Deaths 1920-1921, Part 6

Author: Chelmsford (Mass.)
Publication date: 1920-1921
Publisher:
Number of Pages: 316


USA > Massachusetts > Middlesex County > Chelmsford > Deaths 1920-1921 > Part 6


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60


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 he, 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 the following rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside 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 hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abertion, 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.


1


Form R-302


The Commonwealth of Massachusetts


CERTIFICATE OF DEATH OF NON-RESIDENT


1 PLACE OF DEATH


Coun


middlesex


State


mass


Registered No ..


14


(Place of residence)


St., ......


. Ward


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


2 FULL NAME


(a) Residence.


State


mass.


.City of Town


(If in the Army or Navy of the United States, give rank, organization, etc.) Chelmsford No.


St.


(Usual place of abode)


Length of residence in city or town where death occorred


years


months


14


days


How loog in U. S., if of foreigo birth?


49


Sears 8


6


days


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH (month, day, and yea


) Feb. 23 1920


17


HEREBY CERTIFY, That I attended deceased from


Jeb, 13


19.


to


Feb. 23. 2020


23, 1920


that I last saw Wannalive on


11


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


11.30


to.m.


*State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional space.)


Pulmonary duberaul


(duration) ..


.. yrs.


mos ...


da.


CONTRIBUTORY


(SECONDARY)


(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 ?.


1 1


What test confirmed diagnosis ?


sputum Exam


0


(Signed)


E. G. Livingston


M.D.


2.2019 & (Address)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


DATE OF BURIAL


St. Patrick Lowell. Feb, 26,20


15


Feb. 26 1920 Stephen Flynn (F) Registrar ofcity or town where death occurred Fil mar. 8,1920 Edward X. Robbing


Registrar of city or towo where deceased resided


25-


well


( City or town)


Registered No ..


324


(Place of death)


City or Town


Lowelf


429 Chelmsford


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 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,


of certificate.


PARENTS


11 BIRTHPLACE OF FATHER (city or town) (State or country) freland


12 MAIDEN NAME OF MOTHER Eleanor Judge


13 BIRTHPLACE OF MOTHER (city or (town) (State or country) Ireland


14 While Informant (Address) Chelmsford mars:


20 UNDERTAKER J. F. O Donnellisons


ADDRESS Lowell


3 SEX


4 COLOR OR RACE


mal White married


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


Sarah


Devin


6 DATE OF BIRTH (month, day, and year)June 13 1870


7 AGE


49


-Years


8


Months


Days. . 1.


If LESS than


The CAUSE OF DEATH" was as follows:


If STILLBORN, eater that fact bere


6


1 day, ........ brs. or ........ mio.


8 OCCUPATION OF DECEASED


Shipping Clerk


(a) Trade, profession, or


particular kiod of work ...


(b) Geoeral natore of iodostry, business, or establishment id wbich employed (or employer) (c) Name of employer Provision store


Lowell


9 BIRTHPLACE (city or town) (State or country) mass


10 NAME OF FATHER james) a.


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


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


Statement of occupatic ... - 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, 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," ctc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. .Women at home, who are engaged in the duties of thic houschold 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 domestie 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 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; Bronchopneumonia ("Pneumonia," unquali- ficd, is indefinitc); Tuberculosis of lungs, meninges, peri- toncum, etc., Carcinoma, Sarcoma, ctc., of.


(naine origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Mcasles; 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 .; 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 discase can be ascertaincd as the cause. Always qualify all discases resulting from child- birth or iniscarriage, 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


under the head of "Contributory." (Recommendations on statcinent of cause of death approved by Comunittee on Nomenclature of the American Medical Association.)


Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:


1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, etc.


2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Exposure, etc.


3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.


4. Deaths under circumstances unknown, as A person found dead, etc.


ADDITIONAL SPACE


FOR FURTHER


STATEMENTS BY PHYSICIAN.


:


.


:


R 303. 6-'18. 50,000.


FORM R-301


The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH


26


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


15


State


Registered No.


St ... ...... .Ward


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


2 FULL NAME


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


(a) Residence.


(Usual place of abode)


.St.,


Ward.


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


Length of residence in city or town where death occurred


4


years


months


days.


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


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


(eur/18 1920


(Day)


(Year)


17


I HEREBY CERTIFY, That I attended deceased from


15


to.


March 1


1920.


that I last saw h


en


alive on


Teb, 27


19 20,


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


The CAUSE OF DEATH was as follows : Gen. arteriosclerosis -


Hemiplegia ..


.(duration)


.yrs.


mos .. ds.


CONTRIBUTORY


Haimplique


(SECONDARY)


(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 ?


200.


What test confirmed diagnosis ?


(Sigoed)


Anten G Scolaria, M.D.


(Address)


Celularford, mon.


Date


mar.


/


(Month)


(Day)


1920.


