USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 7
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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, ctc.
3. Sudden deaths of persons not disabled by recognized discase, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
I PLACE OF DEATH
Lowell. Mass. (NoLowell General Hospital St. ; .. Ward)
24
Lowell ..........
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME.
Alice Whitehead
[If married or divorced woman or widow give maiden name, also name of husband.] Alice Bowen -- Charles whitehead
24
@RESIDENCE
North Chelmsford, Mass.
Registered No.
485
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
$ SEX
Female
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Married
191 4
(Month)
(Day)
(Year)
6 DATE OF BIRTH
October 5.
(Month)
(Day)
(Year)
7 AGE
If LESS than
1 day ......... hrs.
62
.. yrs.
5
mos.
23 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)
England
Contributory.
(SECONDARY)
.(Duration)
.......
.. yrs.
ds.
mos.
(Signed)
R.
W. Parker
M.D.
Mar. . 2901. 4 (Address).
Lowell
......
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
IS 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 OR REMOVAL Riverside Cem. Chelmsford, Mass.
DATE OF BURIAL
Kar. 31, 19r
(Informant) Charles Whitehead. (Add@). Chelmsford, Mass.
16
Filed Mar. 39. 4
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
Mar. 27.
191 4 to Nar. 28.
... , 191.4
....
that I last saw h &falive on
Mar. 28,
194
and that death occurred, on the date stated above, ao P. m.
The CAUSE OF DEATH* was as follows :
Appendicitis
(Duration)
.yrs.
mos.
ds.
21
10 NAME OF FATHER Cornelius Bowen
PARENTS
11 BIRTHPLACE OF FATHER (State or country) England
12 MAIDEN NAME
OF MOTHER
Unknown
IS BIRTHPLACE OF MOTHER (State or country)
England
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
1851
16 DATE OF DEATH
March 28,
20 UNDERTAKER
Geo. W. Healey
ADDRESS
Lowell
....
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 agc. For many occupations a single word or term on the first line will be sufficient, c. g., Farmer or Planter, Physician, Compositor, Architect, Loeo- motive enginecr, 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 needcd. 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- 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 (rctired, 6 yrs.). For persons who have no occu- pation whatever, write Nonc.
.
Statement of cause of death. - Name, first, the DIS- DASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualificd, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonacum, etc., Careinoma, Sar- coma, etc., of. .. (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronie 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 .; Broneho-pneumonia (secondary.), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia,". "'An- aemia" (mcrely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus,", "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertaincd as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis,", etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing conditions must be referred to the Medical Examincrs:
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, etc.
--
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Fath Theles fort (No. Highland Or st.
After IT. Laitin
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.Y. @RESIDENCE Highland Des. Forth Chelei ford
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
-
Jecuales Muito
4 COLOR OR RACE
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
6 DATE OF BIRTH
1676
...... (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 ....
......
- At store
(b) General nature of industry, business, or establishment in which' employed (or employer) ...
1
9 BIRTHPLACE
(State or country)
march low.
10 NAME OF "FATHER
11 BIRTHPLACE OF FATHER (State or country) Quefand
12 MAIDEN NAME
OF MOTHER
HER Mary a. Sauum
13 BIRTHPLACE OF MOTHER (State or country)
Aufand
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Obsolet Parqui Viste
(Address)
Highland aur.
16
Filed_ Chr. 16, 1914 Edward Mobbing
REGISTRAR
,
(Duration) 5 ..... yrs.
.mos.
ds.
Valvular trant disease.
Contributory ...
(SECONDARY)
(Duration) 1.5
„yrs.
mos.
...
ds.
(Signed) (
abrite 5.
191.
(Address) ..
..... 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
In the
of death
yrs. ......
.....
.mos. ......
....
ds ........
.. mos.
.ds.
State ....
............ yrs.
. .....
Where was disease contracted, If not at place of death ?.
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL 7
DATE, OF BURIAL
4
191.
20 UNDERTAKER
ADDRESS
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 .
PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very 4 important. See instructions on back of certificate.
-
........
(City or town.) [if death occurred in a hospital or institution, give Its NAME Instead of street and number.]
Registered No. 25
16 DATE OF DEATH
4
.....
(Month)
(Day)
14
1914 ....
(Year)
17 1 HEREBY CERTIFY that I attended deceased from March 10, 1914, afit 14, 1914. that I last saw her alive on april 14, 1914 and that death occurred, on the date stated above, at 3@ ... m. The CAUSE OF DEATH* was as follows :
.
UL
......
825
Ward)
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 agc. 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 nccded. 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 laborcr, 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, 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 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 mcrc symptoms or terminal conditions, such as "Asthenia," "An- acmia" (merely symptomatic), "Atrophy," "Collapsc," 1 "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hacmorrhage," "Inanition," "Marasmus," "Old agc," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all discascs resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "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 discase, as A death upon the street, or one supposed to be due to Alcoholism, ctc.
4. Deaths under circumstances unknown, as A person found dcad, etc.
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
no chemil ford to mass
St. :
Ward)
Registered No. 26
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
8 SEX
4 COLOR OR RACE
male White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Married
$ DATE OF BIRTH
(Month)
(Day)
1
(Year)
7 AGE
If LESS than
1 day ......... hrs.
