USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1914-1916 > Part 8
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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, ctc.
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, ctc
4. Deatlıs uuder circumstances unknown, as A person found dead, etc.
1
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.
Billerica Sh
St. :
Ward)
Curtis Berrich Hagen. 2FULL NAME : [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Chelmsford
PERSONAL AND STATISTICAL PARTICULARS
3 SEX male
4 COLOR OR RACE
white
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
married
6 DATE OF BIRTH
3
1842
(Month)
(Day)
(Year)
7 AGE
If LESS than | day, ........ hrs.
71
.yrs.
mos
mos.
23 .ds. or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
- Farmer
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
Lebanon n.H.
PARENTS
11 BIRTHPLACE OF FATHER (State or country) Hartford Ix.
12 MAIDEN NAME
OF MOTHER
Sarah Wood
13 BIRTHPLACE
OF MOTHER
(State or country)
Lebanon N.H.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Theo E.B. Haylu
(Address) Checmathe W.
16
Filed
apr. 29, 1914 Edward . Bobbing
1 REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
apr.
26
4.
(Month)
(Day)
191 (Year)
17 1 HEREBY CERTIFY that I attended deceased from
191
....... , to
Capr. 26 194
that I last saw h wwwalive on
apr. 26
1914
and that death occurred, on the date stated above, at. m. The CAUSE OF DEATH* was as follows :
arterio Sclerosis
-
1
.(Duration)
.............. yrs.
......
.. mos. ds.
Contributory .. (SECONDARY)
.mos. ds.
barca.
M.D. ,
(Signed)
apr. 29, 1914.
(Address).
Chelmsford, 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
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 Pine Ridge Cem,
DATE OF BURIAL
april 29 94
20 UNDERTAKER
Walter Perham
ADDRESS
Chelmsford,
28
Chelmsford
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No.
28
MARGIN RESERVED FOR BINDING
10 NAME OF
FATHER
Sanford Hagen
... yrs.
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architeet, Loeo- 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 cmployed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definito 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, peritonucum, etc., Carcinoma, Sar- coma, etc., of. (name origin: "Cancer" is less definite ; avoid use of "Tumor " for malignant neoplasms) ; Measles; Whooping cough; Chronie valvular heart disease; Chronie interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (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 causc. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septieaemia," "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.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
3 SEX male PAGE 8 OCCUPATION (b) General nature of industry, business, or establishment in which employed (or employer) .. 12 MAIDEN NAME OF MOTHER PARENTS (Address) 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 ......... 44 yrs.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH North Chelmsford (No. North Lehelsubur st. Ward)
N
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME Hardard mc Connell
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
North
Chelmsford mass
Registered No.
29
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
.
4 COLOR OR RACE
White
5 SINGLE
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
16 DATE OF DEATH
May
4
(Month)
(Day)
(Year)
· DATE OF BIRTH
april
(Month)
(Day)
If LESS than I day, ........ hrs.
.mos. ds.
or ......... min. ?
I HEREBY CERTIFY that I attended deceased from ! april 23, 19/4, to May 4, 1914. that I last saw him alive on May4 1914. and that death occurred, on the date stated above, at 1.30 P.m. - The CAUSE OF DEATH* was as follows :
Gente Endocarditis
9 BIRTHPLACE
(State or country)
antry Pt Stephane NB
10 NAME OF
FATHER
Charles Mc Connell
11 BIRTHPLACE OF FATHER (State or country) reland
Not Known
18 BIRTHPLACE
OF MOTHER
(State or country) Nova Scala
-
Former or
usual residence.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mre Howard QueConneed
North Chelavebosa
15 Filed Man, 4 1914 Edward De Rol firmy
REGISTRAR
Contributory ....
Erysipelas
.......
(SECONDARY)
(Duration) ... yrs.
.. mos.
12
ds.
(Signed)
James & Hoban
....
M.D.
.
May 4, 1014 (Address) no Chelmsford
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
.
t
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
In the
of death.
.. yrs.
.mos.
ds.
........
State
.. yrs.
... Where was disease contracted,
ds
mos.
·
If not at place of death ?.
19 PLACE OF BURIAL OR REMOVAL River Side
DATE OF BURIAL
mar 6°
16
19140
ADDRESS
20 UNDERTAKER
Jahn a Nembeck 16 market
..........
5
ds.
... (Duration) .
... yrs.
mos. ....
1914 ....
16 1870 (Year)
(a) Trade, profession, or
particular kind of work
machiniet
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 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; Broneho- 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 .; Broneho-pneumonia (secondary), 10 ds. Never report more symptoms or terminal conditions, such as "Asthenia," "An- aemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age,". "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all discases resulting from childbirth or miscarriage, as "PUER- PERAL septieaemia," "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.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
21. Chelmsford
.(No
Church
St. ..
