USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 6
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4. Deaths under circumstances unknown, as A person found dead, cte.
ADDITIONAL SPACE
FOR FURTHER STATEMENTS BY PHYSICIAN.
..
R 15. 1-'18. 100,000.
FORM R-301
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH
1
City or Town.
Chelmsford
No
action
St.
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Mau Alica Writes
C. (If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence.
No.
actor It. Thelisting entry
Ward.
(If non-resident give city or town and State)
( Usual place of abode)
Length of residence in city or town wbere 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
16 DATE OF DEATH.
(Month)
march
6
1919.
(Year)
(Day)
17
I HEREBY CERTIFY,
That I attended deceased from
Zab 9 , 1918,
19
that I last saw her alive on 19 ... 1 :
and that death occurred, on the date stated above, at
m.
The CAUSE OF DEATH was as follows : ulm
Scorned yine
(duration)
yrs ......
mos ... ds.
CONTRIBUTORY ( SECONDARY)
(duration)
yrs.
mos ...
ds.
18 Where was disease contracted
if not at place of death ?
Did an operation precede death? Ma, Date of
?Was there an autopsy ?
200.
What test confirmed diagnosis? G. Scolonia Jan
(Signed).
(Address).
Chacuneford, mas.
...
M.D.
Date.
March 7
(Month)
(Day)
(Year)
1919.
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
St. Gating. Quieter. YMEU
(Cemetery)
XCity or town)
DATE OF BURIAL
March 10 1919
20 UNDERTAKER
ADDRESS
15 May, 10,1919 Edward Polling Fil (Month) (Day) (Year)
REGISTRAR
21 I HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me
BEFORE the burial or transit permit was issued award . Robbing V
Official position. Vorm Click
22 Date of issue of burial or transit permit
man. 10,1919
10_'18. 100,000.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
1 PLACE OF DEATH
County ...
Headley
State. thaas
Registered No.
2 FULL NAME
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) Manned
5a If married, widowed, or divorced HUSBAND of (or) WIFE of
Andrew P. Nestes
6 DATE OF BIRTH
( Month)
(Day)
( Year)
7 AGE 44 Years
Months 2 2 Days
If LESS than 1 day, ........ hrs.
If STILLBORN, enter that fact here If STILLBORN, state period of nterogestation. mos.
[우
........ min.
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 ) ...
at Hour
..
(c) Name of employer
9 BIRTHPLACE (City)
(State or country)
10 NAME OF
FATHER
Gating M. Tem
11 BIRTHPLACE OF
FATHER (City) ..
(State or country)
Dufond
12 MAIDEN NAME
OF MOTHER
Catherine Roques
13 BIRTHPLACE OF
MOTHER (City)
(State or country)
Cheland
14 Andrew P. Veite Husband Informant .. (Address) Réfm Gt. helevoting marco
Drefarid
PARENTS
-
184
MARGIN RESERVED FOR BINDING
3 SEX
Female Muter
14. 1874
Feb. 22
Statement of occupation. - Preise 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, c. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civilengineer, Stationary fireman, etc. But in many eases, 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 "Laborcr," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborcr, 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- eifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, ete. 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 -VEATH (the primary affection with respect to timeand 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, ete., 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," ete., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or misearriage, 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.
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 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 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 ean be obtained as to the deceased, or as to the manner or eause 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 deceased died, his name and residence, if known, otherwise a description of such person as full as may be, with the eause 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 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, though disabled by recognized disease unrelated to any form of injury, have died without recent medieal 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 chemieal (drugs or poisons), thermal, or elcetrical 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.
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,
1 PLACE OF DEATH
County ..
Township
Chilensford
or Village
.or
City.
.No.
.. Ward
St.,
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Sarna
Voller
(a) Residence.
No
(Usual place of abode)
Length of residence in city or town where death occurred
years
mooths
days.
How long io U. S., if of foreign birth ?
years
mooths
days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Femail White
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Wedonved
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Henry & Tolles
6 DATE OF BIRTH (month, day, and year)
7 AGE
Years
72
Months
Days
18
If LESS tbao 1 day, ........ hrs. Or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
at Home
particular kind of work.
(h) General nature of iodustry, business, or establishment in which employed (or employer) ... (c) Name of employer
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 ?. ,
(Sigoed)
Susan Fletcher ×7.1919 (Address) I Chelcontado
M.D.
* State the DISEASE CAUSING DEATH, or in deathis from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional spacc.)
14 Jaured & Volles
Informant
(Address)
Maschera kelt
15
File Mas 7, 1919 Edward . Robbins
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
Mch. 7 1919
17
I HEREBY CERTIFY, That I attended deceased from
Mich 2
1919,to ..
