USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1917-1918 > Part 48
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3 SEX
mals
4 COLOR OR RACE
Mets
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Grace
Binno
G DATE OF BIRTH (month, day, and year)
why22.1671
7 AGE
Years
47
Months
/
Days
2F
If LESS than 1 day, ........ hrs. or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
Metal Polisher
particular kind of work ..
(b) General nature of industry,
business, or establishment in
which employed (or employer)
(c) Name of employer
Marking Uhol
9 BIRTHPLACE (city or town). (State or conntry)
10 NAME OF FATHER -
PARENTS
11 BIRTHPLACE OF FATHER (eity or tovyn) ....... (State or country)
12 MAIDEN NAME OF MOTHER
ER @home Pluget 1/1910 (Address) Rachel
13 BIRTHPLACE OF MOTHER (city or town) .... (State or country)
The Commonwealth of Massachusetts
City.
No.
Michael falch
(If in the Army or Navy of the United States, give rank, organization, cte.) .....
(If non-resident give city or town and Stato)
(duration)
... yrs ...
... Jos ...........
ds.
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 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, 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 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 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- eated 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; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toneum, ctc., 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 ds .; 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 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- terminc definitely. Examples: Accidental drowning; Struck by railway train -- accident; Revolver wound of head - homicide; Poisoncd 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." (Recommendations on statement of cause of death approved by Committee 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 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, 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. 10-'18. 5,000.
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,
of certificate.
14 Mes Alle . Sheehan Vister
Informant
(Address)
Cheliv And Man's
15
Filed
Nov. 22 018 Edward S. Rubbing
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATHI (month, day, and year)
nov. 21
19 / 8
17
I HEREBY CERTIFY, That I attended deceased from
Oct. 1
1918, to.
nor. 21
1918
that I last saw h Ir alive on
nov. 20
.... ,
1918
and that death occurred, on the date stated above, at
11,30 0.
m.
The CAUSE OF DEATH* was as follows:
burrhoses
of Liver.
.. (duration)
/
yrs.
mos ..
ds.
CONTRIBUTORY.
(SECONOARY)
_(duration)
... yrs ..
.mos.
ds.
18 Where was disease contracted
if not at place of death ?
Did an operation precede death?
no. Dat
Date of X
Was there an autopsy ?.
220.
What test confirmed diagnosis ?..
1 ×
Amusa Itoward,
LI.D.
, 19
(Address)
Chelmsford, lars,
.. ,
* 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
St. Taking. Country
20 UNDERTAKER
ADDRESS 324 Maiset VS.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Fechala Meter
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) marked
5a If married, widowed, or divorced
HUSBAND of
(o:) WIFE of
Edward Tuas
6 DATE OF BIRTH (month, day, and year)
11884
7 AGE
34
Years
Months
Days
If LESS than 1 day, ........ hrs. or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particular kind of work ..
at Nower
(b) General nature of industry,
business, or establishment in
which employed (or employer)
(c) Name of employer
"
9 BIRTHPLACE (city or town) 9 ore
(State or country)
maso
10 NAME OF FATHER Daniel Smakuy
11 BIRTHPLACE OF FATHER (city or town).
(State or country)
reland
(Signed)
......
12 MAIDEN NAME OF MOTHER Many Calor
13 BIRTHPLACE OF MOTHER (city or town)] .. (State or country) Teland
153 / Cheleurford Jaso
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
Ceity or town)
95
Township
Chelen And
State
....... or Village ..
or
City No.
... Ward
St., ...........
Of death occurred in a hospital or institution, give its NAME instead of street and number) auno
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence.
No.
Chelen ford Mais
.St.
................ Ward.
(If non-resident give city or town and State)
(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 birtb ?
years
months
days
1 PLACE OF DEATH
County ..........
Middlead
Registered No.
2 FULL NAME
IND
MARGIN RESERVED FOR BINDING
PARENTS
......
....
DATE OF BURIAL Los 23/ 2018
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 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 Ptanter, 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 form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precisc. 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 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 "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("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); Mcasles; 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 ds .; 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 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
under the head of "Contributory." (Recommendations on statement of cause of death approved by Committee 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 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, 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. 10-'18. 5,000.
MARGIN RESERVED FOR BINDING
2 FULL NAME 3 SEX 7 AGE (a) Trade, profession, or particular kind of work. PARENTS 14 (Address) 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, of certificate. N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should bo (h) General nature of industry, business, or establishment in which employed (or employer) (c) Name of employer
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) *engle
5a If married, widowed, or divorced HUSBAND of (01) WIFE of
6 DATE OF BIRTH (month, day, and year) Dec 11-1890
Years 2x 27
Months
11
Days
15
If LESS than 1 day, ........ hrs. or ........ min.
8 OCCUPATION OF DECEASED
9 BIRTHPLACE (eity or town).
(State or country) 3. 2.
10 NAME OF FATHER thathe Drethe me
11 BIRTHPLACE OF FATHER (city or town) .. .....
(State or country)
12 MAIDEN NAME OF MOTHER in ma torget
13 BIRTHPLACE OF MOTHER (city or towyde Elisabeth (State or country) 02.
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)
Icolorial M.D.
