USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1910-1912 > Part 50
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The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Denvers State Hospital ..
St. : Ward)
Danvers (City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.}
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.]
McRac.
Benjamin Howatt.
@RESIDENCE
Winthrop, Mass.
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
8 SEX
Female
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Married
6 DATE OF BIRTH
(Month)
(Day)
1 (Year)
7 AGE
If LESS than 1 day ......... hrs.
44
.yrs.
- mos.
- ds.
or ........ min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
Houso-wife
(b) General nature of industry. business, or establishment in which employed (or employer).
9 BIRTHPLACE (State or country)
Prince Edward Island
10 NAME OF
FATHER
James McRae
11 BIRTHPLACE OF FATHER (State or country) P. E. I.
12 MAIDEN NAME OF MOTHER
Elizabeth Pierceval
13 BIRTHPLACE OF MOTHER (State or country) P. E. I.
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informent)
Custis Roch
(Address)
Hethorne, Maos.
Filed ........ .Doc .....__. 191 1 Juluio Peale REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from December 1. 1911. .... December 11. 19 ... ] that I last saw h ..... Or alive on ...... December 11 .... 191 .. ]., and that death occurred, on the date stated above, at. 4.5G.
The CAUSE OF DEATH* was as follows :
General paralysis of the Insane.
(Duration)
6
mos.
-
ds.
Contributory
(SECONDARY)
-
(Duration) .. yrs.
mos. ds.
(Signed)
Harlan ... L. .... Paine
M.D.
Dec. 13. 19] (Address) Hathorne, Mass
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
1$ LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death
rs.
. mos.
105
In the
State
yrs.
mos.
ds.
Where was disease contracted, If not at place of death ?.
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL Winthrop Cemetery Vinthron, Lasse
DATE OF BURIAL
Dec . .... 13, 1917.
20 UNDERTAKER
Edwin G. Brown & Sons
ADDRESS
winthrop,
16 DATE OF DEATH Decomber ..... 11 (Year) 191 .........
(Month) (Day)
Elizabeth J. Howatt,
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative licalthfulness 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 laborer, 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 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, 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 in- 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- FERAL 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- posurc, 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.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Minthogy No. HG Luccala St. ;..
(City or town.)
Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
Lavinia Devison. 2 FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.] . Chaque Davison @RESIDENCE Hb Lincoluit Spuithios
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
W
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
married
0
6 DATE OF BIRTH
(Month)
(Day)
(Year)
7 AGE
If LESS than 1 day, ..... .hrs.
45 yrs.
3 mos.
9.ds.
or
min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work ...
Housewife
(b) General nature of industry, business, or establishment i which employed (or employer) ..
9 BIRTHPLACE
(State or country)
quand
10 NAME OF
FATHER
PARENTS
12 MAIDEN NAME OF MOTHER martha a, Hagel
1ª BIRTHPLACE OF MOTHER (State or country)
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Chas. W. Davison
(Address)
Hb Luicole &t,
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
(Month)
19, 19|1
(Day)
(Year)
I HEREBY CERTIFY that I attended deceased from
Sammar 12, 1911, to
Que. 18 ..
, 1911
Die . 12 ,
that I last saw her
alive on
.. .. , 191/
and that death occurred, on the date stated above, at.
m.
The CAUSE OF DEATH* was as follows :
Chronic Pleuritis, following
removal of carcinoma of bunet.
.(Duration)
.yrs.
.mos. ..
.... ds.
Contributory ..
Carew of Beast.
(SECONDARY)
One year
(Duration). /
yrs.
. mos.
ds.
(Signed)
Sw-Cy
M.D.
Rec-14,
1911
(Address) ..
Gaat Booter.
* 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
In the
yrs. .
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
Якилионсеи 12-16.191г.
:0 UNDERTAKER I. B. Skaggs.
ADDRESS
Heithis
Find 191
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state U/DITE DIATRY
important. See instructions on back of certificate.
11 BIRTHPLACE OF FATHER (State or country) mano.
1866
Dec . 13/1911
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 preciso specification, as Day laborer, Farm iaborer, Laborcr- 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 bo 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 (AUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discase. 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 loss 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 deaths under the following conditions must be referred to the Medical Examiners:
1. Deatbs following injury or violence, as Burns, Falls, Drowning, Gus 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 onc supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B .- Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Winthrop (No. 40 Plu
nm St. :
....
Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
2FULL NAME
mar a Grainger
[If married or divorced woman or widow
give maiden name, also name of husband.]
Dr. Wm. H. Grainger nee Le Blanc
@RESIDENCE
40 Plus
ner St. Winthird Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
December
14 191
(Month)
(Day)
(Year)
6 DATE OF BIRTH
(Month)
(Day)
(Year)
7 AGE
If LESS than
l day, ...
hrs.
