USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1917-1918 > Part 12
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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, 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.
1 PLACE OF DEATH
2 FULL NAME
3 SEX
4 COLOR OR RACE
Mals
6 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
(Month)
(Day)
7 AGE
6 F
8 OCCUPATION
J'ailor
(a) Trade, profession, or
particular kind of work
.......
(b) General nature of industry,
business, or establishment in
which employed (or employer) ..
PARENTS
13 BIRTHPLACE
Queland
OF MOTHER
(State or country)
important. See instructions on back of certificate.
15
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
......
Lawn. yrs. 2
mos .
9
ds.
If LESS than ! day ........ hrs.
or ........ min. ?
9 BIRTHPLACE
(State or country)
Dexter Main
10 NAME OF
FATHER
Dating Malque
11 BIRTHPLACE OF FATHER (State or country) Wieland
12 MAIDEN NAME OF MOTHER Ellen tanto
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informan
(Address) Tott Chelisfind
Filed_
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
July
18
...
......
(Month)
(Day)
191.
(Year)
·DATE OF BIRTH May 9 1849 17
(Year)
......
I HEREBY CERTIFY that I attended deceased from
July 17, 1917, to
July 18, 1917
1 ....
that I last saw h alive on
..... .
nily 18
1917
and that death occurred, on the date stated above, at 1 2.30 9.
The CAUSE OF DEATH* was as follows :
aculi Indigestióni .
2
mos.
ds.
(Duration)
chimie gastritis
Contributory ............
(SECONDARY)
James ft
(Duration).
.. yrs.
..... mos. ds.
(Signed)
...
M.D.
July 19 07 (Address)
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR
RECENT RESIDENTS).
At place
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 REMOVALelity pleasant Valatties Mains
DATE OF BURIAL
July 20 1917
20 UNDERTAKER
ADDRESS
324 Manget St.
/(City or town.) [If death occurred in a hospital or instituticn, give its NAME instead of street and number.]
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Middleet f. Inti Cheles ford
Registered No.
44
7
...........
PERSONAL AND STATISTICAL PARTICULARS
Cheliosford
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
St. : Ward)
STANDARD GEN ...
, peritonacum, etc., Carcinoma, Sar-
.(name origin: "Cancer" is less
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 eaclı 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 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 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, 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 domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- EASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
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,", "Wcakness," etc., when a definite disease ean 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, Suicidc, 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, ete.
4. Deaths under circumstances unknown, as A person found dead, etc.
R. 15-8-'15. 100,000.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
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 Morton Mass- Haute Horpara
St. :
Ward)
monson (City or town.) Tlf deeth occurred In a hospital or institution, give its NAME Instead of street and number.]
? FULL NAME
Richmond s. Michele
[If married or divorced woman or widow
give maiden name, also name of husoand.]
@RESIDENCE
Chelms ford- mass.
Registered No.
17.3
PERSONAL AND STATISTICAL PARTICULARS
$ SEX
male
4 COLOR OR RACE
& SINGLE
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
$ DATE OF BIRTH -
(Month)
(Day)
1857
(Year)
TAGE
If LESS then
I day ......... hrs.
60 yrs. -
mos.
ds.
or ......... min. ?
$ OCCUPATION
(a) Trade, profession, or
particular kind of work ..
Farmer.
(b) General nature of Industry,
business, or establishment in
which employed (or employer).
17
I HEREBY CERTIFY that I attended deceased from
Ame 25, 1917, to.
July 20, 1917
that I last saw alive on.
Jul 20, 1912
and that death occurred, on the date stated above, at 0309.m.
The CAUSE OF DEATH* was as follows :
Pyjama
(Duretion)
.yrs.
... mos ..
....
7
ds.
Contributory Brodu Priamuang
(SECONDARY)
(Duration)
... yrs. .mos. ...... 1
(Signed) B. S-astore
M.D.
..
July 21, 197 (Address)
Palmer May'
.....
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
1S LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
... yrs.
mos.
28 ds.
In the
State ............
......... yrs. ............ mos.
Where was disease contracted, if not at place of death ?. Former or
usual residence
tohelpus food mass
19 PLACE OF BURIAL OR REMOVAL carlisle cemetery carliste. mass
DATE OF BURIAL
July 22 1917
(Address)
Palmy. Mars
16 Filed July 23, 1917 Feelon & Bull
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
July- 20
(Monthy
(Day)
(Year)
1917
....
...
9 BIRTHPLACE
(State or country)
l'article mass.
10 NAME OF
FATHER
Semnan nickles
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
learliste, mass.
12 MAIDEN NAME
OF MOTHER
Lucy Milking
18 BIRTHPLACE
OF MOTHER
(State or country)
Carlisle, mass-
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
Maison
State Hordal
20 UNDERTAKER
A.m. Benefi
albert 9 ven
Carloste 11
......
