USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1919 > Part 9
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(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), thermai, 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
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,
....
......
(City or town)
1 PLACE OF DEATH
County middlesey
State massachusetts
Registered No. 27
Township
Chelmsford
or Village north
... or
City No ١٠٠٠ ..... ...
St.,
.Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(a) Residence. No.
(Usual place of abode)
Lengis of residence in city or town where death occurred
years
months
days.
How long in U. S., if of foreign birtb ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Single
5a If married, widowed, or divorced
HUSBAND of
(01) WIFE of
6 DATE OF BIRTH (month, day, and year)
april 14,1119.
7 AGE Years
Months
Days
If LESS than
1 day, ........ hrs.
or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade, profession, or particular kind of work ..
(b) General nature of industry, business, or establishment in wbicb employed (or employer) (c) Name of employer
9 BIRTHPLACE (city or town) ..
1) north Chelmsford
(State or country) massachusetts !
10 NAME OF FATHER my Thomas mas Semaberie Was there an autopsy ?.
PARENTS
11 BIRTHPLACE OF FATHER (city or town) ensey Island (State or country) England
12 MAIDEN NAME OF MOTHER Cheating machen
13 BIRTHPLACE OF MOTHER (city or town) Jersey Jaland (State or country) England
14 Informant Thomas Limaaurier
(Address) north Chelmlad
15
File ahr, 15, 2019 Edward J. Robbins REGISTRAR
.....
16 DATE OF DEATH (month, day, and year) abril 14 1919
17
I HEREBY CERTIFY, That I attended deceased from
annual 14
........ ,
19
.. , to
., 1919
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 :
still born
(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 ?
Date of.
What test confirmed diagnosis ?
4 (Signed).
Fred EJamey
M.D.
15,19/9 (Address) North Chlustand
* State the DISEASE CAUSING DEATHI, 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 space.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL Riverside Courtes
DATE OF BURIAL Ahl 15 2019
20 UNDERTAKER
Hames sistem upstof Center
ADDRESS Via Chelmsford
of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
,92
.....
(If in the Army or Navy of the United States, give rauk, organization, etc.)
St.,
...........
.Ward.
(If non-resident give eity or town and State)
......
MEDICAL CERTIFICATE OF DEATH
STANDARD CERTIFICATE OF DEATH 4. Sus and American "f" " Association]
, various pursuits ean be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compos- itor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial worked on may form part of the second statement. Never return "Laborer," "Foreman," »' "Manager," "Dealer," 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. Carc 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- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- 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- eurrent) 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" (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 ean 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
of "Contributory." (Recorrer . of cause of death annrow
Sions of chapter 24 of the neviseu 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 eircumstances unknown, as A person found dead, etc.
ADDITIONAL SPACE
FOR FURTHER STATEMENTS BY
PHYSICIAN.
R 15. 10-'18. 5,000.
FORM R-301
The Commmuralth of Massachusetts
STANDARD CERTIFICATE OF DEATH
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
28
Registered No.
St.,.
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
10 Lohn to M' Manoman
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence. No. (Usual place of abode)
Middlesex hurt chieti Stand
Ward.
(If non-resident give city or town and State)
Length nf residence ia city or town where death occurred
62
years
months
days.
How long in U. S., if of foreign hirth ? years
months days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX 4 COLOR ORRACE male white
5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word)
Sa If married, widowed, or divorced HUSBAND of (or) WIFE of
6 DATE OF BIRTH
(Month)
(Day)
( Year)
7 AGE 62 Years
Months
Days
If STILLBORN, enter that fact here
If STILLBORN, state period of uterogestation
..... mos.
8 OCCUPATION OF DECEASED Post master
(a) Trade, profession, or particular kind of work. (b) Generai nature of industry, business, or establishment in which employed ( or employer )
mail Service
(c) Name nf employer Amelie States Department
9 BIRTHPLACE (City) (State or country)
mars
10 NAME OF FATHER
Tatted m'manomin
11 BIRTHPLACE OF FATHER (City). (State or country) Serland
12 MAIDEN NAME OF MOTHER mary mc manus
13 BIRTHPLACE OF MOTHER (City) ......... (State or country)
14 Margaret Em manomin sestens
Inform (Address) midler St north Chebel ord
15 apr. 16 1919 Edmond 1. Bobbing Filed ahr (Month) (Day) (Year)
21 1 HEREBY CERTIFY that a satisfactory stan.
BEFORE the burial or transit permit was issued. Edward & Rotting
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
(Cemetery)
(City or town)
ADDRESS
20 UNDERTAKERO most Formalxtone Touch
Official Com Click position.
22 Date of issue of burial als, 16.19/19 or transit permit.
instructions and extracts from the laws on back of certificate.
10-'18. 100,000.
should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH
in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See
PARENTS
Chelmsford
(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 ?
no.
What test confirmed diagnosis ?
Simplan
(Signed)
M.D.
( Address).
