USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1917-1918 > Part 2
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Cases for the Medical Examiners. - Under the provi- sious of chapter 24 of the Revised Laws deaths under the fol- lowing conditions must be referred to the Medieal Examiners:
1 Deaths following injury or violenee, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, ete.
2. Deaths supposedly eaused by violenee, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, ete.
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 eireumstanees unknown, as A person found dead, ete.
R 18. 5-16. 10,000).
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
.... 7 AGE PARENTS important. See instructions on back of certificate. 16 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 Oommmmwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
- Forth Chelmsford (No
Man, P. Taview ....
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband,
@RESIDENCE
Highland Un. forth Cheluistand
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX - Jewal Nuts
· DATE OF BIRTH
1861
(Month)
(Day)
(Year)
If LESS than
I day ......... hrs.
..... yrs.
. .....
... mos.
.ds.
or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
........
(b) General nature of industry. business, or establishment in which employed (or employer) ...
9 BIRTHPLACE
(State or country)
Queland
10 NAME OF FATHER
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME
OF MOTHER
lot Juniz
13 BIRTHPLACE OF MOTHER (State or country)
Wieland
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Besser Vaique Daughter
(Address) Highland als.
Filed_ Jan, 22, 19 Ederound Robin
REGISTRAR
16 DATE OF DEATH
(Month)
1
- 2/
(Day) ., 1917 ....
(Year)
17
I HEREBY CERTIFY that I attended deceased from
Jar, 8, 1911, to
Jan 2/ 1911
that
[ last saw him alive on
Jan 7/ 1917.
and that death occurred, on the date stated above, at //P
...... m.
The CAUSE OF DEATH* was as follows :
Cherie Brinutio
.(Duration) ......
......... yrs.
............
.... mos.
ds.
Contributory ..
queral Debility
...................
....
(SECONDARY)
.(Duration)
... yrs.
......
.... mos. ... ds.
(Signed)
......
.......... , M.D.
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death.
... yrs.
mos.
ds.
State.
.yrs.
In the
.mos.
. ......
Where was disease contracted, If not at place of death ?...
Former cr
usual residence
19 PLACE OF BURIAL OR REMOVAL Y aire I. Patury Conley
20 UNDERTAKER
DATE OF BURIAL 1917
ADDRESS 1324 may 2 x
Chelios ford
St. : „Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Pedro
....
............
2
3
(Address).
1
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, 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 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- CASE 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" (mere)y 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 Aiseases 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.
. 15-8-'15. 100,000.
The Communitwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
6 tehelmsford (No.
Center
Elvira & Pierces
" FULL NAME [If married or divorced woman or widow give maiden name, also name of husband. ] a RESIDENCE E, Chelmsford.
Elvira, S. Boltan Orrin Pierce
Registered No. 6
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Females White.
' COLOR OR RACE
5 SINGLE,
MARRIED,
Married.
OR DIVORCED
(Write the word)
· DATE OF BIRTH
Auf
(Month)
28.
1833
(Day)
(Year)
If LESS than
1 day, ........ hrs.
8.3
. 4
mos.
26 ds.
or ......... min. ?
B OCCUPATION
(a) Trade, profession, or
particular kind of work
At Home
At Home
9 BIRTHPLACE
(State or country)
M. Boyleton Macer
10 NAME OF
FATHER
George Bolton
11 BIRTHPLACE
OF FATHER
(State or country)
Mason
12 MAIDEN NAME
OF MOTHER
Marinda Gowe.
Maca.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Orrin Pierce.
(Address). E. b helmeford, Mare
16 Filed Jan. 25, 197 Eden = 14, Robbins
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Jan.
23.
(Month)
(Day)
191.2.
.....
(Year
17
I HEREBY CERTIFY that I attended deceased trom
Nov 23
..... 1916, to
Jan. 23
......
that I last saw her alive on
......
Yan, 23, 1917
and that death occurred, on the date stated above, at 6.45Pm.
The CAUSE OF DEATH* was as follows :
Myocardial Negeneration
1
(Duration)
.yrs.
mos.
ds.
Contributory .... ".
(SECONDARY)
(Duration)
... yrs.
.. mos.
(Signed)
Archi S. Jeoforia, M.D.,
Jan 24 1017 (Address)
Etritual, 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
of death.
...... yrs.
In the
.mos.
.... mos. ....
.... ds.
State ....
........... yrs.
......
. ............ .
Where was disease contracted, If not at place of death ?.
Former or usual residence.
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
Edeon Cemetery, Jan. 26, 1912
20 UNDERTAKER
ADDRESS
Polowell, Maca.
1916- 83-
1833-0
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
7 AGE
(b) General nature of industry,
business, or establishment In
which employed (or employer) ...
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
... yrs.
2.28 E Chelmsford (City ogxown.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
St. ;...................... ... Ward)
....
... d
......
7 ...
