USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1920-1921 > Part 33
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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 examinatien upon the view of the dead bodies of only such persons as are supposed to have come to their death by violence. - Revised Lows, Chop. 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 ferm 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 include net 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.
R-302
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
Worcester
(City or town)
Registered No.
442
(Place of death) 11
Registered No. (Place of residence)
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME Edwin i Parler
(If in the Army or Navy of the United States, give rank, organization, etc.)
City or Town Chelmsford
No.
St.
--
Length of residence in city or town where death occurred -
years
] months
7 days
How long in U. S., if of foreign birth?
years
months
days
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Ma le
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
single
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 DATE OF BIRTH (month, day, and year)
-
-1864
7 AGE
Years
Months
Days
57
+
+
If LESS than 1 day, ........ hrs. or ........ min.
If STILLBORN, enter that fact here
8 OCCUPATION OF DECEASED
machinist
(a) Trade, profession, or
particular kind of work.
(b) Name of employer
9 BIRTHPLACE (city or town)
Westford
(State or country)
(SECONDARY)
18
yrs.
+
mos.
ds.
18 Where was disease contracted
if not at place of death ?
At home
Did an operation precede death?
no
Was there an autopsy ?.
no
What test confirmed diagnosis?Clinicalsymptoms
(Signed) .
Robert I Harriman
M.D.
/2 519 2 ]Address)
Worcester
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Fairview
Westford
DATE OF BURIAL
Mar 1
19
21
15 Filed har 1, 1921 rhenen
Registrar of city of town where death occurred
Filed
Mar 4
1921
Registrar of city dr town where deceased resided
11-13-'19. 25,000
of certificate.
14 Hospital records
Informant
(Address)
Worcester
20 UNDERTAKER
Geo Sessions Sons Co
ADDRESS
Worcester
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,
1 PLACE OF DEATH
County ........... Worcester State Mass
City or Town.
Worcester
NoWorcester State Hospital
(a) Residence. State ..... Ma.S.S
(Usual place of abode)
white
17
I HEREBY CERTIFY, That I attended deceased from
Jun 18
21
19
Fel 24
21
19
to
24
21
that I last saw
alive on
19 .. ,
and that death occurred, on the date stated above, at 12.55 p.m.
The CAUSE OF DEATH* was as follows :
* 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.)
Cerebral hemorrhage .
.(duration).
-
.yrs .-
.mos.
2
de.
CONTRIBUTORY
Epilepsy.
(duration)
10 NAME OF FATHER
George ..
PARENTS
11 BIRTHPLACE OF FATHER (city or town)
(State or country)
Acton
12 MAIDEN NAME OF MOTHER Sarah Winchester
Date of
13 BIRTHPLACE OF MOTHER (city or town) (State or country) Lowell
16 DATE OF DEATH (month, day, and year)
Fel. 2419 21
.. im
96
-
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 agc. 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 engincér, 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 Housckecpers 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 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); Measlcs; Whooping cough; Chronic valvular heart discase; 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" (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 ascertaincd 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 (c. g., sepsis, tetanus) may be stated
sions of chapter 24 of the revised Laws deals und wie 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.
FORM R-301
1 PLACE OF DEATH Hildeact,
County
2 FULL NAME
(a) Residence. No.
1633
( Usual place of abode)
Leogth of residence in city or town where death occurred
14 years
months
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Mala
5a If married, widowed, or divorced
HUSBAND of
fora Bell Infto.
(or) WIFE of
Loc. -
24%
G DATE OF BIRTH
(Day)
(Month)
7 AGE
Years
Months
75
Days
2
2
If STILLBORN, enter that fact here
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particular kind of work.
(h) Name of employer
9 BIRTHPLACE (City)
Somerville.
Mas.
(State or country)
10 NAME OF
William Inflé,
FATHER
11 BIRTHPLACE OF
FATHER (City).
domenville
12 MAIDEN NAME
OF MOTHER
13 BIRTHPLACE OF
MOTHER (City)
PARENTS
(State or country)
in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See
(State or conntry)
Maso.
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Married
18400 (Year)
If LESS thao I day, ........ hrs. pr ....... min.
Maso.
14 Who bosa B. Tufte.
Informant
(Address)
1633 Senhor So Schnell
15
Filed Feb. 28, 1921 Edward Selling (Month) (Day) (Year)
REGISTRAR
21 I HEREBY CERTIFY that a satisfactory stan dard certificate of death was filed with devand . Robbing
Official position
Com Cluck
Date of issue of permit
Feb, 28,92/05 /20wall
-
(duration)
.yrs.
.. mos ............ .ds.