1.27.198 (Address)
* State the DISEASE CAUSING DEATHI, OF In deaths from VIOLENT CAUSES. state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional spacc.)
DATE OF BURIAL 19 PLACE OF BURIAL, CREMATION, OR REMOVAL St Josephnelmodo Nov 291911
20 UNDERTAKER
ADDRESS
15 Filed 7.02.28, 1918 Edward S. Robimy .REGISTRAR
154
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
(City or tow )
96
Registered No.
or Village ..
.or
St., ...
...........
... Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
(a) Residence.
No.
Chelmsford
„St.,
Ward.
...
(If non-resident give city or town and Stat ))
(Usual place of abode)
Length of residence in city or town where death occurred
7 years months
days.
How long ia U. S., if of foreign birth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
nor 26
19 / /
17
I HEREBY CERTIFY, That I attended deceased from
August
, 19 ............ , to ..........
Nov.27
I8
.......
.. , 19.
that I last saw her
... alive on
Nov.26
I8
.,19.
and that death occurred, on the date stated above, at
The CAUSE OF DEATH* was as follows : Valvular Heart Disease
....
6 or 7 years (uration)
yrs ..
mos ....
... ds.
...... .......
CONTRIBUTORY (SECONDARY)
-(duration)
..... yr5 ...
.mos.
ds.
Informant
hadren Nec fanns
State mas ...
1 PLACE OF DEATH
County puedeetc
Township Chelmsford
City Of
No.
.. , ...
(If in the Army or Navy of the United States, give rank, organization, etc.)
..........
n
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 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 Ptanter, 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 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, ctc. 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 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 "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("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 ds .; 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," "Scnile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," ctc., when a definite discasc 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 hcad - homicide; Poisoncd by carbolic acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., scpsis, tetanus) may be stated
under the head of "Contributory." (Recommendations on statement of cause of death approved by Committee 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 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, 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 13. 10-'18. 5,000.
MARGIN RESERVED FOR BINDING
1 PLACE OF DEATH
County.
Medey
(Usuai place of abode)
Length of residence in city or town where death occurred
years
4 COLOR OR RACE
white
Months
8 OCCUPATION OF DECEASED
(State or country)
M. W.
so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back
particular kind of work
at home
9 BIRTHPLACE (city or town).
Henniker
10 NAME OF FATHER
John Hathorne
11 BIRTHPLACE OF FATHER (city or town) Henniker (State or country) IV. H.
12 MAIDEN NAME OF MOTHER
-
Leslie
13 BIRTHPLACE OF MOTHER (city or town) Waser (State or country) N.H
Informant
Frank & Luce (San)
(Address)
West Chelmsford
15 Filed Dra 1 1918 Edemand Spotting
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
nor 28 - 19/8
17
I HEREBY CERTIFY, That I attended deceased from
Har 15
19 07 to Her 28
1910
that I last saw ha alive on
9.40 P.
and that death occurred, on the date stated above, at
The CAUSE OF DEATH* was as follows :
Senility
.(duration)
yrs.
.. mos.
ds.
CONTRIBUTORY
(SECONDARY)
.(duration)
.... yrs .....
... mos.
14
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)
Ford Unravey
M.D.
130 29/19. (Address)
* State the DISEASE CAUSING DEATH, 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 spaee.)
Centre Unitiet N. H.
DATE OF BURIAL Die 2 19/8
20 UNDERTAKER ADDRESS Walter Teshar Chylusford
3 SEX 7. 7 AGE Years 92 (a) Trade, profession, or PARENTS 14 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 (b) General nature of industry, business, or establishment in wbich employed (or employer) (c) Name of employer
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
155 Chelunsford.
(City of town)
97
Township
next Chelmsford
.. or Village ..
or
City No.
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number )
2 FULL NAME
Caroline, Ce Lull
(a) Residence. No ...
West Chickensford
St ..
.. Ward.
.....
(If non-resident give city or town and State)
days.
How long in U. S., if of foreign birth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Nathaniel a. Luce
6 DATE OF BIRTH (month, day, and year) Feb, 15.1826
Days 13
If LESS than
I day, ........ brs.
or ........ min.
months
State
Mass
Registered No.
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH
[Approved by U. S. Census and American Public Health Association]
Statement of occupation. - Precisc statement of oceupa- tion 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, Compos- itor, Architect, Locomotive enginccr, Civil engineer, Stationary fireman, ete. But in many eases, 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," ete., without more precise specifieation, as Day laborer, Farm laborer, Laborer - Coal mine, ete. Women at home, who are engaged in the duties of the household only (not paid Housckecpcrs 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- eifically the occupations of persons engaged in domestic serviee for wages, as Servant, Cook, Houscmaid, ete. It the oeeupation has been changed or given up on aeeount of the DISEASE CAUSING DEATH, state oeeupation at beginning of illness. If retired from business, that faet may be indi- eated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
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