USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1917-1918 > Part 9
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Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51
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, ctc.
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 Commmwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Theles for And Maso IN Putuaus aur
St. ;..
Ward)
(City or own.) [lf death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME
Harold Nucleus
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Putwany avr Cheles And Guter
Registered No.
32
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
Mali Mutar
lutar
| 5 SINGLE,
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word)
Single
$ DATE OF BIRTH
may
(Month))
13
1980
(Day)
(Year)
7 AGE
If LESS than I day ......... hrs.
........ min. ?
OCCUPATION
(a) Trade, profession, or
particular kind of work.
School Boy
(b) General nature of Industry,
business, or establishment In
which employed (or employer).
student
9 BIRTHPLACE
(State or country)
Lowell Maso
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
try) Healing F.G.
12 MAIDEN NAME
OF MOTHER
Margaret Menphy
11 BIRTHPLACE OF MOTHER (State or country) Chatham J. B
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant).
(Address) Putudue ave. Cheles ford Yas
15 Filed May 24, 1917 Edward f. Nothing
REGISTRAIT
...
17
I HEREBY CERTIFY that ! attended deceased from
May 17, 1911, to
May 24 1917
.......
that I last saw him alive on.
2. 1917.
and that death occurred, on the date stated above, at
m.
The CAUSE OF DEATH* was as follows :
Nikucheria Haral +Tomadas
.(Duration)
... yrs.
.. mos.
3
ds.
Contributory.
menoles
(SLCONDARY)
abach
(Duration)
y's.
.mos.
7
.... ds.
(Signed)
Arthur Icoloria.
M.D.
May 201 197
( Address)
Chulicefor, mac.
* If death followed injury or violenee the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
In the
At place
of death
... yrs.
.mos.
... ds.
State ...
....... yrs. ..........
... mos.
ds.
Where was disease contracted, If not at place of death 7.
Former or usual residence
19 PLACE OF BURIAL OR REMOVEY Quel I. Patur. Center
DATE OF BURIAL
May 24. 1917
20 UNDERTAKER
....
10 DATE OF DEATH
24
.... .
1917.
(Month)
(Day)
( Year)
7
...... yrs.
mos.
11
ds.
10 NAME OF
FATHER
Driving Parlow
MARGIN RESERVED FOR BINDING
Theles ford Mas
ADDRESS
324 may
Car-
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- 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-
-.... vautti is less definite; avoid usc 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 ali 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. Deatlıs 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 Male 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 Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1PLACE OF DEATH Chelmsford Mass (No Westford Road St. : Ward)
Donald Walker
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
? FULL NAME [If married or divorced woman or widow give maiden name, also name of busband.] @RESIDENCE Chelmsford Dass
PERSONAL AND STATISTICAL PARTICULARS
· DATE OF BIRTH May
15
-
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
(Stato or country)
Chelmsford Mass
10 NAME OF
FATHER
11 BIRTHPLACE
OF FATHER
(State or country)
12 MAIDEN NAME
OF MOTHER
Othel M Walker.
(State or country)
13 BIRTHPLACE
OF MOTHER
Nova Scotia
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mrs Edward R. Jones
(Address)
Maine
Filed
7may 26, 19 7 Edward J. Robbins
REGISTRAFT
MEDICAL CERTIFICATE OF DEATH
10 DATE OF DEATH
(Month)
(Day)
1917
(Year)
17 I HEREBY CERTIFY that I attended deceased from ... 1917. May 15, 1917 to May 25 ...... that I last saw him alive on May 23 ......... . , 1917. and that death occurred, on the date stated above, at 1:30pm. The CAUSE OF DEATH* was as follows :
.(Duration)
........... yrs.
mos.
ds.
Contributory
(SECONDARY)
(Duration)
.......
... yrs.
.mos.
ds
(Signed)
7 E Varney
M.D.
May. 26, 1917 (Address).
....
* If death followed injury or violence the certificate of death must be made out by tho 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 REMOVAL
DATE OF BURIAL
Wistwor emitir May 26,
1917
" UNDERTAKER Simmons + Brown
Branch St Pourle.
8
Registered No.
33
' COLOR OR RACE
White
6 SINGLE
MARRIED,
WIDOWED
OR DIVORCED
(Write tho word)
250
.....
einoma, Sar-
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 If in"
coma, Jancer" is less
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 symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," "Inanition," "Marasmus," "Old agc," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertaincd 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.
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See Instructions on back of certificate. N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should stato 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
No. Chelmsford
(No.
Middlesex
St. ;..
................
.Ward)
" FULL NAME
Fiss Annie Gertrude Welch
[If married or divorced woman or widow
give maiden name, also name of husband .!
@RESIDENCE
Middlesex cor Church Sts. N. Chelmsford
Registered No.
