USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1917-1918 > Part 11
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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, 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.
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.
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.
PARENTS
12 MAIDEN NAME OF MOTHER
13 BIRTHPLACE
OF MOTHER
(State or country)
Practandi
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Tus jvm@ avez
(Address) No Chiendad
16 Filed July 3, 1917 Edualed Y. Robbins
......
REGISTRAR
C
17
I HEREBY CERTIFY that I attended deceased from Jan 25; 1917, to ....... July 2, 1917. that I last saw hMna alive on. July / 1917 and that death occurred, on the date stated above, at. ........ .... m. The CAUSE OF DEATH* was as follows :
Pulmonary Tankeandra
(Duration)
1
.. yrs.
mos.
ds.
Contributory.
(SECONDARY)
.(Duration)
......
... yrs. ...
mos.
.. ds.
(Signed)
.........
‘.D.
July 2, 19/7 (Addres).
* If death followed injury or violenco the certificate of death must be made out by the Medical Examiner.
ds ...
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR
RECENT RESIDENTS).
At place
of death
.. yrs.
.. mos.
ds.
State.
.... yrs.
In the
............ mos. .
.......
Where was disease contracted, If not at place of death ?...
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
Gulf 3, 1917
No salvador
30 UNDERTAKER
Houng Blatz
No Chelmsford 5
(City of town.)
[if death occurred In a hospital or institution, give its NAME Instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
$ SEX
male
4 COLOR OR RACE
whits.
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED Jungle
(Write the word)
$ DATE OF BIRTH
June 16
(Month)
(Day)
-
(Year)
7 AGE
If LESS than
[ day ......... hrs.
38
......... ... yrs. /7 „ds.
- mos.
or ......... min. ?
8 OCCUPATION
machuss
(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)
Scotland
10 NAME OF
FATHER
11 BIRTHPLACE . OF FATHER (State or country) Scotland
10 DATE OF DEATH
July 2
7
(Month)
(Day)
(Year)
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Wright St North Chemungat
The Ummmmmwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
(No
Enox
0
.St. ;
Ward)
40
Registered No.
ADÓRESS
3.3 Quese ME
......... ................
...... ...........
191_
1879.
rieninges, peritonaeum, etc., Carcinoma, Sar-
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, 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. 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 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- 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," unqualified, is indefinite) ; Tuber-
coma, etc., 01 ................ (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 necd not be"stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pncumonia (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," "Hacmorrhage,", "Inanition," "Marasmus," "Old age," "Shock," "Uraemia,", "Weakness," etc., when a definite disease can be ascertained as the eause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia,", "PUERPERAL peritonitis," etc. 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 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 eircumstances unknown, as A person found dead, etc.
R. 15-8-'15. 100,000.
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 WORCESTER
(No.
Worcester State Hospital
St. :
Ward)
WORCESTER (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME
Victoria (Prince) Dubois
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford
wife of Dubois
Registered No.
1/1
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
+ COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word) Married
16 DATE OF DEATH
July 3
197
(Month)
(Day)
(Year,
" DATE OF BIRTH
Nov. 8,
1880
1
(Month)
(Day)
. (Year)
7 AGE
35
7
25
... yrs ..
.mos.
ds.
or ......... min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work ..........
Mill operative
(b) General nature of industry, business, or establishment in which employed (or employer) ...
9 BIRTHPLACE
(State or country)
Canada
10 NAME OF
FATHER
John Prince
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
canada
12 MAIDEN NAME
OF MOTHER
Agnes
Morrill
18 BIRTHPLACE
OF MOTHER
(State or country)
Canada
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
D. R. Gilfilian
(Address)
worcester State Hosp.
Filed. Jul. 9 9 7
..... Buenas REGISTRAR
17
I HEREBY CERTIFY that I attended deceased trom
NOV
9
1917 .....
......
1915 , July 3
...
....
........
......
that I last saw h ...... eralive on.
July 3
1917
...
and that death occurred, on the date stated above, at
2. 35A
.m.
The CAUSE OF DEATH* was as follows :
Primary General Paresis
(Duration)
... yrs.
.. mos.
ds.
Contributory ...
(SECONDARY)
.(Duration).
............ yrs.
... mos. ...........
ds.
(Signed)
D. R. Gilfilan
..
M.D.
July 3, 1917 (Address) Worcester
.......
* 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
Lyrs.
7 mos. 24ds.
In the
State ............ yTs. ...
.. mos ..
Where was disease contracted, if not at place of death ?.
Former or usual residence.
19 PLACE OF BURIAL QR REMOYAL St Joseph Cemetery
Lowell
DATE OF BURIAL
July 5
1917
PUNDERTAKERS: IONS SONS CO
ADDRESSESTER
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
MEDICAL CERTIFICATE OF DEATH
Female
White
If LESS than
! day ........ hrs.
P
STANDARD CERTIFICATE
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, Architcet, Loco- motive engincer, Civil engineer, Stationary fircman, 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 sccond statement. Never return "Laborer," "Forcman," "Manager," "Dealcr," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at homc, who are engaged in the duties of the household only (not paid Housc- keepers who reccive 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 cngaged 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 timc 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 usc of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualificd, is indefinite) ; Tubeř.
