Deaths 1919, Part 20

Author: Chelmsford (Mass.)
Publication date: 1919
Publisher:
Number of Pages: 188


USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 20


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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


THIS CERTIFICATE CONSTITUTES SUCH PERMIT


Form R-305


MARGIN RESERVED FOR BINDING


3-'18. 10,000.


The Commonwealth of Massachusetts


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


(Place of residenec)


St.,


5. Ward


(If death occurred in a hospital or institution, give its NAME instead of strect and number)


(If in the Army or Navy of the United States, give rank, organization, ctc.)


St., -WardNorth Chelmsford, Mass.


(If non-resident give city or town and State)


10


months


days


( 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 : Compound fracture of leg


18 Where was injury sustained


B&ARR between Newton


(Signed) George ..... L.Test


M.D.


(Address) Newton centre, Masa.


Medical Examiner Forth Middlesex Dist.


August 5, 1919


(Month)


(Day)


( Year)


DATE OF BURIAL


Aug . 10, 1919


(Month) (Day) (Year)


ADDRESS


Somerville


22 Date of


issue


-


MEDICAL EXAMINER'S CERTIFICATE OF DEATH


1 PLACE OF DEATH


(ISSUED UNDER THE PROVISIONS OF REVISED LAWS, CHAPTERS 24 AND 29)


County ..


MIDDLESEX


State M199


Registered No ......


(Placc of death)


No. Newton Hospital


City or Town


Newton


308


... Registered No.


2 FULL NAME


Laurie A. Dunn


(a) Residence.


No ...


(Usual place of abode)


Leogth of resideoce in city or town where death occurred


-


years


days


-


months


1


How long io U. S., if of foreign birth?


years


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


4 COLOR OR RACE


White


(Month)


(Day)


Male


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Single


16 DATE OF DEATH


Aumist


5, 1919


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


6 DATE OF BIRTH


March 22, 1889


(Month)


(Day)


(Year)


7 AGE


30


Years


4 Months 14


Days


If LESS thao


Traumatic chock


1 day ......... brs.


If STILLBORN, eoter that fact bere


or ........ min.


R. R. Accident


8 OCCUPATION OF DECEASED


(a) Trade, professioo, or


Telephone Operator


particolar kind of work ..


(b) General nature of iodustry,


business, or establishment io


which employed (or employer)


Power construction Co.


(c) Name of employer


(Sec reverse side for additional spaec)


-


9 BIRTHPLACE (City) Port Howe,


(State or country)


Nova scotia


if not at place of death?


& ... Newtonville


10 NAME OF


FATHER


John M. Dunn


11 BIRTHPLACE OF


FATHER (City)


-


(State or country)Prince Edward Island


12 MAIDEN NAME


Date


OF MOTHER


Ada B. Peppard


13 BIRTHPLACE OF


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


PARENTS


Port Philip, N. S.


MOTHER (City) ....


Londonderry.


(State or country)


N. S


20 UNDERTAKER


14


Informant


Mrs. Magrie F. Yeoman


Francis M. Wilson


(Address)


No. Chelmsford, Mass.


7


21 Burial permit


--


15


issued by


Filed! ug . 11, 1919


Migrant


Official


--


Registrar of city or town wbere death occurred


position.


should be carefully supplied. AGE should be stated EXACTLY. MEDICAL EXAMINERS should state CAUSE OF


See reverse side for extracts from the laws of the Commonwealth and instructions.


DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.


N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information


.... .


Filed :


DEC. 30, 1919 Edward J. Rolling.


(Month) (Day) (Ycar)


Registar of city or town where deceased resided


EXTRACTS


2017


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 stand- ard certificate of death, stating to the best of his knowledge and helicf 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 eauses 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, Secs. 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 dicd; . . . 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 insuffi- cient, 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 permit is so given and the physician who certifics 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 elerk 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 deccased 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 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 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 ahortion, 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.


