USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 2
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(Sigoed)
amara Heri.
M.D.
13.199 (Address)
Cucinatend. Mars.
* State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, aud (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional spaee.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Edson Cemetery
DATE OF BURIAL
Jan, 14, 1919.
20 UNDERTAKER
George W. Healey.
ADDRESS
79 Branch St.
169
Chelmsford. (City or tow
4
(Usual place of abode)
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 ean be known. The question applies to each and every person, irrespective of age. For many oeeupations 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," ete., without more precise specification, as Day laborer, Farm laborer, Laborer -Coal mine, ete. Women at home, who are engaged in the duties of the household only (not paid 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 oeeupations of persons engaged in domestie service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state 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 oceupation whatever, write None.
Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affeetion with respect to time and eausation), using always the same aeeepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemie 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, ete., Carcinoma, Sarcoma, ete., of.
(name origin; "Caneer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronie valvular heart disease; Chronic interstitial - nephritis, ete. The contributory (secondary or inter- current) affeetion need not be stated unless important. Example: Measles (disease eausing death), 29 ds .; Broneho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terininal conditions, such as "Asthenia," "Anemia" (merely symptomatie), "Atrophy," "Col- lapse," "Coma," "Convulsions,"" "Debility" ("Con- genital," "Senile," ete.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- Inus," "Old age," "Shoek," "Uremia," "Weakness," ete., when a definite disease ean be aseertained as the eause. Always qualify all diseases resulting from ehild- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," ete. State eause 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; 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 eause of death approved by Committee on Nomenelature 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 Medieal Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, ete.
2. Deaths supposedly eaused by violenee, 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, ete.
4. Deaths under eireumstanees unknown, as A person found dead, ete.
ADDITIONAL SPACE FOR FURTHER STATEMENTS BY
PHYSICIAN.
11
R 15. 1-'18. 100,000.
170
The Commonwealth of Massachusetts
CERTIFICATE OF DEATH OF NON-RESIDENT
dowe ......
(City or town)
Registered No ........ 178
County
Registered No. 5
(Place of residence) .St., .. Ward
2 FULL NAME
George di
(If death occurred in a hospital or institution, give its NAME instead of street and number) uc kworth ....... If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence.
State
(Usual place of abode)
City or Town Cheelnesford
St.
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
MEDICAL CERTIFICATE OF DEATH
3 SEX
Mals
4 COLOR OR RACE
Molite.
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
.
6 DATE OF BIRTH (month, day, and year)
Jau 6 1919
7 AGE
Years
Months
Days
17
If LESS than
1 day, ........ brs.
or ....... min.
If STILLBORN, enter that fact bere
8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work ...
(b) General nature of industry, business, or establishment in which employed (or employer ). (c) Name of employer
.(duration).
... yrs ..
.. mos. .............. ds.
-
9 BIRTHPLACE (city or town).
(State or country)
CONTRIBUTORY
(SECONDARY)
(duration).
ds.
yrs ...
... mos ..
if not at place of death ?
11 BIRTHPLACE OF FATHER (city or ton
New bedford
Did an operation precede death ?.
Date of.
Was there an autopsy ?__
12 MAIDEN NAME OF MOTHERA clean M. armitage What test confirmed diagnosis ?.
13 BIRTHPLACE OF MOTHER (city of town) 60 (State or country) England
2%.19 / C(Address)
Lowiert
M.D.
.,
14 father
Informant .. (Address)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
M. Chiensford
20 UNDERTAKER
ADDRESS
Filed. Jan 24 1919.
Registrar of city or town where death occurred Filed Feb 1 1919 Edward: Rationing
Registrar/of city or town where deceased resided
16 DATE OF DEATH (month, day, and year)
Jan 23 1919
17 I HEREBY CERTIFY, That I attended deceased from
19 19, to -
Jan 2.3. 2019.
that I last sawh m alive on ....... Jan 23 , 1910 .... and that death occurred, on the date stated above, at 2-30 0 .. m. The CAUSE OF DEATH* was as follows:
* 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.)
astenia (Premature)
10 NAME OF FATHER. George a Duckwar, 18 Where was disease contracted cted
PARENTS
of certificate.
N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should be 80 that it may be properly classified. Exact statoment 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,
1 PLACE OF DEATHMiddlesex
State mass
(Place of death)
City or Town
Lowell
No Lowell Jen Alos by
Mass.
MARGIN RESERVED FOR BINDING .
.
(Signed)
0
DATE OF BURIAL
fare 24 1919
15
(State or country) Mas
REVISED UNITED STATES STANDAE. JIFICATE OF DEATH
[Approved by U. S. Census and American Public [ ... tosociation]
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) Forcman, (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 dutics 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- toncum, etc., Carcinoma, Sarcoma, etc., of.
(name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronie valvular heart discase; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Mcasles (disease causing death), 29 ds .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toins 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 + 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 clisease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deatlıs under circumstances unknown, as A person found dead, etc.
ADDITIONAL SPACE
FOR FURTHER STATEMENTS BY
PHYSICIAN.
R 303. 6-'18. 50,000.
Form R-302
The Commmuralth of Massachusetts
MEDICAL EXAMINER'S CERTIFICATE OF DEATH
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
1 PLACE OF DEATH
(ISSUED UNDER THE PROVISIONS OF REVISED LAWY, CHAPTER 24)
State. man
Registered No.
6
City or Town
Chlansford Max
No ..
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead street and number)
2 . FULL NAME
Unknown.
(If in the Army or Navy of the United States, give rank, organization, etc.)
St.,
Ward.
(a) Residence.
No.
(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
Firmale White
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Singh
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 DATE OF BIRTH.
