USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1920-1921 > Part 50
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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 agc, the disease of which he died [defined so that it can be classified under the international classification of causes of death], where contracted, the duration of his last illness, when last seen alive by the physician, and the date of his death. . - Revised Laws, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chap. 322.
No undertaker or other person shall bury a human body . . . until he has received a permit from the board of health or its agent, . . . or . . from the clerk of the city or town in which the person died; . . . no such permit shall be issued until there shall have been delivered to such board, agent or clerk, . . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which ... shall be accompanied by a satisfactory certificate of the at- tending physician, if any, as required by law, or in lieu thereof a certifi- cate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, the chairman of the board of health, if a physician, or any physician employed by said board or by the selectmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner only shall make such certificate. . .. The person to whom the per- mit is so given and the physician who certifies to the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Reviscd Laws, Chap. 78, Sec. 38.
Medical examiners shall, in all cases, certify to the city or town clerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise a description of such person as full as may be, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are supposed to have come to their death by violence. - Revised Laws, Chap. 24, Sec. 8.
RULES OF PRACTICE
The fulfilment of the purpose of these laws ealls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they 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 ferm of injury, have dicd 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 eaused 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 thoso of persons found dead.
FORM R-301
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
(City or Town)
1 PLACE OF DEATH
State
Mark.
Registered No.
58.59
St .. .Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Sarah Ide Sargent
(If in the Army or Navy of the United States, give rank, organization, etc.)
Wildwood St
St.
Ward.
( If non-resident give city or town and State)
Length of residence in city or town where death occurred
25
years
months
days.
How long in U. S., if of foreign birth ?
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
Herbert S. Sargent
6 DATE OF BIRTH
Oct
( Month)
(Day)
1851 (Year)
Years
Months
11
Days
25
If LESS than 1 day,. ..... hrs,
or ....... min.
If STILLBORN, enter that fact here
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particular kind of work.
at home
(duration)
.. yrs.
mos.
4
....
ds.
CONTRIBUTORY
hur condition
( SECONDARY)
11/2
(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 ?
no.
What test confirmed diagnosis ??
Aucuny, Scalona
., M.D.
(Signed)
(Address).
Chacunford, Mans.
Date
Oct-1 21921,
(Month)
(Day)
(Year)
14 Herbert 5. Sargent
(Address)
Chemin
15 Det 1 1921 Justin L. Moon Filed (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 Justin L Moon
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Farveland Com.
Groveland
DATE OF BURIAL
Cach 3 1921
(Cemetery)
(City or town)
20 UNDERTAKER Hatten Derhan
ADDRESS
Chelmsford
Official vous Bleckis position
Date of of permit 10/1/21
Permit NO ......
12-'20 :00,000
3 SEX 7 AGE 69 FATHER PARENTS Informant should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH (h) Name of employer 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 (State or country)
The Commonwealth of Massachusetts
143
County
Chelmsford
No.
City or Town
(a) Residence. No ...
( Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH.
(Monthy
(Day)
(Year)
17
I HEREBY CERTIFY, That I attended deceased from
March
19
20, to.
Sept 30,
.19
21
that I last saw h ........... alive on
Sept 29, 19
21
and that death occurred, on the date stated above, at
m.
The CAUSE OF DEATH was as follows :
Gente Pretribos
9 BIRTHPLACE (City)
Boston
10 NAME OF
Edward Sweeney
11 BIRTHPLACE OF
FATHER (City)
Boston
(Statc or country)
тел.
12 MAIDEN NAME
OF MOTHER
Sarah Somerville
13 BIRTHPLACE OF
MOTHER (City)
(State or country)
Barton
MARGIN RESERVED FOR BINDING
5
Sipt
30-1921
REVISE
1. ABGACHUSETTS
GOVERNING THE
TURN OF CERTIFICATES OF DEATH
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," "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 disease. 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. 's indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of ..... ... (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," ctc.), "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.
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertakeror other authorized person or of any member of the family of tho dceeased, 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 dicd, defined as re- quired by section one, where same was contracted, the duration of lis last illness, when last seen alive by the physician or officer and the date of his death. ...- Gen. Laws, Chap. 46, Sec. 9.
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 town where the person died; . . . No such permit shall beissued until thereshall have been delivered to such board, agent or clerk ... a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certi- ficate of the attending physician, if any, as required by law, or in licu thercof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certi- ficate. ... Tho person to whom the permit is so given and the physi- cian certifying the cause of death shall thercafter furnish for registration any other necessary information which ean be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Gen. Laws, Chap. 114, Sec. 45.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have dicd by violence. - Gen. Laws, Chap. 38, Sec. 6.
. . . He shall in all cases certify to the town clerk or registrar in the place where the deceased dicd his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -Gen. Laws, Chap. 38, Sec. 7.
RULES OF PRACTICE
The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical examiners will investigate and certify to all deaths sup- posably due to injury. These 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, tho sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Form R-302
The Commonwealth of Massachusetts
CERTIFICATE OF DEATH OF NON-RESIDENT
Towks bury
1 PLACE OF DEATH
County
Middlesex
State.
Massachusetts.
Registered No.
320
(Place of death)
Registered No. 59 56
(Place of residence)
St.,
. Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Frank Gilman
(If in the Army or Navy of the United States, give rank, organization, etc.)
City or Town
No. No. Chelmsford
St.
(a) Residence. State
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
14
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, day, and year)
Copt. 14 19 21
17
21
I HEREBY CERTIFY, That I attended deceased from
Auc. 51
19
Sept. 14
19
...
to
that I last saw h ..
&live on
19
8:30 ₽
and that death occurred, on the date stated above, at
m. The CAUSE OF DEATH" was as follows :
* State the DISEASE CAUSING DEATII, 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.)