61 .. yrs. mos. ds.
or min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
touseufe
(b) General nature of industry, business, or establishment in which employed (or employer)
9 BIRTHPLACE (State or country) Brooklyn n 4
PARENTS
12 MAIDEN NAME OF MOTHER mary moore
1ª BIRTHPLACE OF MOTHER (State or country)
new york n.4
"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Dr. Edward J grainger
(Address)
40 Plummer && will
15
Filed 191
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
Dec 14
1911
to
191
.. ,
that I last saw her alive on
Dec 14, 1911.
and that death occurred, on the date stated above, at 6 Pm.
The CAUSE OF DEATH* was as follows :
Diabetes
/ year
(Duration)
yrs.
mos.
ds.
Contributory.
Coma
36 eno
.. (Duration)
.yrs.
mos.
ds.
(Signed)
M.D.
Dec 15, 1911 (Address).
2 anshin St.
* 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.
In the
ds.
State ...
.yrs.
Where was disease contracted,
.mos.
ds ......
....
if not at place of death ?.
Former or usual residence ..
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
Dec, 16, 1911
ADDRESS
20 UNDERTAKER J.J. Lane, S.J.L.
20 Havre Sx.
3 SEX 7
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
married
BOSTON (City or town.)
...
10 NAME OF FATHER ambrose Le Blanc
(SECONDARY)
11 BIRTHPLACE OF FATHER (State or country) Canada
Dec. 14, 1911
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statemont 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 singlo 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 noeded. As examples: (a) Spinner, (b) Cotton mill; (a) Salcs- 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 mbre 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 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 neoplasms) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (socond- ary or intercurrent) affection need not be stated unless im- portant. Examplo: Measles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " Asthenia," " All- aemia " (mercly symptomatic), " Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Sonile," 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 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
1
(No. 409
Shirley
St. ;...
Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
"
6 DATE OF BIRTH
12 (Month)
11
(Day)
(Year)
7 AGE
If LESS than 1 day, .... „hrs.
yrs. mos
ds.
er min. ?
8 OCCUPATION
(a) Trade, profession, or particular kind of work,
(b) General nature of industry,
business, or establishment in
which employed (or employer).
9 BIRTHPLACE
(State or country)
10 NAME OF
FATHER!
Char Co denigre
PARENTS
11 BIRTHPLACE OF FATHER (State or country) E. Boston
12 MAIDEN NAME OF MOTHER
White.
12 BIRTHPLACE OF MOTHER (State or country)
Po. Karton
14 THE ABOVE IS TRUE, TO THE BEST OF MY KNOWLEDGE
(Informant)
Checkitundnen
(Address)
. 6
Filed 191
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Dec
(Month)
15 (Day) ., 191.1. (Year)
I HEREBY CERTIFY that I attended deceased from
Dec 15
1
191
to
191
that I last saw her ative on
Dec. 15
........
and that death occurred, on the date stated above, at ... 8 p.m?
The CAUSE OF DEATH* was as follows : Stillborn hydrocephalus Spina bifida .(Duration) .... yrs.
mos.
ds.
Contributory
(SECONDARY)
(Duration)
yrs.
mos.
ds.
(Signed)
Questa Booth
M.D.
Dec 18, 1911 (Address
2 Centime EB.
* 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.
In the
ds.
State. ... yrs.
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
Hin Hof Ceux 12-20, 1911.
10 UNDERTAKER
ADDRESS
(City or town.)
still born Lundgren 2 FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.11. @RESIDENCE 409 Thulay St
, 911
17
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occupa- tion is very important, so that tho relative healthfulness of various pursuits can be known. Tho 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, o. 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) tho 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 bo used only when needed. As examples: (u) 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 iaborer, Laborer - Coal minc, etc. Women at home, who are engaged in tlre 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 tho 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 cercbro-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 definito; avoid use of "Tumor " for malignant neoplasms) ; Measles ; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. Tho contributory (sccond- ary or intercurrent) affection need not bo stated unless im- portant. Example: Mcasles (disoase causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mero symptoms or terminal conditions, such as " Asthenia," " AII- aemia " (merely symptomatic), " Atrophy," " Collapse," "Coma," " Convulsions," "Debility " ("Congenital," "Senile," otc.), "Dropsy," " Exhaustion," "Heart failure," "Haemorrhage," " Inanition," " Marasmus," " Old age," "Shock," " Uraemia," " Weakness," etc., when a definito discase 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 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.
@RESIDENCE 3 SEX 6 DATE OF BIRTH 7 AGE 8 OCCUPATION 10 NAME OF FATHER PARENTS important. See instructions on back of certificate. 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 V
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