USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 17
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Medical examiners shall, in all cases, certify to the city or town elerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise
a description of such person, as full as may be, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are sup- posed to have come to their death by violence. - Revised Laws, Chap. 24, See. 8.
RULES OF PRACTICE
The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness. from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such · deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from in- jury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medieal Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are knewn. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) eaused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homi- cidal." "Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of ether administered as a surgical anasthetic." "Fracture of the skull with associated internal injury sustained under eircumstances unknown."
If investigation shows the death to have been due to dis- ease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal gangloid) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS : No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have come to his death by violence, until a permit in writing, signed by the Medical Examiner, has first been obtained. - Revised Laws, Chap. 24, Sec. 20.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
FORM R-301
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
216
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
1 PLACE OF DEATH
County.
Middlesex
State Mass
Registered No. 51
City or Town No. Chelsmford
No.
West Chelmsford Road
St.
.Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Joseph Liebedzinski
( If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence. No ...
West Chelsmford Road
St.,
Ward.
(If non-resident give city or town and Statc)
( Usual place of abode)
Length of residence in city or town where death occurred
years
5
months
days.
How long in U. S., if of foreign hirth ?
years
mooths
days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
mæle
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR
white
DIVORCED (write the word)
signie
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 DATE OF BIRTH
Jan.
14
1.91.9
( Month)
(Day)
(Year)
7 AGE
Years
6
Months
16 Days
If LESS than
If STILLBORN, enter that fact here
1 day, ........ hrs.
If STILLBORN, state period of uterogestation
mos.
or ....... min.
8 OCCUPATION OF DECEASED (a) Trade, profession, or none
particular kind of work ... (h) General nature of industry, husioess, or establishment in which employed ( or employer ).
(c) Name of employer
9 BIRTHPLACE (City)
No. Chelmsford
(State or country)
10 NAME OF Michael Liebedzinski FATHER
PARENTS
11 BIRTHPLACE OF FATHER (City). (State or country) Russia
12 MAIDEN NAME OF MOTHER Mary Saloka
13 BIRTHPLACE OF MOTHER (City) (State or country) Russia
2
4919
Date
(Monthy
(Day)
(Year)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
St. Patricks
Lowell
DATE OF BURIAL
July3,19
19
(Cemetery)
(City or town)
20 UNDERTAKER John L. McDonough
176
ADDRESS
Gorham
Lovell
21 | HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the hurial or transit permit was issued ...
Edward J. Robbing
position.
Official Canon Clerk
22 Date of issue of burial or transit permit .. al July 2, 1919
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH
10_'18. 100,000.
14 Michael Liebedzinski
Informant
(Address) No. chelmsford Mass /
15 July 2, 1919 Edward J. Robbers REGISTRAR
Filed (Month)/(Day) (Year)
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH July
(Monthy
(Day)
(Year)
17 I HEREBY CERTIFY, That I attended deceased from
20, 1919, to Zudo
, 19 ./ ........
that I last saw halive on
4.0
and that death occurred, on the date stated above, at.
m.
The CAUSE OF DEATH was as follows :
/ duration)
yrs ...
.mos ...
ds.
CONTRIBUTORY Dealscostante
(SECONDARY)
(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) ..
Frank & Thecity
M.D.
(Address) 20 Chel
MARGIN RESERVED FOR BINDING
.
2.1219
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH
[Approved by U. S. Census and American Public Health Association]
Statement of occupation. - Precise statement of occupation 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, 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 material worked on may form part of the second statement. Never return "Lahorer," "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 house- hold only (not paid Housekeepers who receive a definite salary), may he centered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should he taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has heen changed or given up on account of the DISEASE CAUSING DEATH, state occupation at heginning of illness. If retired from husiness, that fact may be indicated thus: Farmer (retired, 6 yrs.). T'or 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 discase. Examples: Cere- brospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Broncho pneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, 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 he stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," otc.), "Dropsy,""Exhaustion,""Heart failure," "Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite disease can he ascertaincd as tho cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.
