USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1910-1912 > Part 42
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culosis of lungs, meninges, peritoneum, etc., Carcinoma, Sar- coma, etc., of. . (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronie valvular heart disease; Chronie interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mero symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," " Haemorrhage," " Inanition," " Marasmus," " Old age," "Shock," "Uraemia," " Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicacmia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deaths under tho 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, Ex- posure, 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.
COMMONWEALTH OF MASSACHUSETTS.
RETURN OF A DEATH-1911.
CITY OF BOSTON.
FULL NAME
Ruth Daily
Registered No .. 9678
Place of Death }
Boston
and Residence S
Date of Death
.. 1911.
Age
6
years
10
months
16
days.
STATISTICAL DETAILS.
SEX
COLOR
F
W
SINGLE, MARRIED, WID., DIV. S
Maiden Name
STRAR'S
PATRIBUN, SIT DEL Primary (Duration)
Burns(accidental hot water
Birthplace ..
Waterbury, Conn
Name of
Father
Charles H. Daily 1830.
ISREGIMI!
Birthplace
of Father
Waterbury, Conn.
Contributory : (
Nephritis - 45 days
(Duration)
Maiden Name of Mother .. Nellie Cody
Birthplace Waterbury, Conn.
of Mother.
(Signed)
J.W.J.Marion
M.D.
Occupation
School girl
1911
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Informant
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from
1911, to.
1911, that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows:
Husband's Name
CITY
EFFICE
burnsł 47 days
BOSTONIA CONDITA A.
A A. 1822.
DONATA A
ST
O
N. MASS.
In hospital 47 days
Place of Burial or removal ...
Winthrop"Winthrop. Cem Usual Residence
Winthrop(537 Shirley st)
Oct. 23
Undertaker
C R Bennison
Filed
1911
A true copy .
Attest
ErMSlenen
Registrar.
Childrens Hospt.
Sept.2nd.
CIVITATISRE
Sept. 2, 191
N. B. - Every item of information 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 instructions on back of certificate.
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
England
12 MAIDEN NAME
OF MOTHER
Mary Sohlire Bell
13 BIRTHPLACE
OF MOTHER
(State or country)
England
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Willemi E. Roberta
(Address)
Filed 191
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
3 SEX
female
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Linjer
6 DATE OF BIRTH
(Month)
27 (Day)
1897
(Year)
7 AGE
14.
yrs.
8
mos.
19
.ds.
... min .?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
The CAUSE OF DEATH* was as follows : Perforated appendix operation
Streptococcus infection
(Duration)
yrs.
mos.
98
.ds.
Contributory.
(SECONDARY)
(Duration)
Birmetcalf
yrs.
mos.
ds.
M.D.
Sujet 18'
19| 1
... (Address)
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
yrs.
mos.
96 ds.
In the
b
„yrs.
mos.
ds ...
Where was disease contracted,
If not at place of death ?
29 mermaid are Worthof
usual residence
29
Former or
monnaie med wanted
19 PLACE OF BURIAL OR REMOVAL Wurchent- Quick-
DATE OF BURIAL
1911
ADDRESS
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Metcalf Hospital (No.
St. ;....
Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
May Robili Isabel
2 FULL NAME .. [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 29 mmmural avez Wucheng Registered No.
PERSONAL AND STATISTICAL PARTICULARS
16 DATE OF DEATH
Sept
15
(Month)
(Day)
191.1
(Year)
17
I HEREBY CERTIFY that I attended deceased from
If LESS than
June
12
. 191.L., to
Sept 15th
1911
I day,
hrs.
that I last saw her
alive on
Sept 15
, 1917
and that death occurred, on the date stated above, at.
7309m.
(b) General nature of industry, business, or establishment in which employed (or employer)
9 BIRTHPLACE
(State or country)
Belfast Ireland
10 NAME OF
FATHER
William Edward
Roberts
(Signed)
-DOSTUN
(City or town.)
20 UNDERTAKER
C.R. Bana.
STANDARD CERTIFICATE OF DEATH.
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 age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive 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) Sales- man, (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 minc, etc. Women at home, who are engaged in the duties of the household only (not paid Ilouse- keepers who receive a definite salary), may be entered as Ilousewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically 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: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of "Croup") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) : Tuber-
culosis of lungs, meninges, peritoneum, etc., Carcinoma, Sar- coma, 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 (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Mcasles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- acmia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," " Debility " ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," " Heart failure," " Haemorrhage," " Inanition," " Marasmus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertaincd as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicaemia," " PUERPERAL peritonitis," ctc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions 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, Ex- posure, 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.
