USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 25
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Statement of cause of death. - Name, first, the DISEASE CAUSING NEATH (the primary affection with respect to time and causation), using always the samo accepted term for the same diseasc. 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; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, 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 .; 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," etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite disease can be aseertained 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 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 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, 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 thereafter furnish 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, 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 sup- posably due to injury. These inelude 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.
Form R-305
The Commonwealth 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 LAWS, CHAPTERS 24 AND 29)
County Middleser State Mans Registered No. 264
Registered No ...
(Place of residence)
10 200
St., 0, Ward
(If death occurred in afhospital orlinstitution, givenits NAME instead of street and number)
2 FULL NAME Year
mas marter
(If in the Army or Navy of the United States, give rank, organization, ctc.)
St.,.
Ward.
(a) Residence.
No.
(Usual place of abode)
Length of residence in city or towo where death occurred
1 (Chelmsford)
years
months
days
How long in U. S., if of foreign birth?
year's
mooths days
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
white
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
married
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Lillian 8
6 DATE OF BIRTH
Jeb. 17 1875
(Month)
Way)
7 AGE
44
Years
6
Months
9 Days
Painter
9 BIRTHPLACE (City).
St. agnes
(State or country)
Canada
Johns
11 BIRTHPLACE OF
FATHER (City)
Canada
12 MAIDEN NAME OF MOTHER mary Jane miller
(State or country)
Canada
14
Informant
(Address) Chelmsford Mais.
Filed Sept. 169919
Registrar of city or town where dealb occurred Chefren Eduardl Rotony Filed Seft 26 (Month@ (Day) (Year)
Registrar of city or town where deceased resided
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH .. September 12/9/9 (Day)
(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 : Fractures of Baseof Skull (Year) If LESS than 1 day ......... hrs. accidentally struckby automobilpin roadday or ........ min.
(See reverse side for additional space) 18 Where was injury sustained helmaford Massi if not at place of death ?
(Signed) V
....... ., M.D.
(Address)
Lowell
Medical Efumier for 5 th ist middle
Sept. 15, 1919.
6
Date.
(Month)
(Days
( Year)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL Pine ridge Cem, Kelimeler
DATE OF BURIAL Sept 15199. (Month) (Day) '(Year)
20 UNDERTAKER DADDRESS dr. S. Brown Lowel
21 Burial permit issued by
Official position
22 Date of issue
9-'18. 10,000.
3 SEX male 10 NAME OF FATHER PARENTS 15 N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information 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. (b) Geoeral nature of indostry, business, or establishment in which employed (or employer). (c) Name of employer
MARGIN RESERVED FOR BINDING
(State or country) 13 BIRTHPLACE OF MOTHER (City) should be carefully supplied. AGE should be stated EXACTLY. MEDICAL EXAMINERS should state CAUSE OF If STILLBORN, eoter that fact here
236
7/
City of Town Lowell Quello. (Place of death)
mais
(If non-resident give city dy/town and State)
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particolar kiod of work.
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 wbon 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 bis 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, tbe duration of his last illness, when last seen alive by the physician, and the date of bis 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 bealtb 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, wbich ... 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 tbe 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 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 tbe 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. 8.
RULES OF PRACTICE
The fulfilment of the purpose of these laws ealls 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 bave given bedside eare during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deatbs only as those of persons who, tbougb disabled by recognized disease unrelated to any form of injury, bave died witbout 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 deatbs 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 deatbs 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 eity and town sball fortbwith 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 tbe elerk of a city or town without the commonwealth, shall record the same. - Revised Laws, Chap. 29, Sec. 13, as amende. ' by Acts of 1910. Chap. 93, Sec. 3.
DESCRIPTION (for unknown person)
N. B. - WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should be so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,
of certificate.
14
(Address) te siemevol
15
Filed Seht. IS, 1919 Edward Y Rorbom REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
Sent. 14 1919
7
17
I HEREBY CERTIFY, That I attended deceased from
sept.n
, 19 19, to
Sept. 14 1919.
that I last saw h Mies alive on
Sist.13.1919
and that death occurred, on the date stated above, at
6.15 a. m.
The CAUSE OF DEATH* was as follows :
gastro Entérites
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 mor.
ds.
CONTRIBUTORY (SECONDARY)
.. (duration)
yrs ..
mos.
cs.
Did an operation precede death?
Www Date of
Was there an autopsy ?.
720.
What test confirmed diagnosis ?.
Autun 9. Scolaria
(Signed)
., I.I.D.