Ward)
Eugenia Talbot
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Church At.
U. Cleliafero.
Registered No. 30
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
May
(Month)
(Day)
1919
(Year)
6 DATE OF BIRTH
January
(Month)
19
(Day)
1914
(Year)
3
.... yrs.
... mos.
15
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)
Mass.
10 NAME OF
FATHER
Ovila Jalbal
11 BIRTHPLACE
OF FATHER
(State or country)
Lowell Mars
12 MAIDEN NAME
OF MOTHER
Josephine Goudreau
18 BIRTHPLACE
OF MOTHER
(State or country)
Lowell Muss
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
avila Talbot
(Address)
Church At
16 Filed_ May 4, 1914 Edward Robbing
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
apr 20, 1914, to.
may 3
1914
.....
that i last saw her alive on.
.......
May !!
1914
and that death occurred, on the date stated above, at 6 Am.
The CAUSE OF DEATH* was as follows :
f
Mucho- I'mlumouse
.(Duration)
.. yrs.
mos.
14 de.
Contributory ..
(SECONDARY)
................. (Duration). .... yrs. .
......
..........
M.D.
(Signed)
may 4, 1914
(Address)
2 Runel Bldi
* 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 OR REMOVAL St. Joseph
DATE OF BURIAL
191.
May 4
4
-
20 UNDERTAKER
a. archambault
738
ADDRESS
MercikSh
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
3 SEX Zem 7 AGE 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 ....
30
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.}
4 COLOR OR RACE
white
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
single
If LESS than
1 day ........ hrs.
E.g. Welch
mos.
... ds.
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of oeeu- 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 oceupations 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, ete. But in many cases, especially in industrial employments, it is nceessary 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 specifieation, as Day laborer, Farm laborer, 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 specifically the occupations of persons engaged in domestie service for wages, as Servant, Cook, Housemaid, ete. If the oeeupation 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 oceu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- EASE CAUSING DEATH (the primary affeetion with respect to time and eausation), 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., Carcinoma, Sar- coma, ete., of. .(name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ete. The contributory (second- ary or intereurrent) affeetion need not be stated unless im- portant. Example: Measles (disease eausing death), 29 ds .; Broncho-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," ete.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shoek," "Uraemia," "Weakness," ete., when a definite disease ean be ascertained as the eause. Always qualify all diseases resulting from childbirth or misearriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis," ete. State eause 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 violenee, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, cte.
2. Deaths supposedly eaused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, ete.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the strect, or onc supposed to be due to Alcoholism, ete.
4. Deaths under circumstances unknown, as A person found dead, ete.
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 Lowell, Mass.
(No .. Lowell General Hospital St. : Ward)
2 FULL NAME
Frederick K. Ripley
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
North Chelmsford, Mass.
Registered No.
702
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED
OR DIVORCEDMarried
(Write the word)
16 DATE OF DEATH
May 11.
191 ....
4
....
(Month)
(Day)
(Year)
6 DATE OF BIRTH
June 18. (Month)
1846
(Day)
(Year)
7 AGE
If LESS than
I day, ........ hrs.
67
.. yrs .. 10 mos.
23 ds.
or ......... min. ?
8 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)
N. Chelmsford, Mass.
(Duration)
yrs.
.mos.
ds.
Contributory ...
Obstructive Prostate
.... (SECONDARY)
.. (Duration)
.... yrs.
...........
.. mos.
.........
ds.
(Signed)
J. Arthur Gage
M.D.
May 11, 1914 (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).
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
N Chelmsford Mass. Riverside Cemetery.
DATE OF BURIAL
May 13
4
191
16
Filed. May 13, ..
.....
...... ...........
REGISTRAR
17 I HEREBY CERTIFY that I attended deceased from
May 6,
1914 to May 11,
191.
4
that I last saw him alive on May 10,
191.
4
....
and that death occurred, on the date stated above, a
6.05 8.
The CAUSE OF DEATH* was as follows :
Chronic Nephritis
10 NAME OF
FATHER
Louis Ripley
PARENTS
11 BIRTHPLACE OF FATHER (State or country) New Hampshire
12 MAIDEN NAME
OF MOTHER
Sophia Gardner
13 BIRTHPLACE
OF MOTHER
(State or country)
New Hampshire
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mrs. Josephine K. Ripley
(Address)
N. chelmsford, Mass.
31
Lowell
(City or town.) [lf death occurred in a hospital or institution, give its NAME instead of street and number.]
I
......
20 UNDERTAKER
George W. Healey
APPBEŞ 11
F
MARGIN RESERVED FOR BINDING
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 caclı 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 wlien 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, 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 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 oceu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- LASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of. .................
............ „(name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia,". "An- aemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus,", "Old age," "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,", etc. State cause for which surgical operation was undertaken.
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