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of oceu- 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, 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 necded. 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 dutics 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, 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: Farmcr (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 affection with respect to time and causation), using always the samc accepted term for the same disease. Examples: Cerebro-spinal fcver (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber
culosis of lungs, meninges, peritonacum, ete., Carcinoma, Sar- coma, etc., of. ......... .. (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (sceond- 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" (merely symptomatic), "Atrophy," "Collapsc," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhagc," "Inanition," "Marasmus," "Old age," "Shock," "Uracmia," "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 diseasc, 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 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 DANVERS State Hosts.
St. ;.. .............. .. Ward)
229 DANVER'S .......
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
South Chelmsford
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX J'enale
4 COLOR OR RACE
white
5 SINGLE
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
$ DATE OF BIRTH
(Month) (Day)
- (Year)
7 AGE
66
.......... yrs. mos. ds.
....... min. ?
& 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)
Hudson N. H.
10 NAME OF FATHER
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME
OF MOTHER
1ª BIRTHPLACE OF MOTHER (State or country)
"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Eustis Rock
(Address)
Hathorne Masa.
16 Filed Jan 1919 Julius Wcale
...... REGISTRAN
10 DATE OF DEATH
1an
25
1917
(Month)
(Day)
(Year)
17 I HEREBY CERTIFY thatal attended deceased from
1916
Jan. 25
1917
to.
2 4 1917 and that death occurred, on the date stated above, at. 7.4. m.
The CAUSE OF DEATH* was as follows :
Einbral Hemorrhage
... mos.
.ds.
Contributory ...
(SLCONDARY)
(Duration) yrs.
mos. d 3.
Anna H. Kandil
M.D.
(Signed)
1917
(Address).
Hathorne
* If death followed infury 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 /2
.yrs
6
mos.
19 ds.
In the
State .....
... yrs.
... mos.
.. ds
Where was disease contracted, If not at place of death ?.
Former or usual residence ..
DATE OF BURIAL
19 PLACE OF BURIAL OR REMOVAL Middleton Gem
1917
20 UNDERTAKER
4. & Rud
ADDRESS
Hathorne
41
MEDICAL CERTIFICATE OF DEATH
If LESS than
1 day ......... hrs.
that I last saw høy alive on
(Duration).
Hydrostatic Pneumonia
vrs.
......
important. See instructions on back of certificate.
Cynthia &. Melvin
STANDARD CERTIFICATE OF DEAT'
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, 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," ete., 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 faet 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 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 "Epidemic eerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never ro- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite); Tuber-
culosis of lungs, meninges, peritonacum, etc., Careinoma, Sar- eoma, 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, etc. The contributory (second- ary or intereurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary.), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- aemia" (merely symptomatic), "Atrophy," "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 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.
1
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.
R 18. 3-'16. 10,000.
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH East Clubsford (No 1545 Torhaus
St. : .................... .Ward)
2.30 East Chelmsford ...... (City or town. {If death occurred in a hospital or institution, give its NAME Instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED™
(Write the word)
Single
· DATE OF BIRTH april 9 1906 17
(Month)
(Day)
(Year)
If LESS than [ day ........ hrs.
........ min. ?
(a) Trade, profession, or
particular kind of work
at School
9 BIRTHPLACE (State or country) Tewksbury Wars
10 NAME OF
FATHER
Joseph Peltier
11 BIRTHPLACE
OF FATHER
(State or country)
Canada
12 MAIDEN. NAME
OF MOTHER
Theeria Wall
"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mrs. Warthatslov E
1545 Jordanist
16 Filed Jam 30, 1917 Edward J. Robbins
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
May
(Month) 27 1
(Day
191 (Year)
I HEREBY CERTIFY that I attended deceased from
4cm, 27de
...... .
1917, to Cam 2010
191.7.,
....
that I last saw h alive on.
Sam 28d
191.7 ...
and that death occurred, on the date stated above, at 3 307 m.
The CAUSE OF DEATH* was as follows :
Bronchial Pneumonia
.......
... (Duration) ................ yrs. ................ mos.
............... ds.
N
.
Contributory
acute Brighis
....
(SECONDARY)
.. (Duration) ..........
.yrs.
mos. 47 ds.
(Signed)
Wieder Jawym
....
M.D.
. 1917 (Address) Cs less Linach den
/ * 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.
.. yrs.
Where was disease contracted, If not at place of death ?.
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL Waslawn Cemetery
DATE OF BURIAL
Jan 31, 19/1
20 UNDERTAKER Se I Zastuans
ADDRESS
363 Ruda St
3 SEX Male 4 COLOR OR RACE White 7 AGE 10 yra. OCCUPATION (b) General nature of industry, business, or establishment In which employed (or employer) ... PARENTS 13 BIRTHPLACE Batimuns OF. MOTHER (State or country) (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 ......... ...... yrs. 9 mos 19) .mos ..
Joseph Wall Flower ' FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
1545 Yorlar St
Registered No.
8
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; 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," "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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