State cause for which surgical operation was undertaken.
(Recommendations on statement of cause of death approved hy Com- mittee on Nomenclature of the American Medical Association.)
Bronchopneumonia: If primary cause, write the word "pri- mary" ; if secondary, give primary cause.
Certificates will be returned for additional information which give any of the following diseases, without explanation, as the ·, sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- · riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and helief the name of the deccased, his supposed age, the disease of which he died [defined so that it can be classified under the international classification of causes of death], where contracted, tho duration of his last illness, when last scen alive by the physician, and the date of his death. . . . - Revised Laws, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chap. 822.
No undertaker or other person shall bury a human body . . . until he has received a permit from the board of health or its agent, . . . or . . from the clerk of the city or town in which the person died; . . . no such permit shall be issued until there shall have been delivered to such board, agent or clerk, . . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which ... shall be accompanied by a satisfactory certificate of the at- tending physician, if any, as required by law, or in lieu thereof a certifi- cate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, the chairman of the board of health, if a physician, or any physician employed { by said board or by the selectmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner · only shall make such certificate. . . . The person to whom the pcr- mit is so given and the physician who certifies to the cause of death shall thereafter furnish for registration any other necessary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Revised Laws, Chap. 78, Sec. 38.
Medical examiners shall, in all cases, certify to the city or town clerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise a description of such person as full as may be, with the causo and manner of his death, and shall make cxamination upon the view of the dead hodies of only such persons as are supposed to have come to their death hy violence. - Revised Laws, Chap. 24, Sec. 8.
RULES OF PRACTICE
The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
.
MARGIN RESERVED FOR BINDING
County. 2 FULL NAME (a) Residence. 3 SEX Hemale 7 AGE Ycars 8.3 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 be (b) Geoeral nature of iodustry, business, or establishment io wbich employed (or employer) ... (c) Name of employer
The Commomuralth of Massachusetts
STANDARD CERTIFICATE OF DEATH
(City orcown)
1 PLACE OF DEATH
State.
mass
.....
Registered No. 52
Township
Chelmsford
.or Village ...
or
City No ..
... ,
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Julia am Seeme
(If in the Army or Navy of the United States, give rank, organization, etc.)
No ......
Locust Road
St.,
.........
.. Ward.
Leogth of residence io city or town where death occurred 50
years
months
days.
How long in U. S., if of foreign birth ?
years
mooths
days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
19/9
17 I HEREBY CERTIFY, That I attended deceased from July 4 1919, to Only 10, 1919.
that I last saw her
.......... alive on
Juh 10, 19 19.
and that death occurred, on the date stated above, at 10 G.
The CAUSE OF DEATH* was as follows :
Broncho- Pneumonia ...
Primary 710 .ds.
.(duration)
.yrs.
mos.
CONTRIBUTORY
(SECONDARY)
(duration)
.... yrs ....
.mos ..
ds.
18 Where was disease contracted
if not at place of death?
X
Did an operation precede death? To Date of X
...........
Was there an autopsy ?.
no.
What test confirmed diagnosis ?
(Signed).
Amarastoward.
M.D.
Das, 19 19 (Address)
Chelmsford Mass
* 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 space.)
Informant H.C. Breve
15 Filed July 13, 1919 Edward Y. Robbing
REGISTRAR
19 PLACE OF BURIAL, CREMATION, OR REMOVAL Florefracture Com
20 UNDERTAKER
Walter Perham
St.,
........ Ward
.....
(Usual place of abode)
4 COLOR OR RACE
white
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Widow
5a If married, widowed, or divorced
HUSBAND ·S
(01) WIFE of
alongo S. Greena
6 DATE OF BIRTH (month, day, and year)
6 Months
2 Days
If LESS than
1 day, ........ hrs.
or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
at home
9 BIRTHPLACE (city or town) Hoyboro mass · (State or country)
10 NAME OF FATHER Benis i+ Hodges
11 BIRTHPLACE OF FATHER (eity or town).
(State or country)
Sharon Man
12 MAIDEN NAME OF MOTHER Julia a Bassanes
13 BIRTHPLACE OF MOTHER (city or town) Horbare (State or country)
217
....