COPIES OF RECORDS OF DEATHS OF NON-RESIDENT DECEDENTS


The clerk of each city and town shall forthwith make certi- fied copies of the records of all . . . deaths recorded during the previous month, if the .. . deceased [was a resident] of any other city or town in this commonwealth or in any other state at the time of said . . .. death, and transmit them to the clerk of the city or town of which such . . . deceased person [was] resident at the time of the said ... death ... and the clerk of a city or town in this commonwealth so receiving such certified copies, or certified copies of . .. deaths, from the clerk of a city or town without the commonwealth, shall record the same. -- Revised Laws, Chap. 29, Sec. 13, as amended by Acts of 1910, Chap. 93, Sec. 3.


DESCRIPTION (for unknown person)


....


.I


....


....... ..


.. ...


٥١ وماي


.


100


.


..


FORM R-301


MARGIN RESERVED FOR BINDING


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. should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


224 OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


County middlesex


State


Masy


City or Town ..


Clubmsford


No.


Westford Sr.


St.


Ward


(If death occurred in a hospital or institution, give its NAME instead of street and number)


Paul napoliin Islady


(a) Residence.


No ..


Westford


St.,


Ward.


Length of residence in city or towo where death occurred


years


mooths


days.


How loog in U. S., if of foreign birth ?


ycars


mooths


days


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


married.


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


Olia Jassemin


1866


(Year)


7 AGE


52


Years


8


Months


Days


1 day, ........ hrs. or ........ min.


retired farmer


9 BIRTHPLACE (City)


Marieville


(State or country) 0.2.


10 NAME OF


FATHER


alexis Iladu


11 BIRTHPLACE OF


FATHER (City).


(State or country)


Canada


12 MAIDEN NAME


OF MOTHER


Meduise Doce


Canada


(Address)


Chelmsford


15


any 8, 1919 Edward ), Bottoms


Filed


(Month) (Day) (Year)


REGISTRAR


21 ! HEREBY CERTIFY that a satisfactory stao- dard certificate of death was filed with me BEFORE the burial or transit permit was issoed . Edward ). Rolling


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH.


(Month)


Day)


(Year)


17 I HEREBY CERTIFY, That I attended deceased from


July 31


., 19/5 to Que 7


r


that I last saw h


am alive on


.....


ant 6


, 1919.


and that death occurred, on the date stated above, at 50


..... m.


If LESS than


The CAUSE OF DEATH was as follows:


Cerebralhemorrhage


(duration)


.......


... yrs .............


... mos.


14 ds.


CONTRIBUTORY.


( 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)


ESBellehumeur


M.D.


Date ..


( Address) ...


813 merrimack


7


1919


(Mouth)


(Day)


(Year)


19 PLACE QF BURIAL, CREMATION, OR REMOVAL


DATE OF BURIAL


Il Josephis Chelmofon Ceux 9 1919.


(City or fown)


20 UNDERTAKER


9. albert


ADDRESS


17/Gucken


Official Town Cluck ...... position.


Date of issoe of permit. ang 9,99 No >


Permit


1-6-'19 ** ^ 000.


1 PLACE OF DEATH


2 FULL NAME


(Usual place of abode)


3 SEX


m


4 COLOR OR RACE


W.


6 DATE OF BIRTH


Dec.


(Month)


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work.


(b) Geocral oature of industry,


business, or establishment io


which employed ( or employer).


(c) Name of eorployer


13 BIRTHPLACE OF


PARENTS


MOTHER (City)


(State or country)


14


Informant ..


in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See


If STILLBORN, enter that fact here


If STILLBORN, state period of uterogestatioo


....... mos.


(If non-resident give city or town and State)


1919.


(If in the Army or Navy of the United States, give rank, organization, etc.)


Registered No. 1


1


(Day)


K.A . m/ ris. . JA .. . ^^ 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 engincer, 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 "Laborer," "Foreman," "Manager," "Dcaler," etc., without more precise specification, as Day laborer, Farm laborer, Laborcr - 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 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, stato occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death. - Namo, 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: Cere- brospinal fcver (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoncum, 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 contributery (secondary or inter- current) affection need not be stated unless important. Example: Measles (discase causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Ancmia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Wcakness," etc., when a definite disease can be ascertained as the 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 by 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 tho death of a person whom he has attended during his last illness, at the request of an undertaker or othier authorized person or of any member of the family of the deceased, furnislı for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed agc, 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. 22, Secs. 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 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 per- mit is so given and the physician who certifies to the cause of death shall thereafterfurnish for registration any other necessary information 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 supposed to have come to their death by violence. - Revised Laws, Chap. 24, Ecc. 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 attendanco or whose physician is absent from home when tho 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 abertion, but also deaths from disease resulting from injury or infection related to occupation, the sudden doaths of persons not disabled by recognized disease, and those of persons found dead.


