 2/ 19/11
(Address)
north chembla
16 File Dras. 24, 1914 Edward V. Robbifus
0
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
mich
(Month)
(Day)
1914
(Year)
17
I HEREBY CERTIFY that I attended deceased from
191 ....... , to
Mek 20, 1914
191
that ! last saw he
............. alive on
....... .
and that death occurred, on the date stated above, at
.m.
The CAUSE OF DEATH* was as follows :
stillborn
10 NAME OF
FATHER
Thomas Murphy
PARENTS
11 BIRTHPLACE OF FATHER (State or country) Lowell Mah
12 MAIDEN NAME
OF MOTHER
Jennie Wloyd
13 BIRTHPLACE OF MOTHER (State or country)
Canada
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Thomas Mural
....
ADDRESS 20 UNDERTAKER this lo Metermich rokocham
.....
.
-
Registered No. 21
1
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of oecu- 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) 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, ete. 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 specifieally 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 oecu- 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 aceepted 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; Broneho- pneumonia ("Pneumonia," unqualified, is indefinite); Tuber-
culosis of lungs, meninges, peritonaeum, 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- aemia" (merely symptomatic), "Atrophy," "Collapsc," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old agc,". "Shock," "Uracmia," "Weakness," ete., when a definite disease can be ascertaincd as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "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 deatlis 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, ctc.
2. Deaths supposedly eaused 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.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
The Commonwealth of Massachusetts
Thelead fond 122
1 PLACE OF DEATH
(City or town.)
STANDARD CERTIFICATE OF DEATH
Ward)
[if death occurred in
a hospital or institution,
..........
St. :
give its NAME Instead
of street and number.]
(Felice ford
.... (No
Church
Frank Comgan
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Registered No.
Church Street.
22
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE,
16 DATE OF DEATH
MARRIED
WIDOWED,
tidning
4
OR DIVORCED
...
(Write the word)
3
25
1917
(Year)
(Month)
(Day)
$ DATE OF BIRTH
1
17
(Month)
(Day)
(Year)
I HEREBY CERTIFY that I attended deceased from
Mar 24, 1914, to.
May 25, 1914.
If LESS than
I day ........ hrs ..
that I last saw hun alive on Mar 2, 1914,
or ......... min. ?
and that death occurred, on the date stated above,
at CSC.P.
The CAUSE OF DEATH* was as follows :
7 AGE
89
....... yrs ..
mos.
ds.
& OCCUPATION
Retired
(a) Trade, profession, or
particular kind of work
(b) General nature of industry,
Laborer
Serie Debilità
business, or establishment In
which employed (or employer) ..
(Duration)
9 BIRTHPLACE
(State or country)
Ueland
Contributory ...
(SECONDARY)
....
.yrs.
.mos.
ds.
10 NAME OF
FATHER
.. (Duration) ............
.... yrs.
mos,
... ds.
John Corrigan
........
(Signed)
Mar 26, 108
(Address) ...
11 BIRTHPLACE
OF FATHER
(State or country)
Unefand
Michelinfort
..........
CHaban
M.D.
* If death followed injury or violence the certificate of death must be made
out by the Medical Examiner.
12 MAIDEN NAME
OF MOTHER
Mau Unut!
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR
RECENT RESIDENTS).
PARENTS
At place
Quelaund
of death
.. yrs.
.mos. .......
ds.
State.
......... yrs ..
In the
1
............ mos.
. ............ ...............
18 BIRTHPLACE
OF MOTHER
(State or country)
Where was disease contracted,
if not at place of death ?...
Former or
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
usual residence.
(Informant)
Rohu & Corrigan in
19 PLACE OF BURIAL OR REMOVAL
F Jalmuy Cemetery
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.
(Address)
With Thelives And
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
....
16 File March 27, 1914 Edward Y. Blabbro
REGISTRAR
DATE OF/ BURIAL
1/125 94
20 UNDERTAKER Ist. Amwell
ADDRESS 324 Mausetof
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) 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 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 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. - 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, 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," "Collapsc," "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 onc supposed to be duc to Alcoholism, ete.
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
No Chelmsford Mass (No.
St. : Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME Instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
married
.......
(Month)
(Year)
6 DATE OF BIRTH
Allo 37 7
1811
(Month)
(Day)
-
(Year)
7 AGE
If LESS than
1 day, ........ hrs.
69
.... yrs.
.... mos. ...
26 ds.
Or ......... min. ?
3 OCCUPATION
(a) Trade, profession, or
particular kind of work ..
Retired
(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
Not known
18 BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Mrs G E Spalding
(Address)
Chelmsford Mass
16
File march 28, 1914 Edward . Robbins ....... REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from March 19, 1914, to March 25, 1914 .
m. that I last saw h que alive on March 25, 194. and that death occurred, on the date stated above, at .... .................
The CAUSE OF DEATH* was as follows :
haft hammyblique
-
Cerebral harmontage
.. (Duration) ...
.........
.. yrs.
.mos. ...
.ds.
Contributory
(SECONDARY)
Q (Duration)
yrs.mos
.... ds.
(Signed)
Antun & Scarboral
M.D.
marche 25 101
1914 (Address).
Chelmsford mons.
* 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 Forefathers Cemetry
DATE OF BURIAL
mar 28
Chelmsford Mass
......
191
20 UNDERTAKER
G.M. Young
ADDRESS
33. Viercorfit
V
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
March 25 7974
(Day)
191
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
Registered No. 23
2 FULL NAME George E. Spalding
[If married or divorced woman or widow
give maiden name, also name of hnsband.]
@RESIDENCE
No Chelmsford Mass
23
10 NAME OF
FATHER
James Spalding
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 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- keepers who receive a definite salary), may be entered as ʻ Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- EASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discase. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of. .. (name origin: "Cancer" is less definite; avoid 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," "Dcbility" ("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.
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