7-11/19 /9 (Address)
clucasford, 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.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL redem
DATE OF BURIAL Deels 19
ADDRESS
20 UNDERTAKER Allemaal out
237
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
(City or town)
1 PLACE OF DEATH
County
State
Registered No ...
72
Township
.... or Village ..:
.. or
City Lenehvernel
No.
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number) A elame fr
2 FULL NAME
Wife
(a) Residence. No telehavebad
St.,
.Ward.
(Usual place of abode)
Length of residence in city or town where death occorred
years
6
months
days.
How loog in U. S., if of foreign birth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
5a If married, widowed, or divorced HUSBAND of (01) WIFE of
6 DATE OF BIRTH (month, day, and year )(@/6/7/918
7 AGE
Years
Months
8
Days
28
If LESS tbao 1 day, ........ hrs. or ......... min.
9 BIRTHPLACE (city of town) Temel
(State or country)
10 NAME OF FATHER COLON COLONNE
PARENTS
11 BIRTHPLACE OF FATHER (city e town)
(State or country)
упис
12 MAIDEN NAME OF MOTHER
there Boville
13 BIRTHPLACE OF MOTHER (city or town powell (State or country).
18 Where was disease contracted
if not at place of death ?
.
......
(If non-resident give city or town and State)
MARGIN RESERVED FOR BINDING
.
:
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 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 ma- terial worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spc- 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 usc of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronehopneumonia ("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; Chronie valvular heart disease; Chronie interstitial nephritis, etc. The contributory (secondary or inter- current) affection nced not be stated unless important. Example: Measles (disease causing death), 29 ds .; Broncho- pneumonia (secondary), 10 ds. Never report inere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Con- genital," "Senile." etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from child- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS STATE MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, or HOMICIDAL, or as probably such, if impossible to de- termine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoned by earbolie acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may be stated
under the head of "Contributory." (Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Association.)
Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, etc.
2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Exposure, ctc.
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. 1-'18. 100,000.
FORM R-301
MARGIN RESERVED FOR BINDING
1 PLACE OF DEATH 2 FULL NAME (Usual place of abode) 3 SEX 6 DATE OF BIRTH 7 AGE 12 Years (c) Name of employer 13 BIRTHPLACE OF PARENTS MOTHER (City) .. (State or country) Informant .. 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
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
State Mass
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS Registered No. 167373
St. Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Jennie Mn. Buntel
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence.
No Hro Chelmsford
St.,
Ward.
(If non-resident give eity or town and State)
Length of residence in city or town where death occurred
12
years
months
days.
How long in U. S., if of foreign hirth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
(Month)
Sulla
16
1919 (Year)
17
I HEREBY CERTIFY, That I attended deceased from
Sfr. 9
1919, to 8f-16
1919
that I last saw h
alive on
19 19 and that death occurred, on the date stated above, at 8-500 m. The CAUSE OF DEATH was as follows :
Infantile Jasalycis
( duration)
yrs ..
mos ....
8
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)
Fund Edamer
M.D.
(Address).
Date.
16
1919
A ..
( Month)
(Day)
(Year)
14 alfred Buntel
(Address ) No Thelque ford Mars
15 Sept. 16.1919 Edward 9. Bobbing Filed (Month) (Day) (Year)
REGISTRAR
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
Riverside Sobhelmsfach Seht 172019.
(Cemetery)
(City or towa)
20 UNDERTAKER yong& Blake
33 Prescott
21 I HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued Edward . Robbing Official him Clerk position ....
22 Date of issue of burial or transit permit
Sept. 16, 1919
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Seht
( Month)
15 1907
(Day)
(Ycar)
Months Days
If LESS than
1 day, ......
.. hrs.
....... min.
8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work ... (h) General nature of industry, business, or establishment in which employed ( or employer ) ..
Student.
BIRTHPLACE (City) Tyngsboro
(State or country)
10 NAME OF
FATHER
alfred Buntel
11 BIRTHPLACE OF England FATHER (City ) (State or country)
12 MAIDEN NAME OF MOTHER Georgie reaux
Suncork
10-'18. 100,000.
County ......
Iddlesurf
City or Tow
n ro Chelmsford No
238
ADDRESS
(Day)
/
Saft. 16
/
.... mos.
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH
[Approved by U. S. Census and American Public Health Association]
Statement of oeeupation. - 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 he 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 "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 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 domestie service for wagcs, 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 occupation whatever, write None.
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