Deaths 1919, Part 27

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


USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 27


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


2 FULL NAME Grace Parks


Middlesex St.


St., ..


Ward.


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


Length of resideoce ia city or towo where death occurred


months


days.


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


years


months


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


Ira Parks


6 DATE OF BIRTH


June


( Month)


(Day)


(Year)


3 Months


12


Days


If LESS than


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


If STILLBORN, state period of uterogestatioo ..


.mcs.


or ........ mio.


8 OCCUPATION OF DECEASED (a) Trade, profession, or House- Wife


9 BIRTHPLACE (City)


Amesbury,


(State or country)


Mass.


10 NAME OF


FATHER Hilde Gervais


11 BIRTHPLACE OF


FATHER (City).


Canada


12 MAIDEN NAME


OF MOTHER


Delvina Poulin


Canada


14 SIra Parks


(Address)


Ne. Chelmsford, Mass.


15 Sept. 26 1919 Edward ). Rotting


Filed ..


(Month) (Day) (Year)


REGISTRAR


21 I HEREBY CERTIFY that a satisfactory stau- dard certificate of death was filed with me BEFORE the burial or transit permit was issued. Edward . Bobbing


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH Sl


(Month)"


"(Day)


(Year) \


17 I HEREBY CERTIFY, That I attended deceased from


....


, 1914, to Self 25


, 19 19.


that I last saw h_ alive on


....... , 19 ...... 9,


and that death occurred, on the date stated above, at 4.30 0 m.


The CAUSE OF DEATH was as follows :


child birth.


.(duration)


mos .....


ds.


CONTRIBUTORY Heart


(SECONDARY)


.(duration)


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


mos ...


ds.


18 Where was disease contracted


if not at place of death?


Did an operation precede death? Ww Date of


Was there an autopsy ?


-


What test confirmed diagnosis ?


(Signed)


M.D.


(Address)


25


1919


Date.


(Month)


(D.HX


(Year)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


St. Joseph


E. Chlemsford


DATE OF BURIAL


9/27


1919


(Cemetery)


(City or town)


20 UNDERTAKER


A. Archambault


ADDRESS


Lowell


Official ... position


Vom Clark


Date of issue of permit Soft, 26, 4,8%. Permit


3 SEX


FEM


7 AGE 36


Years


particular kind of work .....


(b) Geoerai nature of industry,


business, or establishment io


which employed ( or employer ) ...


(c) Name of employer


(State or country)


13 BIRTHPLACE OF


MOTHER (City) ......


PARENTS


(State or conntry)


Inform


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 here


MARGIN RESERVED FOR BINDING


1-6-'19. 150,000.


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


(a) Residence. No.


( Usual place of abode)


6


years


13.1883


yrs ....


25


1918


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. Tho question applies to each and every person, irrespective of age. For many occupations a singlo word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, ctc. 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) 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 entored 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 tho occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death. - Name, first, the DISEASE CAUSING DEATII (tho primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cere- brospinal fever (the only definite synonym is "Epidemie 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 mero 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,""Wcakncss," etc., when a definite discase can bo 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 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 deccased, his supposed age, the disease of which he died [defined so that it can be classificd 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. 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- cato as hercinafter 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 mako 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 observanee 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, thoughi 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 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.


MARGIN RESERVED FOR BINDING


City 3 SEX make PARENTS Informant carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, of certificate. 15 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 particular kiod of work.


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


..........


1 PLACE OF DEATH


County ....


Index


State.


Mass


Township


Chelmsford


be-Village ..


South Chelongford


or


No ..


St ..


Ward


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


2 FULL NAME


....


Charles Lavis adams


Co G 29th Marnes


(a) Residence.


No. South Chelmsford


St.,


.Ward.


(Usual place of abode)


Length of residence io city or town where death occurred


19 years


months


days.


How loog io 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)


Oct. 2 1919


17


I HEREBY CERTIFY, That I attended deceased from


,


1919 to Man 4 1919


that I last saw ha alive on


March 4 1919.


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


..... m.


The CAUSE OF DEATH* was as follows :


If LESS than


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


or ........ min.


Murcardit - and


amiqua Pectorio ~


....


.. (duration)


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


.... mos.


ds.


CONTRIBUTORY


(SECONDARY)


(duration)


..........


... yrs ...


... mos ..


ds.


9 BIRTHPLACE (city or town).


Stoneham


(State or country) maine


10 NAME OF FATHER


adam


11 BIRTHPLACE OF FATHER (city or town)


(State or country)


main


12 MAIDEN NAME OF MOTHER not known


13 BIRTHPLACE OF MOTHER (city or town) ..


(State or country)


maini


14 This Chas. adama


(Address)


South Chelten


Filed. Oct. 5,199 Edward ), Roll-up


REGISTRAR


18 Where was disease contracted


if not at place of death ?


Did an operation precede death?


no


Was there an autopsy ?.


no.


