USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1917-1918 > Part 34
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June 12
19/8
17 I HEREBY CERTIFY, That I attended deceased from January 1917, to June 12. 1918
les 12
198
that I last saw him alive on
....
and that death occurred, on the date stated above, at 2 G, M .-
The CAUSE OF DEATH* was as follows :
(duration) ...
2
.. yrs .....
... mos ..
ds.
CONTRIBUTORY.
(SECONDARY)
alcohol= sophiled ?)
.... (duration)
.yrs ..
18 Where was disease contracted if not at place of death?
Did an operation precede death ?
Date of.
Was there an autopsy ?.
Sigoed).
Lud EJanney
/14, 19/8 (Address) North Chelich fand Mars
* State the DISEASE CAUSING DEATHI, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional space.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
Riverside Cemetery.
No. Chelmsford, Hace. June 15. 1918.
20 UNDERTAKER
ADDRESS
19 Branch &q
.mos ..
ds.
M.D.
of certificate.
City
No
(If non-resident give city or town and State)
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH [Approved by U. S. Census and American Public Health Association]
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healtlifulness 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, Compos- itor, Architeet, Locomotive 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) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial 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 Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the oceupation 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 indi- cated 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: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronehopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toneum, etc., Carcinoma, Sarcoma, 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 (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 &s .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Con-
genital," "Senile," etc.), "Dropsy," "Exhaustion,"
" 'Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertaincd as the cause. Always qualify all diseases resulting from child- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS STATE MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, or HOMICIDAL, or as probably sueh, if impossible to de- termine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoncd by earbolie acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may be stated
under the head of "Contributorv." (Recommendations on statement of cause of death approved by Committec on Nomenclature of the American Medical Association.)
Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Merlina" 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, Exposure, cte.
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.
ADDITIONAL SPACE
FOR FURTHER STATEMENTS BY
PHYSICIAN.
R 15. 1-'18. 100,000.
1917 - 1834-
83.
MARGIN RESERVED FOR BINDING
N. B. - WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should be so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
105 No. Chelmsford. (City-ortowny
1 PLACE OF DEATH
County Middlesex
State.
Mare.
.Registered No.
47
Township
... or Village
No. Chelmsford
.. or
St. .. Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Lydia Ar Greener
(a) Residence.
No
Middles
St.,
.. Ward.
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
days.
How long in U. S., if of foreign birth ?
years
months days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female.
4 COLOR OR RACE
White
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Oliver M. Greener
6 DATE OF BIRTH (month, day, and year) July 20.1834.
7 AGE 83
Years
Months
10
Days
26
If LESS than I day, ........ hrs. or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
At Home.
particular kiod of work.
(b) General nature of industry,
business, or establishment in
which employed (or employer).
(c) Name of employer
At Home.
ne
CONTRIBUTORY.
(SECONDARY)
.. (duration)
yrs ..
.. mos ..
ds.
9 BIRTHPLACE (city or town).
Ashley, Masa
(State or country)
10 NAME OF FATHER
William Greene,
11 BIRTHPLACE OF FATHER (city or town) (Ashby Maso (State or country)
12 MAIDEN NAME OF MOTHER Sally Whitcomb
13 BIRTHPLACE OF MOTHER (city of town) Action (State or country) Macer
14
wilfred y Greene.
Informant (Address) No. Chelmsford Mare.
15
Filed June 16. 2015 Edward ProPachino
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year) June 15. 1918.
17 I HEREBY CERTIFY, That I attended deceased from 19/F. to
that I last saw h Ar alive on
Som 13
..... 1918
4A
and that death occurred, on the date stated above, at
.......
.m.
The CAUSE OF DEATH* was as follows :
Werno Carcinoma
(duration)
.yrs ..
mos ..
ds.
18 Where was disease contracted
if not at place of death ?
Did an operation precede death?
Date of ...
Was there an autopsy ?.
What test confirmed diagnosis ?
(Signed)
Fred Eljames
M.D.
2/16, 19/8 (Address)
* State the DISEASE CAUSING DEATII, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional space.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL Mot. Freake Cemetery Waltham, Mara
DATE OF BURIAL June 17. 19 18.
20 UNDERTAKER
GromHealey,
ADDRESS
79 Branch Sq.
PARENTS
of certificate.
City.
No.
(If non-resident give city or town and State)
REVISED UNITED STAT
[Approved by U. S. Census av.
F DEATH
Statement of occupatien. - 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, Compos- itor, Architeet, Locomotive enginecr, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial worked on inay 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, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically 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 aceount of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indi- eated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death .- Namc, first, the DISEASE CAUSING DEATH (the primary affection with respect to timc and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronehopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toneum, etc., Carcinoma, Sarcoma, etc., of.
(naine origin; "Caneer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ete. The contributory (secondary or inter- current) affeetion need not be stated unless important. Example: Measles (disease causing death), 29 Gs .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy,"* "Col- lapse," "Coma,"" "Convulsions," "Debility" ("Con- genital," "Senile," "Dropsy," etc.), "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "'Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from child- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS STATE MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, or HOMICIDAL, or as probably such, if impossible to de- termine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoned by carbolic acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may be stated
. head of "Contrib' on statement of cause of
mmen
on Nomenclature of the Alicu Cases for the Medical Exam
sions of chapter 24 of the R following conditions Examiners:
Comin Association the provi- under the e Medical
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, Exposure, 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.
ADDITIONAL SPACE FOR FURTHER STATEMENTS BY
PHYSICIAN.
R 15. 1-'18. 100,000.
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
1PLACE OF DEATH
No. Chelmsford
(No.).