Much 7
, 1919
that I last saw h
alive on
1919
and that death occurred, on the date stated above, at .....
9.30 G
.m.
The CAUSE OF DEATH* was as follows :
(duration)
yrs ..
... mos ....
.. ds.
9 BIRTHPLACE (city or town).
Dunstable Mass
(State or country)
10 NAME OF FATHER Moses Dare
PARENTS
11 BIRTHPLACE OF FATHER (city or town) Dunstable
(State or country) masa
12 MAIDEN NAME OF MOTHER
13 BIRTHPLACE OF MOTHER (city or town).
(State or country)
) Deux table mass
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
Dunstable Marc Mar 9 1919
20 UNDERTAKER
Water Phand
ADDRESS
Haskrank
MARGIN RESERVED FOR BINDING
of certificate.
The Commomuralth of Massachusetts STANDARD CERTIFICATE OF DEATH .
155
(City or town)
State
masz
Registered No. 20
r
Wright
St ..
Ward.
(Ifnon-resident give city or town and State)
Sept 171846
REVISED UNITED ST. [Apprend . .
Statement ··
1
tion is very impoì .
various pursuits can NU AuUnAL. 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 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 houschold ouly (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At sehool 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- catcd 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 discase. 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; Bronehopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toneum, ctc., 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 necd not be stated unless important. Example: Measles (disease causing death), 29 ds .; Broneho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (mercly symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Con- genital," "Scnilc," ctc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," ete., 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," ctc. 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 (c. g., sepsis, tetanus) may be stated
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 diseasc, 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.
„RM R-301
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
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
1 PLACE OF DEATH
County.
PuddleseL
State mars
Registered No.
21
City or Town
€
If death occurred in a hospital or institution, give its NAME instead of street and number) "Sandeau)
2 FULL NAME
(a) Residence.
No.
Chelmsford Gelser
( Usual place of abode)
(If non-resident give eity or town and State)
Leogth of resideoce in city or towo where death occorred
years
months
days.
How loog io U. S., if of foreigo hirth ?
years
mooths
days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH.
Muauch
8
Klonth)
(Day)
1919 (Year)
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 DATE OF BIRTH ..
March (fonth)
8
(Day)
(Year)
7 AGE
-Years -Months
-Days
-
If LESS thao
If STILLBORN, enter that fact here If STILLBORN, state period of uterogestation mos.
1 day, ........ hrs.
er ........ min.
8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work. (h) Generai nature of industry, business, or establishment in which employed ( or employer ) ..
(c) Name of employer
Whichispaid Center
9 BIRTHPLACE (City)
(State or country)
10 NAME OF FATHER
George Rondeau
11 BIRTHPLACE OF
FATHER (City) ..
Canada
(State or countrygz
12 MAIDEN NAME OF MOTHER Oliva Grene
13 BIRTHPLACE OF MOTHER (City) (State or country)
dull mais
Date ..
march
8
1919
.. .........
(Month)
( Day)
( Year)
14
Informant. (Address) Acheburkhard Genlis
15 Mar, 10, 1919 Edward &, Robbins (Month) (Day) (Year)
REGISTRAR
19 PLACE, OF BURIAL, CREMATION, OF REMOVAL DATE OF BURIAL Trung Thelunfar Mach ( 19,
ADDRESS 1 380
20-UNDERTAKER A Dichambault hunoch
21 ] HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued. Edwards, Robban
Official
position
Com click
22 Date of issue of barial mar. 10.1919 or transit permit.
10-'18. 100,000.
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Single
17 I HEREBY CERTIFY, That I attended deceased from
to.
Maren 8, 1919
, 19
19/4/ that I last saw h alive on . 19
,
and that death occurred, on the date stated above, at ..
... m.
The CAUSE OF DEATH was as follows :
Slitt Bari
.(duration)
yrs ..
mos ...
ds.
CONTRIBUTORY (SECONDARY)
.(duration)
.yrs h.
mos ..
ds.
18 Where was disease contracted
if not at place of death ?
Did an operation precede death ?..
A
Date of ..
Was there an autopsy ?
What test confirmed diagnosis ?..
(Signed)
LaRochetto
M.D.
(Address).
732 Mornach
PARENTS
MARGIN RESERVED FOR BINDING
186
St.,
.Ward
(If in the Army or Navy of the United States, give rank, organization, etc.)
Ward.
3 SEX
المحددة
REVISED UNITED STATES STANDARS
[Approved by U. S. Census and American Public Health Association)
Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civilengineer, 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, 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 domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSINO 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 DEATH (the primary affection with respect to time and causation), using always the same 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 ... (nam 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 necd 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," "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 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 ONWEALTH OF MASSACHUSE!Y. 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 otlier 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 contractcd, 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.
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