The Commomuralth of Massachusetts


225


STANDARD CERTIFICATE OF DEATH


(City of town)


1 PLACE OF DEATH


County Middlesex


State


Mass


Registered No ..


Township


Chelmsford


.. or Village ...


or


No.


Bellerica


St.


Ward


(If death occurred in a hospital or institution, give its NAME instead of street and number)


2 FULL NAME.


Agnes L Ingalls


(a) Residence.


Chelmsford Mass st,


Ward.


(Usual place of abode)


Length of residence in city or town where death occurred


2


years


months


days.


How long io U. S., if of foreigo birth ?


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Female


4 COLOR OR RACE


White


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Married


5a If married, widowed, or divorced


HUSBAND of


(01) WIFE


of


George H6 Ingalls


6 DATE OF BIRTH (month, day, and year)


Years


Months


11


Days


4


If LESS than


1 day, ........ hrs.


or ........ min.


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work ..


House.


Wife


(b) Geoeral nature of industry, business, or establishment in which employed (or employer) .. (c) Name of employer


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH (month, day, and year)


aug. 71


19/


17


I HEREBY CERTIFY, That I attended deceased from


June 5,


1919, to


,1919


that I last saw her alive on


1919


and that death occurred, on the date stated above, at


m.


The CAUSE OF DEATH* was as follows : Slough. Fibroil Tumor offtherug


following Cesarean Section.


Phlebitis ofhelt leg. Paulitis


-


Myocardial Drqueration


.. yrs ..


mos.


ds.


time weeks .


CONTRIBUTORY


(SECONDARY)


.(duration)


.yrs ...


.mos ...........


ds.


18 Where was disease contracted


if not at place of death?


Calcareone Section


Did an operation precede death ?


... Date of ...


June 5, 1919.


Was there an autopsy ?.


no.


What test confirmed diagnosis ?. 2 ..


(Signed)


Autun 4. Scoloria


Chelmsford, mais.


II.D.,


* 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.)


14 George Il Ingalls


Informant


(Address)


chelmsford Mars


15 any 9, 1919 Edward J. Rabbim


REGISTRAR


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


Pine Ridge


DATE OF BURIAL Auga 1919


ADDRESS


20 UNDERTAKER


Walter Perham Chelinked


MARGIN RESERVED FOR BINDING


N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should be so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back


City 7 AGE · PARENTS carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, 30 of certificate.


BIRTHPLACE (city


North Sandwich


(State or country) N.M.


10 NAME OF FATHER


John Peaslee


11 BIRTHPLACE OF FATHER (city or town) North Sandwich


(State or country)


N. 16.


12 MAIDEN NAME OF MOTHER Hellen Morrison 8-8, 1919 (Address)


13 BIRTHPLACE OF MOTHER (city or town) Andover


(State or country)


Mass


(If non-resident give city or town and State)


H


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 applics to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compos- itor, Architeet, Locomotive engineer, Civil engineer, Stationary fireman, 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 necded. 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, 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- eifically 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 faet 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 acecpted term for the same discase. Examples: Cerebrospinal fever (thc 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; "Caneer" is less definite; avoid use of "Tumor" for malignant ncoplasms); Measles; Whooping cough; Chronie 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" (mercly symptomatic), "Atrophy," "Col- lapse," "Convulsions," "Debility" ("Con-


genital," "Senilc," etc.), "Dropsy," "Exhaustion,". "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite discase can be ascertained as the cause. Always qualify all discases 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, Ol' IIOMICIDAL, or as probably such, if impossible to dc- terinine 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




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