Date aquil 15
1919
( Month)
(Day) .... (Year) 7
17 I HEREBY CERTIFY, That I attended deceased from aquil 1 1919, to abril 15, 19/19
that I last saw h .... alive on abril 14, 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. Cerebral Her auf
.(duration)
yrs ......
cmos 18 ds.
CONTRIBUTORY
(SECONDARY)
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH ..
(Month)
15 1919
(Day) (
(Year)
MARGIN RESERVED FOR BINDING
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information
193
1 PLACE OF DEATH County /Middleary,
State mass
City or Town Chelmang No. middlesexet
2 FULL NAME
1859
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. 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, Locamotive 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 husincss or industry, and therefore an additional line is provided for the latter statement; it should he used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Gracery; (a) Foreman, (b) Autamobile factory. The material worked on may form part of the second statement. Never return "Lahorer," "Foreman," "Manager," "Dcalcr," etc., without more precise specification, as Day labarer, Farm laborer, Labarer - Coal mine, etc. Women at home, who are engaged in the duties of the house- hold only (not paid Hausekeepers who receive a definite salary), may be entered as Housewife, Hausework, or At home, and children, not gainfully employed, as At school or At home. Care should he taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Caak, Housemaid, etc. If the occupation has heen changed or given up on account of the DISEASE CAUSING DEATH, state occupation at heginning of illness. If retired from business, that fact may he 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 NEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cere- braspinal fever (the only definite synonym is "Epidemic cerchrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhaid fever (never report "Typhoid pncumonia"); Labar pneumonia; Branchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinama, Sarcoma, etc., of .......... (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whaaping caugh; Chronic valvular heart disease; Chranic 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,""Dehility" ("Congenital,""Senile," etc.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite disease can he ascertained as the cause. Always qualify all diseases resulting from childhirth 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 hest of his knowledge and helicf the name of the deceased, his supposed age, the discase of which he died [defined so that it can he classified under the international classification of causes of death], where contracted, the duration of his last illness, when last seen alive hy 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 can he 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. 1
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 hy violence. - Revised Laws, Chap. 24, Sec. 8.
RULES OF PRACTICE
The fulfilment of the purpose of these laws calls for the ohservance 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 disahled by recognized disease unrelated to any form of injury, have dicd without recent medical attendance or whose physician is ahsent 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.
FORM R-301
in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See 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
,94
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
1 PLACE OF DEATH
County.
City or Town
To chiliford
No.
Stor
Rd
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Olive Denault
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence. No.
( Usual place of abode)
Groton Road
St.,
Ward.
(If non-resident give city or town and State)
Leogtb of residence in city or town where death occorred
4 years
montbs
days.
How long io U. S., if of foreign birth ?
35
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
JEmale
4 COLOR OR RACE
White
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Francois O. Denault
6 DATE OF BIRTH
( Month)
(Day)
( Year)
7 AGE 84 Years 2 Months 1 4 Days
If STILLBORN, eoter that fact bere If STILLBORN, state period of uterogestation. .. mos.
If LESS than
1 day, ........ hrs.
or ........ min.
8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work .. (h) Geoerai nature of industry, business, or establishment in which employed ( or employer ) ..
(c) Name of employer
9 BIRTHPLACE (City) (State or country)
10 NAME OF
FATHER
Flavien Boucher
11 BIRTHPLACE OF
FATHER (City).
(State or country)
Canada
12 MAIDEN NAME
OF MOTHER
Agnese Brassard
13 BIRTHPLACE OF MOTHER (City) ... (State or country) Canada-
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH.
fylonth)
abril
21
1919
(Day)
(Year)
17 I HEREBY CERTIFY, That I attended deceased from
19
to
,19.29
that I last saw h
alive on
.... . 19 19.
and that death occurred, on the date stated above, at.
5 a.m.
The CAUSE OF DEATH was as follows :
(duration)
yrs ..
Lhos ....... / .. 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)
For Manay M.D.
(Address) ..
21
1919
Date.
(Month)
( Day)
....
(Year)
14 Pretance Gaudette
Informant.
(Address)
Frater Rx. No. Chalcenter
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
St. Joseph Eight Chiluns ford
(Cemetery)
(City or town)
DATE OF BURIAL Cfr. 23 2019
15 apr. 22, 1919 Edward . Robbing
(Month) (Day) (Year)
REGISTRAR
20 UNDERTAKER
a. archambault
ADDRESS
738
merkst
ires ,
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 for Jobbing
Official Jown Click
position.
22 Date of issue of burial or transit permit ..
als. 22, 1919
-
Canada.
PARENTS
10-'18. 100,000.
STANDARD CERTIFICATE OF DEATH
State
Massi
Registered No.
29
2 FULL NAME
MARGIN RESERVED FOR BINDING
1835
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. 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, Compositor, Architect, Locomotive engineer, Civilcngincer, 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 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 DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discase. 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, 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 contributory (secondary or inter- current ) affection necd 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 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- inittee 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.
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