(Year)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


DATE OF BURIAL


1920


(Cemetery)


(City or town)


20 UNDERTAKER


ADDRESS Somall Man


Permit


21 I HEREBY CERTIFY that a satisfactory stao-


BEFORE the burial or transit permit was issued Delward & Rolfuns


Official Joven Clerk


position


Date of issoe of permit Mars, 2, 920 No


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


1-6-'19. 150,000.


1 PLACE OF DEATH


County


City or Town


4 COLOR OB RACE


Abrite


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED. (write the word)


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


David Leave


July Srl 1848


6 DATE OF BIRTH


(Month)


"(Day)


(Year)


7 AGE


71


Years


7


Months


2 6 Days


If STILLBORN, enter that fact here


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.


(b) General nature of industry,


hosiness, or establishment in


which employed ( or employer).


(c) Name of employer


Lowell


9 BIRTHPLACE (City)


(State or country)


Max2


10 NAME OF


FATHER


le Mailis Dellecher


11 BIRTHPLACE OF


FATHER (City).


(State or country)


Chytrium


12 MAIDEN NAME


OF MOTHER Allie Ofvreten


13 BIRTHPLACE OF


MOTHER ( City) ....


(State or country)


Meatin


14


Any Walturas dassler


Informant ...


(Address)


Adelinafad Der


15 mars 2, 1920 Edward , Kolbung Filed (Month) (Day) (Year)


REGISTRAR-


16 DATE OF DEATH ..


(Month)


3 SEX


Finale


MARGIN RESERVED FOR BINDING


PARENTS


No.


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 be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive cngincer, Civil engineer, Stationary fireman, ete. Butin 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 "Laborer," "Foreman," "Manager," "Dealer," ete., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, ete. 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- eifieally 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 CAUSINO DEATH, state occupation at beginning of illness. If retired from business, that faet 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 DEATHI (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 "Epidemie cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, ete., of .. ... . (name origin; "Caneer" 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 symptomatie), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Debility" ("Congenital,""Senile," ete.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," ete., when a definite disease can be aseertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.


.


-


State cause for which surgical operation was undertaken.


(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)


Bronchopneumonia: If primary cause, write the word "pri- mary" ; if secondary, give primary cause.


Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the 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. 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 elerk 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 ecrtifi- 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 be obtained as to the deceased, or as to the manner or cause 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 sueli 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 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 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.


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.


The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH


27


Chelmsford


(City or town)


1 PLACE OF DEATH


County.


Middlesex


Township


Chelmsford


or Village


or


St.,


.Ward


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


Pliney Clark Bliss.


2 FULL NAME


(a) Residence.


No ..


Billerica Road


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


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


Length of residence in city or town where death occurred


months


days.


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


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


male


4 COLOR OR RACE


white


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


married


5a If married, widowed, or divorced


HUSBAND of


(01 ) WIFE of


Jessie M. B1188


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


Sep. 10, 1854.


7 AGE


65


Ycars


Months


5


Days


21


If LESS than


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


or ........ min.


General arteriosclerosis .


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work ..


farmer


(b) General nature of industry,


business, or establishment in


which employed (or employer)


(c) Name of employer


.(duration)


.....


yrs.


.. mos ..


ds.


CONTRIBUTORY


(SECONDARY)


-(duration)


3


mos.


1


ds.


18 Where was disease contracted


if not at place of death?


Did an operation precede death ?


220, Date of.


Was there an autopsy ?.


200.


What test confirmed diagnosis ?


(Signed)


Anten G, Scolaria /


M.D.


3-4, 19 -20 (Address)


Chalut ford, 2500


* 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.)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


Pine Ridge Cem. Chelmsford


DATE OF BURIAL


Ian 4 1220


19


(Address)


15 Filed Mar. 4, 1920 Edward J. Robbins REGISTRAR


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH (month, day, and year)


march 2


1920


17


I HEREBY CERTIFY, That I attended deceased from


20


March 2


to


1920-


...........


Dec. 3


19


that I last saw him alive on


Feb. 20


19 .. 20 ..


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


m.


The CAUSE OF DEATH* was as follows :


.yrs ....


9 BIRTHPLACE (city or town)Rochestor


(State or country)


Vermont


10 NAME OF FATHER


Chester Bliss


11 BIRTHPLACE OF FATHER (eity or town)


(State or country)


Vermont


12 MAIDEN NAME OF MOTHER Electa Nason


13 BIRTHPLACE OF MOTHER (eity or town).


(State or country)


Vermont


14


Informant


Mrs. P. C. Bliss


20 UNDERTAKER


Walter Perham


ADDRESS


Chelmsford


MARGIN RESERVED FOR BINDING


PARENTS


(Usual place of abode)


27


years


City


No.


....


.State.


Massachusetts


Registered No.


16


-


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH [Approved by U. S. Census and American Public Health Association]


Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of 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 dutics 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- eifically the occupations of persons engaged in domestie 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 "Epidemie 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.




Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.