CONTRIBUTORY
(SECONOARY)
(duration)
yrs ................
mos ....
ds.
18 Where was disease contracted
if not at place of death ?
Did an operation precede death ?
no.
Date of
Was there an autopsy ?
220.
What test confirmed diagnosis ? Aucun 4. Scottona (Signed).
M.D.
(Address ) ..
Date
726-28
(Month)
(Day)
(Year)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Toburn
(Cemetery)
(City or town)
20 UNDERTAKER
I Bon
ADDRESS 14500mg SV.
6-'20. 20,000.
The Commonwealth of Massachusetts
97
Mage.
(City or Town)
City or Town
( Each) Calmaford No. 1633
State .. Gorham
Registered No.
12
St., ......... .Ward (If death occurred in a hospital or institution, give its NAME instead of street and number)
Sammel Areon
(If in the Army of Navy of the United States, give rank, organization, etc.)
St.
Ward.
(If non-resident give city or town and State)
days
MEDICAL CERTIFICATE OF DEATH
11-30PM
26-1921
(Day)
(Year)
17 HEREBY CERTIFY, That I attended deceased from I
to
Jan. 31
19.
21
fib 26
1.9
21
that I last saw h man alive on
Fint: 26
21
19
and that death occurred, on the date stated above, at .. m. The CAUSE OF DEATH was as follows: Marieal arterio Sclerose Myocarditis -
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
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information MARGIN RESERVED FOR BINDING
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
days.
How long in U. S., if of foreign birth ?
years
16 DATE OF DEATH
(Month)
months
1921,
DATE OF BURIAL W/Or, 1 0/21
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, irrespectivo 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 necded. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Forcman, (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 tho duties of the house- hold only (not paid Housekeepers who receive a definite salary), may be entercd as Housewife, Houscwork, 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 servico 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, writo 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- brospinal fever (tho 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 discase; 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 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 causo 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.
RETURN OF VENTIL IVAILY VI
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 deccased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belicf 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. 328.
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 licu 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 deccascd 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 tho 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 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.
The Commonwealth of Massachusetts
98 Chelinefund
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
County.
Middlesex
State
Mass
Township
Chelunsford
or Village
Centre
or
City
No.
St ... .Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Amaia Howard
(a) Residence.
No.
Chelmsford Center
Ward.
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
How long in U. S., if of foreign birth ?
years
months
da ys
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
M.
4 COLOR OR RACE
W.
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Marrie
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Louise W. Howard
6 DATE OF BIRTH (month, day, and year) Apr. 20-1857
7 AGE
Years
63
Months
10
Days
10
If LESS than 1 day, ........ hrs. or ........ min. arterio sobrasis
8 OCCUPATION OF DECEASED
(a) Trade; profession, or
particular kind of work
Physician
(b) General nature of industry, business, or establishment in which employed (or employer) (c) Name of employer
(duration)
?
.yrs ....
.......
.mos.
..........
.ds.
CONTRIBUTORY
(SECONDARY)
ore
(duration)
.............. yrs .............
.. mos.
20 às:
9 BIRTHPLACE (city or town).
Chelmsford
(State or country)
mars.
10 NAME OF FATHER
Levi Howard.
11 BIRTHPLACE OF FATHER (eity or town).
Still Giver
(State or country)
Mass.
12 MAIDEN NAME OF MOTHER
Lydia . Hapgood
13 BIRTHPLACE OF MOTHER (city or town) Waterford
(State or country)
Maine
18 Where was disease contracted
if not at place of death?
Did an operation precede death?
Date of.
Was there an autopsy ?.
ho
What test confirmed diagnosis ?
(Signed)
Marchal R. Allung
M.D.
3/47. 1924 (Address) Lawwell, made
* 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
Forefacture Civilstand.
DATE OF BURIAL Mich 5 1921
15 Filed
March 5 1921 Questione L. More
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year) march 2 1921
17
I HEREBY CERTIFY, That I attended deceased from
19/3
to
19
....
that I last s
un alive on
March 1
19
21
and that death occurred, on the date stated above, at
1:30p.m.
The CAUSE OF DEATH* was as follows:
MARGIN RESERVED FOR BINDING
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, N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of information should be of certificate.
PARENTS
14
Informant(
Are. Louise Howard
(Address)
20 UNDERTAKER
ADDRESS
Walter Terham - Clicking ford
(City of/town)
13
Registered No.
(If in the Army or Navy of the United States, give rank, organization, ete.)
days.
(If non-resident give city or town and State)
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 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. 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 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- 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" (merely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Con- genital," "Scnile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock,"" "Uremia," "Weakness," ctc., when a definite disease can be ascertained as the causc. 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
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