COMMONWEALTH OF MASSACHUSETTS.
RETURN OF A DEATH-1911.
CITY OF BOSTON.
FULL NAME
Peter Costello
Registered No ... 8870
Place of Death )
Boston
Hotel Venice, Hanover st.
and Residence
Sept.18
45
Date of Death
1911.
Age
years
2
months
14
. .. days.
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
M
M
Maiden Name.
ST
RAR'S
Husband's Name
CITY.
3019
( suicidal)
Name of John Costello
Father.
Birthplace Ireland
of Father.
Maiden Name
Bridget Concannon
of Mother.
Birthplace Ireland
of Mother
Occupation. Musician
Sept.20 1911
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Place of Burial or removal.
Winthrop"Winthrop Cem. "
Winthrop(Fort Banks)
Usual Residence
Sept.26 1911
Undertaker
Filed ..
Winthrop
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from 1911, to .. .1911, that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows:
DATR
BUS. SIT DE Primary (Duration)
Poisoning by ill. gas
Birthplace. Quincy
LVJ.LAIJ BOSTONIA" CONDITA AL.
A).182
1830.
DONATA A.
.55.
TO
N. MA
Contributory : ( (Duration)
(Signed)
G.B.Magrath, Med. Ex.
M.D.
Informant.
17 C Skaggs
A true copy.
Attest .
EMMYlenen
Registrar.
80 REGI
Depl. 18, 1919
N. B. - Every item of information 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 instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Wintheok (No. 35 Waldirman
Wundert (City or town.)
Ward) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
'FULL NAME Harriet anne Kenworthy
[If married or divorced woman or widow give maiden name, also name of husband.]
Harriet anne. Hangon Wife of Hubert
@RESIDENCE
35 Mulderman avenue
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
female
4 COLOR OR RACE
White
5 SINGLE
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
manil
6 DATE OF BIRTH
och
30
(Month)
(Day)
1870 (Year)
7 AGE
If LESS than I day ..... . . hrs.
40
yrs.
11 mos. 12 ds.
or .min. ?
8 OCCUPATION (a)' Trade, profession, or particular kind of work .. house cafe
(b) General nature of industry, business, or establishment in which employed (or employer).
at home
9 BIRTHPLACE
(State or country)
Huddersfield England
10 NAME OF
FATHER
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME
OF MOTHER
13 BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Hubert Kenworthy
(Address) 35 Walderman Cie
REGISTRAR
16 DATE OF DEATH
Seff
/ (Month) 18 (Day)
191. (Year)
17
I HEREBY CERTIFY that I attended deceased from
191 .... . , to
Fely
Sett 18
1911 .
that | last saw h .........
alive on
Sift 18
. ,
191(.,
and that death occurred, on the date stated above, at // L Cm.
The CAUSE OF DEATH* was as follows :
acute Cardiac Dilatatieri
aufrationale yrs.
mos. ds.
Service labor
Contributory
(SECONDARY)
8 hours(duration)
(Signed)
Soft 20, 1911 (Address)
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
.yrs.
mos.
ds.
State .
.. yrs.
In the
mos.
ds ...
......
Where was disease contracted, If not at place of death ?.
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
Left 20
191
1
....
20 UNDERTAKER
ADDRESS
mos
PARENTS
Filed .. 191. ...
STANDARD CERTIFICATE OF DEATH.
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 age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive 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) Sales- man, (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 luborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Ilousewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically 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: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis") ; Diphtheria (avoid use of " Croup") ; Typhoid fever (never re- port " Typhoid pneumonia") ; Lobar pneumonia; Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, 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 (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy,""Exhaustion," "Heart failure," " Haemorrhage," " Inanition," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as " PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions of chapter 24 of the Revised Laws deathis 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, Ex- posure, 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.
:
COMMONWEALTH OF MASSACHUSETTS.
RETURN OF A DEATH-1911.
CITY OF BOSTON.
FULL NAME
Evelyn Ginepra
Registered No. 8896
Nass. Char. E.& E.Inf.
Place of Death ) Boston
and Residence S
Date of Death
1911.
Age
18
years
9
months.
27
days.
STATISTICAL DETAILS.
SEX F
COLOR W
SINGLE, MARRIED, WID., DIV.
S
Maiden Name
Husband's Name
Boston
CIT
Birthplace
Name of
Charles S. Ginepro 1830.
Father
ST
ONI MASS.
abscess ? Brain abscess, pur. Meningitis - 10 days
Birthplace
of Father.