Bolu. R.R. Cwiring
St.
albus Quit
,
2 FULL NAME {If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE No. Brook field, hadd.
Registered No.
1.8
PERSONAL AND STATISTICAL PARTICULARS
3 SEX male
4 COLOR OR RACE
Mite
5 SINGLE,
MARRIED
WIDOWED,
OR DIVORCED
(Write the word)
Single
6 DATE OF BIRTH
(Month) /
(Day)
16
1891
(Year)
7 AGE
26
. 10
mos.
6
ds.
8 OCCUPATION (a) Trade, profession, or particular kind of work
Manager
(b) General nature of industry, business, or establishment in which employed (or employer) ..
automobile
(Duration) ...
.......
... yrs.
mos.
ds.
Contributory. (SECONDARY)
... yrs.
mos.
ds.
.. ,
M.D.
(Signed) you. 27, 1018 (Address). MEDICAL EXAMINER
* State the DISEASE CAUSING DEATH, or, in deaths from VIOLENT CAUSES, state (1) MEANS of INJURY; and (2) whether ACCIDENTAL, SUICIDAL or HOMICIDAL.
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
CO UNDERTAKER
ADDRESS 324 Barros
Poury
16 DATE OF DEATH
(Month)
(Day)
( Year
17 1 HEREBY CERTIFY that I have investigated the death of the deceased.
If LESS than i day ...... hrs. The CAUSE OF DEATH* was as follows : - Compound Fracture Du rismo or ........ min. ? men's of body- 1
9 BIRTHPLACE (State or country) - Lott Brook field Bass
10 NAME OF FATHER
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
Queland
12 MAIDEN NAME OF MOTHER
Budget Dunfer
13 BIRTHPLACE OF MOTHER (State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Steffen Que father
(Address)
15 File June 22, 1918 Edward & Robbins
REGISTRAR
106
Cheles ford (Unity or town.) Ward) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
MARGIN RESERVED FOR BINDING
important. See instructions on back of certificate.
MEDICAL CERTIFICATE OF DEATH
191
....
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, 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 minc, etc. Women at home, who are engaged in the duties of the household only (not paid House- kcepers 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, ete. 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 oecu- 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 "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, peritonacum, etc., Carcinoma, Sar- coma, etc., of .(name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Mcasles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ctc. The contributory (second- ary or intercurrent) affection necd not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- acınia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Dcbility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease ean be aseertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicacmia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS State MEANS OF INJURY and qualify as ACCI- DENTAL, SUICIDAL, or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoned by carbolic acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis tetanus) may be stated under the head of "Contributory."
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 onc supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
R 16. 1'17. 10,000.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
State
Maso
Registered No. 49
or Village
.. or
St.
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Rosanna Lachance
(a) Residence. No.
actor fr.
St.,
.Ward.
(If non-resident give city or town and State)
days
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Single.
6 DATE OF BIRTH (month, day, and year) Del 1869.
If LESS than
I day, ........ hrs.
or ........ min.
10 NAME OF FATHER Horace Lachance
Su Baruta
Q.2.
12 MAIDEN NAME OF MOTHER Celina Larcuierd
13 BIRTHPLACE OF MOTHER (city or town) ...
(State or country)
Vermont
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
July x
19 / 5
17 I HEREBY CERTIFY, That I attended deceased from
22
Ink 4
19.18
.. , to
that I last saw her
.... alive on
,1918
and that death occurred, on the date stated above, at 10 ... m.
The CAUSE OF DEATH* was as follows : Discou of Mitral Nacre
Attro Scherario-
Embolism of vessels ofinglés.
foot and lead.
uration)
CONTRIBUTORY
SISECONDARY)
(duration)
.yrs ..
mos ..
12
ds.
18 Where was disease contracted
if not at place of death?
Did an operation precede death?
two -Date of.
Was there an autopsy ?.
no.
What test confirmed diagnosi ?..
(Sigoed)
Autun cobora
M.D.
/4, 19/8 (Address)
Chilenafon, maso.
* State tho DISEASE CAUSING DEATHY, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional space.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
Le Joseph pelmatoriJuly 6 2015
20 UNDERTAKER
A albero
ADDRESS 17/Cube
15 Filed July 4 1918 Edward Do Mat Ton REGISTRAR
107
Chelmsford (City of town)
MARGIN RESERVED FOR BINDING
1 PLACE OF DEATH
County ....
Township
City.
No.
(Usual place of abode)
Length of residence in city or town wbare death occurred
years
3 SEX
4 COLOR OR RACE
W.
1
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
7 AGE
Years
Months
Days
47
6
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particolar kiod of work
atHome
(b) General nature of industry,
business, or establishment io
which employed (or employer)
(c) Name of employer
9 BIRTHPLACE (city or town)
Spencer
11 BIRTHPLACE OF FATHER (city or town)
(State or country)
PARENTS
14
Informant
mro J. N. Cratt
(Address)
acton
carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,
of certificate.
N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should be
so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back
(State or country)
maro.
months
days.
How long in U. S., if of foreign birth ?
years
mooths
1918
.. yrs .....
Omos
mos ...
ds.
REVISED UNITED STATES STANDARD CERTIFICAT [Approved by U. S. Census and American Public Hecht
Statement of occupation. - Precise statement
tion is very important, so that the relative boa various pursuits can be known. The ques' 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, Compos- itor, Architect, Locomotive 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) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial worked on may forin 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 Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Houscmaid, etc. It 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 indi- cated 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: Cerebrospinal fever (the only definite synonym is "Epidemie cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fcver (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- loneum, etc., Carcinoma, Sarcoma, etc., of_
(name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Mcasles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The eontributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 Gs .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" (“Con-
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