Unknown
(Month)
(Day)
(Year)
7 AGE
Years
Months
Days
If LESS than
I day. ........ hrs.
If STILLBORN, enter that fact here
or ........ min.
8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work. (b) General nature of industry, business, or establishment in wbich employed (or employer) (c) Name of employer
9 BIRTHPLACE (City)
(State or country)
10 NAME OF
FATHER
Unknow
11 BIRTHPLACE OF
FATHER (City)
Unknow
(State or country)
12 MAIDEN NAME
OF MOTHER
Unknow
13 BIRTHPLACE OF
MOTHER (City)
Unknown
(State or country)
14 IS Buckley
Informant
(Address)
1
man.
15
Filed .
San 30, 1919 adward ). Rolling
(Month) (Day) (Year)
REGISTRAR
21 Burial permite dran 1), Resting issued by
Official Over position .
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH ..
štothy
(Month)
(Day)
1919
(Year)
17 I HEREBY CERTIFY, That I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows : asphyxia-Lta nature of the death
(See reverse side for additional space)
18 Where was injury sustained
if not at place of death?
(Signed)
Franks Buckelus
M.D.
(Address)
al Exam
for 16 D ist Middle 5
Date
Jan
29
1919
(Month)
(Day)
( Ycar)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL Jan, 30, 1919 (Month) (Day) (Year)
20 UNDERTAKER
& R. Packhuet
ADDRESS
Chelmsford
click 22 Date of Samv 30 19891 issue
8-'18. 13,000.
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information
MARGIN RESERVED FOR BINDING
See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. should be carefully supplied. AGE should be stated EXACTLY. MEDICAL EXAMINERS should state CAUSE OF
171
County mudalieux
(If non-resident give eity or town and State)
January
28
4 COLAR OR RACE
PARENTS
ayer mas O
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 attentod 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 stand- ard certificate of death, stating to the best of his knowledge and belief the name of the deceased, 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, the duration of his last illness, when last seen alive by the physician, and the date of his death. . - Revised Laws, Chap. 29, Sccs. 10 and 1, as amended by Acts of 1910, Chap. 322.
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 containing the facts required by law to be returned and recorded, which . .. shall be accompanied by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate 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 vio- lence, the medical examiner only shall make such certificate. The person to whom the permit is so given and the physician who certifies to the cause of death shall thereafter furnish for registration any other necessary infor- mation which can be 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 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, Sec. 6.
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 injury 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
For VIOLENT DEATHS STATE MEANS OF INJURY and qualify as ACCIDENTAL, 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) should also be stated.
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
79
The Commonwealth of Massachusetts
CERTIFICATE OF DEATH OF NON-RESIDENT
Lamel (City or town)
1 PLACE OF DEATH
County ...
Middlesex
State.
marsl
Registered No ......
.......
(Place of death)
Registered No ..
City or Town
Lamell
No ..
Lowell Sen. Hospital
...
(Place of residence)
St., 7
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Emma ann Bairstow
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence.
State
(Usual place of abode)
City or Town no. CheliesAnd No.
St.
Length of residence io city or towo where death occorred
years
months
days
How long in 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)
Jau 30
1919
3 SEX
female white
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
married
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
George
6 DATE OF BIRTH (month, day, and year) March 6.1869
7 AGE
Years
49
Months
10
Days
24%
If LESS than
I day, ........ brs.
or ........ min.
8 OCCUPATION OF DECEASED
at Home
(a) Trade, professioo, or
particular kind of work ...
(b) Geoeral oature of industry, business, or establishment io which employed (or employer).
(c) Name of employer
.. (duration),
yrs.
mos ..
de.
CONTRIBUTORY.
fecal fistula - central
(SECONDARY)
hermia (duration) /
__ yrs. ................ mos ...
ds.
18 Where was disease contracted if not at place of death ?
Did an operation precede death? GIRL Date of Jau tan 29
Was there an autopsy ?.
Uno
What test confirmed diagnosis ?...
I Mage
..............
M.D.
14
husband
Informant (Address) No Rohelisford. W.re
15
Filed.
Hieb 4 1919/19
Fs :
Registrar of city or town where death occorred
Filed.
Feb. 7 1919 Gewand X-1
Registrar of city or town where deceased resided
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Lowell Cemetery
DATE OF BURIAL
Fiel 3 1919
ADDRESS
Am 26. Saunders 217 apprection
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 classifled. 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.
9 BIRTHPLACE (city or town) .. 5 (State or country) England
10 NAME OF FATHER James Johnson
PARENTS
11 BIRTHPLACE OF FATHER (city or town)~ (State or country) England
12 MAIDEN NAME OF MOTHER Carrella
13 BIRTHPLACE OF MOTHER (city or town) (State or country) England
17 HEREBY CERTIFY, That' I attended deceased from Jan 3 ., 1919
to
Jan 30, 1919.
that I last saw h en/ live on.
N
Sau 30
.. 1919
and that death occurred, on the date stated above, at 9.50,3
If STILLBORN, enter that fact here
.... m.
The CAUSE OF DEATH* was as follows :
* 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.) Surgical Shock
, (Sigoed)
/31, 19 /9 (Address)
Lowell
20 UNDERTAKER
227
4 COLOR OR RACE
REVISED UNITED &
[Approved by U.
Statement or occupation. - Preeisc statement of oeeupa- 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 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," ete., without more precise specifieation, as Day laborer, Farm laborcr, Laborcr - Coal mine, ete. 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. Carc should be taken to report spe- eifieally the occupations of persons engaged in domestie serviee for wages, as Servant, Cook, Housemaid, cte. If the oeeupation 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 indi- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write Nonc.
Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affcetion 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 ecrebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopncumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toncum, cte., Carcinoma, Sarcoma, ete., of _.
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