Maiden Name Lyda Varney
of Mother .
Boston
Birthplace of Mother.
Occupation
Stenographer
Informant.
Place of Burial or removal.
Calvary
Undertaker
Porcella & Granara
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
1911,
from 1911, to that to the best of my knowledge and belief death occurred on the date stated above, and that the CAUSE OF DEATH was as follows:
TRAR'S
PATRI
Rt. Otitis Media, supp.with
polypi-mastoiditis, etra-dural
CONDITA AL
1 .A. 182
Italy
Contributory : ) (Duration)
F.P.Emerson
(Signed) M.D.
.. 1911 ..
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Winthrop(135 Main st)
Usual Residence.
Sept.27
Filed
A true copy.
Attest :
ErMSlenen
1911
Registrar.
...
Sept.21
RIBUS SIT DEN Primary (Duration) RICE
CIVITA BOSTONIA"
-
N. B .- Every item of information 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 instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
I PLACE OF DEATH
(No .. 175 Somerset AM
Annie Kahier Gribbon
2 FULL NAME
Annie Napier Milne - James Gribbon
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 175 Somerset Avenue
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
white
Female
6 DATE OF BIRTH
7 AGE
8 OCCUPATION
PARENTS
WITTE PLAINLT, WITHT ONTAUING INK THIS IS A PERMANENT NECONU.
(b) General nature of industry,
business, or establishment
În
which employed (or employer)
-
(Month)
(Day)
1
(Year)
If LESS than
1
day ..... ... hrs.
84
„.yrs.
-
mos.
... ds.
or min. ?
(a) Trade, profession, or
particular kind of work
Home
9 BIRTHPLACE
(State or country)
Scotland
10 NAME OF
FATHER
Alexander Milne
11 BIRTHPLACE
OF FATHER
(State or country)
Scotland
12 MAIDEN NAME
OF MOTHER
Annie bowie
13 BIRTHPLACE
OF MOTHER
(State or country)
Scotland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Mrs Edna M. Metcalf
(Address)
175 Somerset Avenue
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Sept
(Month)
(Day)
22 1911 (Year)
17
I HEREBY CERTIFY that I attended deceased from
Left. 20, 1911, to
191
that I fast saw her alive on
20, 1911.
and that death occurred, on the date stated above, at.
79.m.
The CAUSE OF DEATH* was as follows :
Central Hervorhogy
1
(Duration)
yrs.
mos.
3
ds.
Contributory.
(SECONDARY)
Senility
(Duration) ..
.. yrs. ...
. mos.
ds.
M.D.
(Signed)
Lek. 2.2/191
(Address).
Minitrope
* if death followed injury or violence the certificate of death must be made gut by the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
yrs.
. mos.
In the
ds.
State .... .. ... yrs.
mos.
ds ..
Where was disease contracted,
If not at place of death ?.
Former or
usual residence
DATE OF BURIAL
19 PLACE OF BURIAL OR REMOVAL
St. Peters Hudson City Syd.
..
191
:0 UNDERTAKER
M.D. Kelly
ADDRESS
49 Maverick Sy
Ward)
..... ..
Winthrop BOSTON
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No.
Filed 191
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
medora
STANDARD CERTIFICATE OF DEATH.
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 age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive 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: («) Spinner, (b) Cotton mill; (a) Sales- man, (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- Coul mine, etc. Women at home, who are engaged in the duties of the household only (not paid House- keepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gain- fully employed, as At school or At home. Care should be taken to report specifically 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: Cerebro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis ") ; Diphtheria (avoid use of "Croup ") ; Typhoid fever (never re- port " Typhoid pneumonia ") ; Lobar pneumonia, Broncho- pneumonia (" Pneumonia," unqualified, is indefinite) : Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of .. (name origin: "Cancer" is less definite ; avoid use of " Tumor" for malignant neoplasmns) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " An- aemia " (merely symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility " ("Congenital," "Senile," etc.), "Dropsy," " Exhaustion," "Heart failure," "Haemorrhage," " Inanition," " Marasmus," " Old age," "Shock," "Uraemia," " Weakness," etc., when a definite disease can bo ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," " PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the provisions 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, Ex- posure, 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.
N. B. - Every item of information 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 instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Tinttrofo
(No. 55 Somerset Com.
268
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
'FULL NAME. Rata Blake Stockbridge
[If married or divorced woman or widow give maiden name, also name of husband.] Kate B. Elwell.
@RESIDENCE
Heuttrop mass.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
married
6 DATE OF BIRTH Sept.
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