35
.. yrs .. mos. ds.
or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Jeamster mill ford
(b) General nature of Industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
Canada.
PARENTS
12 MAIDEN NAME
OF MOTHER
Louise Pachetto
13 BIRTHPLACE
OF MOTHER
(State or country)
Canada
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Napoleón Liverny
(Address)
no chelmsford
16 april 15, 1914 Edward J. Robbins ......
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
about for
1914, to.
april 15
that I last saw him alive on. 191× and that death occurred, on the date stated above, at 71200
The CAUSE OF DEATH* was as follows :
Cenyvilela
(facial).
.. (Duration)
... yrs.
mos.
.ds.
Contributory.
(SECONDARY)
(Duration)
... yrs.
.mos.
... ds.
(Signed)
7 E Jamey
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
In the
of death
yrs.
... mos.
.mos. .
ds ....
....
Where was disease contracted, If not at place of death ?.
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL St treffen Com. Chelineford man
DATE OF BURIAL
april 16.
1914
........
20 UNDERTAKER & albert
ADDRESS
17/ acker.
26 no Chelmalou (City or town.y {If death occurred in . a hospital or institution, give its NAME instead of street and number.]
Désire Sérian
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
50 Chelmsford Maso.
16 DATE OF DEATH
april
1915
(Month)
(Day)
..... (Yéar)
.....
....
....
10 NAME OF
FATHER
Joseph Sevigny
11 BIRTHPLACE
OF FATHER
(State or country)
Canada.
...
191 4 (Address)
ds.
State.
.......... yrs.
.......
...............
MARGIN RESERVED FOR BINDING
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation is very important, so that the relative healthfulncss 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 naturo 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) Groccry; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealcr," etc., without morc precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, ctc. Women at home, who are engaged in the duties of the houschold only (not paid House- kccpers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employcd, 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, 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. - Namnc, 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 rc- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
1. Varne
culosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- coma, etc., of. ...... ....... .. (name origin: "Cancer" is Icss definitc; 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 nced not be stated unless im- portant. Example: Measles (discasc causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or te minal conditions, such as "Asthenia," "An- aemia" (mcrely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Dcbility" ("Congenital," "Scnile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hacmorrhage," "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 recognizcd disease, as A death upon the street, or onc supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
1
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
3 SEX Mael 6 DATE OF BIRTH ---- 7 AGE 50 8 OCCUPATION S BIRTHPLACE (State or country) PARENTS 13 BIRTHPLACE OF MOTHER (State or country) 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 which employed (or employer) ...
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Lowell, Mass.
(No.
St. John's Hospital
St. :
Ward)
2/
Lowell .....
(City or town.) [If death occurred In a hospital or institution, give Its NAME Instead of street and number.]
2 FULL NAME
Thomas Tobin
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
North Chelmsford, Mass.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
April 19
191.
4
(Month)
(Day)
(Year)
--- 18 64
1
(Month)
(Day)
(Year)
If LESS than
1 day, ........ hrs.
(a) Trade, profession, or
particular kind of work.
Section Hand
(b) General nature of industry,
business, or establishment In. &. M. R. R.
New Castle, N. B.
10 NAME OF
FATHER
William Tobin
11 BIRTHPLACE
OF FATHER
(State or country)
Ireland
12 MAIDEN NAME OF MOTHER Catherine
Ireland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) William_ J Tobin. Son
(Address)
N. Chelmsford, Mass.
Filed.
April 21, 4 .......
REGISTRAR
17 I HEREBY CERTIFY that I attended deceased from
Apr.
18.
191.
..........
4
, to
Apr. 19.
194
that i last saw himnalive on
18,
19| 4
and that death occurred, on the date stated above, at 2. ma.
The CAUSE OF DEATH* was as follows : Surgical Shock ( Post Operative)
(Duration)
yrs.
.. mos.
ds.
Contributory ..
Strangulated Hernia --
....
(SECONDARY)
Inguinal
.. (Duration)
.yrs.
.mos.
ds.
(Signed)
J. V. Meigs
M.D.
Apr. 20
191
& (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 St. Patrick's Cem. Lowel
21.
4
191
20 UNDERTAKER ' Donnell & SongADDRESS Powell
2% 601
Registered No.
4 COLOR OR RACE
White
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED Married
(Write the word)
ds.
......... min. ?
.yrs.
--
--
mos.
MARGIN RESERVED FOR BINDING
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of oceu- 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 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 ouly when nccded. As cxamples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery; (a) Foreman, (b) Automobile factory. Thc material worked on may form part of the second statement. Never return "Laborcr," "Foreman," "Manager," "Dealer," etc., without more precise spceification, 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, Houscwork, 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, 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 indieatcd thus: Farmer (retired, 6 yrs.). For persons who have no occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- DASE CAUSING DEATH (the primary affection with respect to time and causation), usiug 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 rc- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinitc) ; Tuber-
culosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- coma, etc., of .. ... (name origin: "Caneer" is Icss .
definite; avoid usc of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ctc. The contributory (second- ary or intercurrent) affection necd not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia,". "An- aemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senilc," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hacmorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uraemia," "Wcakncss," etc .; when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis,", etc. State eause for which surgical operation was undertaken.
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