... men zinger, meritonaeum, etc., Carcinoma, Sar-
vumu, etc., of .. (name origin: "Cancer" is less definite; avoid usc of "Tumor" for malignant neoplasms) ; Mcasles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (sccond- 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 scpticacmia," "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 discasc, 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, ctc.
R 18. 3-'16. 10,000.
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
EastrChelmsford
(No
East Road
St. :
Ward)
(City or town.) [lf deeth occurred in a hospital or institution, give its NAME Insteed of street and number.]
2 FULL NAME
Nrs. Bridget Regan
[If married or divorced woman or widow
Bridget Regan (Jeremain Regan)
give maiden name, also name of husband.]
@RESIDENCE
East Road E. Chelmsford
Registered No.
42
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
+ COLOR OR RACE
white
& SINGLE,
MARRIED
WIDOWED, MEdow ed
OR DIVORCED
(Write the word)
$ DATE OF BIRTH
(Month)
(Day)
1
(Year)
7 AGE
If LESS than
I day ......... hrs.
63
.... yrs.
.. mos.
ds.
.......
or ........ min. ?
· OCCUPATION
(a) Trede, profession, or
particular kind of work
House-wife
(b) General nature of industry, business, or establishment In which employed (or employer) ...
9 BIRTHPLACE
(State or country)
Ireland
Contributory
(SECONDARY)
(Duration)
....... yrs ..
... mos.
ds.
(Signed)
Borden Pollen
M.D. Que 10, 1917 (Addres). Sun Bed
* 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.
............ nos.
Where was disease contracted, If not at place of death ?.
Former or usual residence.
19 PLACE OF BURIAL OR REMOVAL
St. Patrick's
DATE OF BURIAL
July 12 .191 7
Filed.,
Inky 11, 1917 Edward X. Rolling
REGISTRAR
....
(Month)
(Day)
191
(Year)
17
I HEREBY CERTIFY that I attended deceased from
....
1910, to.
July 8
1917
that I last saw her alive on
.
1917
and that death occurred, on the date stated above, at.
.m.
The CAUSE OF DEATH* was as follows :
Cardio renal
durán
.(Duration)
5-
.. yrs.
................ mos. ds.
................ .
........
10 NAME OF
FATHER
Jeremaih Moynihan
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Ireland
12 MAIDEN NAME
OF MOTHER
Mary Daley
18 BIRTHPLACE
OF MOTHER
(State or country)
Ireland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Miss Hattie Regan
(Address) East Road E. Chelmsford
16
20 UNDERTAKER O' Connell & Mack.
ADDRESS
658 Gorhem St
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
buly
1.0
E. Chelmsford
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 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, ete. 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 specifieation, 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 specifically the occupations of persons engaged in domestie 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 indieated thus: Farmer (retircd, 6 yrs.). For persons who have 110 occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- EASE CAUSING DEATH (the primary affeetion 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, etc., 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 imn- 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," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the eause. Always qualify all discases 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 violenee, 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.
@ Calling Building
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
3 SEX 7. ' AGE $ OCCUPATION (a) Trade, profession, or particular kind of work (b) General nature of industry, business, or establishment in which employed (or employer). 10 NAME OF FATHER PARENTS 13 BIRTHPLACE OF MOTHER (State or country) CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very 17 ...... yrs.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH So Cheliusfund (No
...........
................
St. :
Ward)
Registered No.
4.3
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED,
Jungle
(White the wer
13/1900
(Year)
If LESS than 1 day ......... hrs.
28
2 mos. ds. or ......... min. ?
at home
9 BIRTHPLACE
(State or country)
try To. Chelmsford
Walla R. Winning
11 BIRTHPLACE OF FATHER (State or country) 3) andover- Mars.
12 MAIDEN NAME
OF MOTHER
Rutte Johnson
Cullu maine
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
W. R. Winning (fattura)
(Address)
15 Filed __ July 12, 1917 Edward Y. Robbin REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
17 I HEREBY CERTIFY than I attended deceased from June 15, 1917, to. Nily 11, 1917. ..... ...... that I last saw ht. alive on ...... mhp 11, 197. and that death occurred, on the date stated above, at 3- Pm. The CAUSE OF DEATH* was as follows : acute Tramphatic
(Duration)
... yrs.
mos. ...
40 ds.
Contributory
(SECONDARY)
(Duration)
............... yrs.
.mos.
.ds.
O. r. Neves
M.D.
(Signed)
July 15, 197
, 1917 (Address).
nexthard Manas
* 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
DATE OF BURIAL
July 15-1917 - Hart Pond Cereturgh
20 UNDERTAKER
ADDRESS
Wallen Tenham Chelmsford.
(Month)
11
191.7
(Day)
(Year)
· DATE OF BIRTH avril
(Month)
(Day)
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.
.
2FULL NAME Hagel Freue Winning [If married or divorced woman or widow give maiden name, also nanke of husband.] @RESIDENCE South Cheluce afund.
18 Chelustund (City of town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
......
AT-
STANDARD CER
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 A 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 rc- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber .
nu; etc., of ....
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," "Haemorrhagc," "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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