20
1 PLACE OF DEATH
-
Carcinoma, Sar-
"Cancer" is less
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 eaclı 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) Forcman, (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, 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 homc. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Houscmaid, 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 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-
definite; avoid use of "Tumor" for malignant neoplasms); Mcasles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- acmia " (merely symptomatie), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shoek," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc
4. Deaths under circumstances unknown, as A person found dead, etc.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
3 SEX 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 ...
The Commumuralth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Chelmsford (No.
2 FULL NAME
Küz
okoski
[If married or divorced woman ør widow
give maiden name, also name of husband.]
@RESIDENCE
Chelmsford Mass
......
PERSONAL AND STATISTICAL PARTICULARS
MÉDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
July 26
(Month)
(Day)
191
(Year)
· DATE OF BIRTH
deg 24
(Month)
(Day)
19/10
(Year)
If LESS than
I day ......... hrs.
8
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)
Chelmsford
10 NAME OF
FATHER
frank Oskoski.
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME
OF MOTHER
Mary
acoyou.
1
1ª BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) frank okoski
(Address) chelmond
Filed ...
July 26 1917 Edward Ji Retours
REGISTRAR
....
17
I HEREBY CERTIFY that I attended deceased from 23, 1917, to July 26 ... 1917. that I last saw him alive on - Jus 26 1917. and that death occurred, on the date stated above, at. .m. The CAUSE OF DEATH* was as follows :
Cholera Infantuna
.(Duration)
.......
... yrs.
„mos. G
ds.
Contributory.
(SLSONDARY)
.(Duration)
.yrs.
.. mos.
..........
ds.
(Signed)
armasa
toward
M.D.
Ouh 27
7. 1917 (Address)
Chelmsford
* 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
mos.
ds .............
... угв.
Where was disease contracted, If not at place of death ?.
Former or usual residence.
12 PLACE OF BURIAL OR REMOVAL Edson
DATE OF BURIAL
July 27. 1917
20 UNDERTAKER
ADDRESS
Joseph Gilbert \171 aken
21
.....................
(City or town.)
[If death occurred In a hospita! or institution, give its NAME instead of street and number.]
St. :
Ward)
Registered No.
46 66%
4 COLOR OR RACE
-
1 5 SINGLE,
MARRIED,
WIDOWED
OR DIVORCED
(Write the word)
Single
....
L
etc., Carcino?
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 engincer, Stationary fireman, ctc. 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 nceded. 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 minc, 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 diseasc. Examples: Cercbro-spinal fever (the only definite synonym is "Epidemie eerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
1
of ....................... (naine 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 (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Mcasles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- aemia" (mercly symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senilc," 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 ali diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "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 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, etc.
-
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 important. See instructions on back of certificate.
-
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Chelwex ford Maso (No. Oh) Beta Junkera Road
St. :
Ward)
(City or down.) [If death occurred in a hospital or institution, give its NAME instead of street and number.j
Ellen Holland
' FULL NAME [If married or divorced woman or widow give maiden name, also pame of husband.[ @RESIDENCE Old Katon Junkers Toad (Pelestort
PERSONAL AND STATISTICAL PARTICULARS
J
MEDICAL CERTIFICATE OF DEATH
' COLOR OR RACE
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
Vingler
16 DATE OF DEATH
July za 30
(Month)
(Day)
(Year.
17
I HEREBY CERTIFY that I attended deceased trom
Sam 25
.1917, to.
Tuar, 19, 1917.
that I last saw her alive on
Pan. 25 197
and that death occurred, on the date stated above, at 3a m.
The CAUSE OF DEATH> was, as follows :
Chronic Interstitial Weplint
.. (Duration)
.yrs.
.. mos.
ds.
Contributory.
Cardiac dilatation
(SECONDARY)
.(Durațion)
.......
.... yrs.
............
.... mos.
.......... ds
(Signed)
July 30
.....
1917 (Address)
Jowell
* 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 S. Palinga Century
DATE OF BURIAL
Queg 1. 1917
(Address)
Chelucio ford mass
16 Filed
REGISTRAR
(Month)
(Day)
1855
..........
(Year)
If LESS than
1 day ......... hrs.
J
mos.
.ds.
or ......... min. ?
Mperatur
Cotton mill
9 BIRTHPLACE
(State or country)
Juland
10 NAME OF
FATHER
James Salland
11 BIRTHPLACE
OF FATHER
(State or country)
befand
12 MAIDEN NAME
OF MOTHER
Budgett Nowlett
Wieland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Charles & Vallaud Nuother
20 UNDERTAKER
ADDRESS 1324 Market .
3 SEX DATE OF BIRTH 7 AGE 6 2 8 OCCUPATION (a) Trade, profession, or particular kind of work. (b) General nature of industry, business, or establishment in which employed (or employer) ... PARENTS 1ª 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 .... ....... yrs.
2211 Cheluisford na
4.7
Registered No.
1917
....
M.D.
STANDARD CERTIFICATE Ur 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, 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," "Dcaler," 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 reccive 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
mil
coma, etc., -
uninges, peritonaeun., etc., Carcinoma, Sar- .. (name origin: “₾
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 symptomatie), "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 septieaemia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
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