What test confirmed diagnosis ?......


(Sigoed)


Auch T. cobara


M.D.


10-4/ 1919 (Address)


Chiliford' mars.


* 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 spacc.)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


Havvi Con Westford


DATE OF BURIAL


Ect 5 1919


20 UNDERTAKER


Walter Perfum


ADDRESS


Chelmsford


...............


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


4 COLOR OR RACE


whate


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


married


5a If married, widowed, or divorced


HUSBAND of


(01) WIFE of


Effie C. adama


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


Sep 19 1839


7 AGE 80 Ycars


Months


Days


13


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


Farmer


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


....


......


....


Date of.


242 Chelmsford (City or town) Registered No. 17


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


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


{Approved by U. S. Census and American Public Health Association]


Statement occupation. - Precisc 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 fircman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) 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 laborcr, Laborer - Coal minc, 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 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 fevcr (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" (mcrely 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 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, 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.


E 15. 10-'18. 5,000.


MARGIN RESERVED FOR BINDING


1 PLACE OF DEATH


County.


middlesex


City or Town &


Lowell


alexander


2 FULL NAME


mais.


Length of residence in city or town where leuth- Beninred


6


years


months


3 SEX


4 COLOR OR RACE


male White


5a If married, widowed, or divorced


)


HUSBAND of


(or) WIFE of


7 AGE


13


Years


.


Months


Days


If STILLBORN, enter that fact bere


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work.


Severalboy


0


(b) General nature of industry,


business, or establishment in


which employed (or employer ) ..


.(c) Name of employer


Powell


9 BIRTHPLACE (city or town).


10 NAME OF FATHER Cormack


11 BIRTHPLACE OF FATHER (city or town)


(State or country)


nada


PARENTS


13 BIRTHPLACE OF MOTHER (city or town) ....


(State or country)


land


14


Informant ..:


Fathera


(Address)


no Chelmsford


of certificate.


carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,


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 statoment of OCCUPATION is very important. See instructions on back


(State or country)


mais


12 MAIDEN NAME OF MOTHERCUlencameron


15 Det.6, 1919 Stephen Flynn ( P) Registrar of city of town where Bath occurred Filed Gets 29, 19 19 Edevard &Korting ......


Registrar of city or town where deceased resided


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH (month, day, and year) 04. 3 199


17


I HEREBY


CERTIFY, That I Attended deceased from


Sept. 28


19


60let. 3


19


9 40


that I last saw henklive on.


Le


3


19 and that death occurred, on the date stated above, at 9.30 40 The CAUSE OF DEATH* was as follows : ...... m.


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. (Sce reverse side for additional space.) mitral Regurgitation Cardio Renal Micras


( duration) ............................... mos ...........


CONTRIBUTORY Propen Compensation


(SECONDARY)


.... (duration).


.yrs.


mos ..


ds.


18 Where was disease contracted Of 10mp


if not at place of death ?


Did an operation precede death? 12b.


Was there an autopsy ?_


What test confirmed diagnos ??


DWm . FLawler


M.D.


10-4 19 (Address)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


St. Patrick howell.


DATE OF BURIAL


Det. 6 19 19.


20 UNDERTAKER P.H. Lavag gg


ADDRESS Lowell


34.7


Registered No ...


Registered No ...


(Place of residence)


St .... Ward


(If deathoccurred ina hospital or institution, give its NAME instead of street and number)


(Yin the Army of Navy of the United States, give rank, organization, etc.)


(a) Residence. State.


City or Town Lo, Chelmsfordo highland auf SE.


(Usual place of abode)


days


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


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Single


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


If LESS than


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


gr ....... min.


243


The Commonwealth of Massachusetts


CERTIFICATE OF DEATH OF NON-RESIDENT ~.


State mars.


(Place of death) 78


194.


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


"ª. ce ly %. 2. Census and American Public Health Association]


Statement ui ucupation. - Precise statement of vucupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to cach and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compos- itor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, ctc. 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) Automobilc factory. The ma- terial worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," ctc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who arc engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Houscwork, 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 fact may be indi- catcd thus: Farmer (retired, 6 yrs.). For persons who liave no occupation whatever, write None.


Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to tiinc and causation), using always the same accepted term for the same discase. Examples: Cerebrospinal fever (thc only definite synonym is "Epidemie cerebrospinal menin- gitis"); Diphtheria (avoid usc of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- ficd, 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; Chronic valvular heart discase; Chronic 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 mere symp- toins or terminal conditions, such as "Asthenia," "Anemia" (mcrely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Con-


genital," "Senilc," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old agc," "Shock," "Uremia," "Weakness," etc., when a definite disease ean be ascertained as the causc. Always qualify all diseases resulting from ehild- 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 hcad - homicide; Poisoned by carbolic acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., scpsis, 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, Drowning, Gas poisoning, Suicide, Homicide, etc.




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