Carcinoma stomach
(duration)
7
yrs.
6
mos ............
da.
CONTRIBUTORY
(SECONDARY)
(duration) .yrs.
mos
...........
.ds.
18 Where was disease contracted Towell
if not at place of death?
Did an operation precede death?
Yes
Date of
Ipr. 18, 197
Was there an autopsy?
TTO
12 MAIDEN NAME OF MOTHER Virginia (not leaned
13 BIRTHPLACE OF MOTHER (city or town) (State or country)
9/1
Informant
Hospit I Record .
21.
, 19
/
Registrar of city or towy where death occurred
Filed 10/11 192/ justin a neaok
Registrar of city ur town where deceased resided
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Ct. Joseph's Ce.n. Cholms
DATE OF BURIAL
Sept. 16
19 27
For
ADDRESS
20 UNDERTAKER Joseph .Ilbert.
e
MARGIN RESERVED FOR BINDING
2 FULL NAME 3 SEX Male 7 AGE Years 70 (b) General nature of industry, business, ur establishment in which emplayed (ur employer) (c) Name uf employer PARENTS 14 15 9,15% Filed .. ... of certificate. Breit · 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 carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, If STILLBORN, enter that fact bere
4 COLOR OR RACE
"Thite
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) Dec. 17, 1850
Months
8
Days
28
If LESS than
1 day, ........ brs.
or ....... min.
8 OCCUPATION OF DECEASED (a) Trade, profession, or
particular kind of work
Mill hand
9 BIRTHPLACE (city or town)
(State or country)
Canada
10 NAME OF FATHERLuDie Gilman
11 BIRTHPLACE OF FATHER (city or town)
(State or country) Canada.
What test confirmed diagnosis ?. Sherman Perry
(Signed)
5/.19 27
(Address)
State Infirmary,
TETET"
.M.D.
(City or town)
City or Town
Tewksbury
No.
Stato Infirmary
... 9
141
im
Sept. 14.
21
30
-
REVISED UNITED STATE
"ed by ". ... "
JASONIVIN VI occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compos- itor, 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) Groecry; (a) Foreman, (b) Automobile factory. The ma- terial worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," cte., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, ete. 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, ete. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATII, state occupation at beginning of illness. If retired from business, that faet may be indi- cated 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 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; Bronehopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toneum, cte., Carcinoma, Sarcoma, etc., of_
(name origin; "Caneer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, ete. The contributory (secondary or inter- current) affcetion need not be stated unless important. Example: Measles (disease eausing death), 29 ds .; Broneho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatie), "Atrophy," lapse," "Coma," " "Convulsions," "Debility" (“Con-
"Col- genital," "Senile," ete.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," ete., when a definite discase ean be ascertained as the eause. Always qualify all discases 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, Of 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 earbolic 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 Nomenelature 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 Medieal Examiners:
1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, ete.
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, ete.
ADDITIONAL SPACE FOR FURTHER STATEMENTS BY
PHYSICIAN.
₹
R 303. 6-'18. 50,000.
FORM R-301
OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
County
Heder
State
Mas
(City or Town)
City or Town
Chelmsford
No.
St.
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
asa Grenville Charles
(If in the Army or Navy of the United States, give rank, organization, etc.)
(a) Residence. No .....
( Usual place of abode)
Mitral Square
.St.,
Ward.
(If non-resident give city or town and State)
Length of resideoce in city or towo where death occorred
20
years
months
days.
How long in U. S., if of foreign hirth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
maks
4 COLOR OR RACE
white
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Married
5a If married, widowed, or divorced HUSBAND of (=) WIFE Of Harriet E. Charles
6 DATE OF BIRTH
( Month)
(Day)
(Year)
7 AGE
Years
88
Months
4
Days
20
I day, ........ hrs. or ....... min.
If STILLBORN, enter that fact here
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particolar kind of work
(h) Name of employer
Retired
9 BIRTHPLACE (City)
Hoyebury, Mains
(State or country)
10 NAME OF
FATHER
asa Charles
11 BIRTHPLACE OF
FATHER (City)
Concord n. H.
(State or country)
12 MAIDEN NAME OF MOTHER
Harriet Nard
13 BIRTHPLACE OF
MOTHER (City)
(State or country)
n.H.
14 Frank B. Charles
Informant.
(Address)
Sources man.
15 Och, 29, 1921 Stotine R. 8hours Filed REGISTRAR (Month) (Day) (Year)
20 UNDERTAKER
Walter Perham
ADDRESS
Chelmsford
21 I HEREBY CERTIFY that a satisfactory stao- dard certificate of death was filed with me certece BEFORE the burial or transit permit was issued. Justice R. Marce Official
Freon deck „position.
Date of issue of permit. 10/29/21
Permit
No
17
I HEREBY CERTIFY, That I Attended deceased from
aug
3
1921
Oct. 28
19.2 ... ..
to
that I last saw him
alive on
Oct. 28
1971.
and that death occurred, on the date stated above, at
6.45
If LESS than The CAUSE OF DEATH was as follows : artino Agelencio Myocarditis Cerebral embolus
.(duration)
.. yrs ...
3
mos.
25 de.
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 ?
200
What test confirmed diagnosis ?
2
(Signed)
(Address)
Chelmsf
Dale
Oct
(Month)
( Day)
(Year)
19.21.
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
Pine Ridge
Chelmsford
(Cemetery)
(City of town)
DATE OF BURIAL
Oct 31 1921
M.D.
Concord
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH.
(Month)
UCK 29th
(Day)
1921
(Year)
MARGIN RESERVED FOR BINDING
12-'20.100,000
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
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