34
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
8 SEX
female
4 COLOR OR RACE
white
5 SINGLE,
MARRIED
WIDOWED,
single
OR DIVORCED
(Write the word)
· DATE OF BIRTH
(Month)
(Day)
1 (Year)
T AGE
If LESS than
i day ......... hrs.
25
........ yrs. .. mos. ds.
or ......... min. ?
* OCCUPATION
(a) Trade, profession, or
particular kind of work
At. Home
(b) General nature of Industry, business, or establishment in which employed (or employer) ....
9 BIRTHPLACE
(State or country)
No. Chelmsford
.(Duration) .....
yrs,
.... mos.
ds.
Contributory ...
.......
general Debility
....
(SECONDARY)
.. (Duration)
............. yrs.
.......
.mos.
.................
ds.
M.D.
(Signed)
May 31, 19 ...
(Address) ..
Tto chelunland
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
IS LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR
RECENT RESIDENTS).
At place
In the
of death
... yrs.
.... mos.
ds.
State ..
mos.
ds.
.......
... yrs.
Where was disease contracted, If not at place of death ?..
Former or usual residence.
19 PLACE OF BURIAL OR REMOVAL
St. Patrick's Lowell
DATE OF BURIAL
June
3
191 7
(Address) Middlesex St. N. Chelmsford
Filed Jame 2, 1917 Edward X. Robbery
REGISTRAR
17 HEREBY CERTIFY that I attended deceased from
mit,de, 1917, to
May 20, 1917
..........
that I last saw her alive on.
May 20, 1917
and that death occurred, on the date stated above, at 9P
.m.
The CAUSE OF DEATH" was as follows :
Mitral Regurgitation
10 NAME OF
FATHER
Richard Welch
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Lowell, Mass.
12 MAIDEN NAME
OF MOTHER
Margaret Longhue
1ª BIRTHPLACE
OF MOTHER
(State or country)
Lowell, Mass.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mrs. Margaret Welch
20 UNDERTAKER 08Connell & Meck.
ADDRESS.
658 Corham
Lower
...
16 DATE OF DEATH
May
30
1917
(Year)
(Month)
(Day)
MARGIN RESERVED FOR BINDING
N .
Chelmsford (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
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 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," ctc., without more precise specification, as Day laborer, Farm laborer, Laborcr - Coal mine, etc. Women at home, who arc 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 Nonc.
Statement of cause of death. - Name, first, the DIS- EASE CAUSING DEATH (the primary affection with respect to timc and causation), using always the same accepted term for the same discase. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid usc of "Croup"); Typhoid fever (never rc- 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) ; Measles; Whooping cough; Chronic valvular heart discasc; 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 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 ascertaincd 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.
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.
Oliver
3 SEX
5 SINGLE
Male
4 COLOR OR RACE
-
WIDOWED,
OR DIVORCED
(Write the word)
-
· DATE OF BIRTH
June
5
(Month)
(Day)
7 AGE
-
2
8 OCCUPATION
(a) Trade, profession, or
particular kind of work.
(b) General nature of industry,
business, or establishment In
which employed (or employer).
11 BIRTHPLACE
OF FATHER
(State or country)
Canada
PARENTS
13 BIRTHPLACE
OF MOTHER
(State or country)
Canada
(Informant)
Hather
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
............. yra.
mos.
...
..........
ds.
·MARRIED
single
1917
(Year
If LESS than
I day ..
...... bfs.
or ......... min. ?
-
16 DATE OF DEATH
I HEREBY CERTIFY that I attended deceased from
5
......... , 1917 ., to
1917.
that I last saw hace alive on.
.... .
... 1917.
and that death occurred, on the date stated above, at 1 Pm.
The CAUSE OF DEATH* was-as follows :
(Duration) .
yrs. .............
mos.
ds.
Contributory ..
(SECONDARY)
(Duration).
...... MOST
................. s.
(Signed)
M.D.
June7, 1917 (Address) 199 Mark21
* 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
.. y:s.
............ mos.
ds ...
Where was dlsease contracted, If not at place of death ?
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL St Patrick
DATE OF BURIAL
June 8
191
16 Filed_ 0
REGISTRAR
10
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
7 PLACE OF DEATH
No. Chelmsford
(No.
Cottage low St
Ward)
00 fingere.
(City or town.)
fif 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
Optage Row
Registered No.
35
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
(Month)
7
(Day) 1917 ....
(Year)
9 BIRTHPLACE
(State of country) Worth Chelmsford
10 NAME OF
FATHER
Joseph Fungere
12 MAIDEN NAMÉ OF MOTHER Deline Marcoux
14 THE ABOVE IS THUE TO THE BEST OF MY KNOWLEDGE
(Address)
20 UNDERTAKER ADDRESS Lead Molloy Lowell.
....
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 cach 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, peritoneum, 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 (discase 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 Aiseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia,", "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
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