(If non-resident give city or town and State)
.......... m.
DATE OF BURIAL July 13 2019 ADDRESS Chelmsford.
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 "Laborcr," "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 employcd, 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 diseasc. 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," "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 diseascs 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. ª Examples: Accidental drowning; Struck by railway train - accident; Rcvolver 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.)
Casos 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, Drouming, 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.
FORM R-301
City or Town.
2 FULL NAME
(Usual place of abode)
3 SEX
4 COLOR OR RACE
Imale H hat.
5a If married, widowed, pr divorced
HUSBAND of
(or) WIFE of
Lean 3
( Month)
7 AGE
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particular kind of work ..
(h) General nature of industry,
business, or establishment in
wbich employed ( or employer) ..
(c) Name of employer
(State or country)
"11 BIRTHPLACE OF
FATHER (City ) ..
13 BIRTHPLACE OF
PARENTS
MOTHER (City).
(State or country)
should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information
instructions and extracts from the laws on back of certificate.
in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See
If STILLBORN, enter that fact bere
If STILLBORN, state period of uterogestation ........................ mos.
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
6 DATE OF BIRTH ..
10
(Day)
(Year)
Years
10
Months
Days
If LESS than
1 day, ........ brs.
...... min.
At Home
1
9 BIRTHPLACE (City)
lianada
10 NAME OF
FATHER
Inasthase Bouduan
(State or country) Canada
12 MAIDEN NAME
OF MOTHER
Many Renee
Caviada
14 albert Gallarditz
Informant (Address) Juan Stable Rd
15 July 8, 1919 Edward S. Robbing
(Month (Day) (Year)
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH ..
..........
(Month)
July
6~
(Day)
,
1919
(Year)
17 I HEREBY CERTIFY, That I attended deceased from to La 6 1969
19
.. ,
that I last saw halive on
1914.
.... m.
and that death occurred, on the date stated above, at 3×
The CAUSE OF DEATH was as follows :
Ceressal Himange
( duration)
yrs ..
mos ...
.ds.
CONTRIBUTORY.
( SECONDARY)
.(duration)
yrs.
mos ....
ds.
18 Where was disease contracted
if not at place of death?
Date of
Was there an autopsy ?
What test confirmed diagnosis ?.
(Signed)
Fred EVarney
M.D.
(Address) MenteChalfald
Date
(Month )
(Day)
(Year)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL I Joseph East Chelon Infaly 9 Cemetery) (City or toyn)
1919
ADDRESS 738 Milest.
21 I HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued.
10-'18. 100,000.
The Commonwealth of Massachusetts .
218
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
1 PLACE OF DEATH middlesex
County
.
State
mars
Registered No ......
53
Den stable
Rd
St
Ward
(If death oceurred in a hospital or institution, give its NAME instead of street and number)
Lignes
Gallardet
(a) Residence.
No Dunstable Rds
Ward.
(If non-resident give eity or town and State)
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
1833
+43
MARGIN RESERVED FOR BINDING
STANDARD CERTIFICATE OF DEATH
Edward J. Robbins.
Official position
Cour Click
22 Date of issue of hurial or transit permit July 8, 1919
20 UNDERTAKER S archambault Than
7 1919
(If in the Army er Navy of the United States, give rank, organization, ete.)
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH
&. - Public Health Association]
Statement of occupation. - Precise statement of occupation 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 werd or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary fireman, etc. Butin 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) Salcsman, (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 house- hold only (not paid Housekeepers who receive a definite salary), may be entøred 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 indicated thus: Farmer (retircd, 6 yrs.). For persons who have no occupation whatever, write None.
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