Town of Winthrop : Record of Deaths 1910-1912, Part 86

Author: Winthrop (Mass.)
Publication date: 1910
Publisher:
Number of Pages: 956


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1910-1912 > Part 86


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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 important. See instructions on back of certificate.


The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH


1 PLACE OF DEATH


Point Shirley. (No ... Undinc ..... Avenue, ... St. ;.. Ward)


Winthrop. (City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]


2 FULL NAME


Eugene Denton Brooks.


[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Undine Ave .. Point Shirley, Winthrop. Mass.


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


Male


' COLOR OR RACE


white


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


widowed


8 DATE OF BIRTH


Feb. 22. 1835.


(Month)


(Day)


(Year)


7 AGE


If LESS than


I day ......


.. hrs.


77


.. yrs. 8 mos. O ds. or ......... min. ?


& OCCUPATION


(a) Trade, profession, or


particular kind of work


Real ..... state.


(b) General nature of industry, business, or establishment in which employed (or employer).


Pincho Gentlemia


(Duration)


yrs.


mos.


ds.


mycoulitis


Contributory


(SECONDARY)


(Signed)


Get 23, 1912 (Addres)


M.D.


Arlington


* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.


IS 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


Mt. Auburn Cemetery.


DATE OF BURIAL


Q.c.t. ....... 25., 191.2.


Filed


191


REGISTRAR


17


I HEREBY CERTIFY that I attended deceased from Aug 25, 1912, to 191 2 that I last saw unalive on 191 and that death occurred, on the date stated above, at HP m. The CAUSE OF DEATH* was as follows : 1


Hodgkinin diceare


9 BIRTHPLACE


(State or country)


Boston, Mass.


PARENTS


11 BIRTHPLACE


OF FATHER


(State or country) Templeton. Mass.


12 MAIDEN NAME


OF MOTHER


Miriam Foster.


13 BIRTHPLACE


OF MOTHER


(State or country)


Billerica. Mass.


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


Lyman W. Brooks,


(Address) 97 Langdon Ave. . Watertown.


16


16 DATE OF DEATH


(Month)


227, 19/2


(Day)


(Year)


* UNDERTAKER


auceLitchfield


Small. are,


401


Cantudal


..... mos.


ds.


10 NAME OF


FATHER


Luke Brooks.


N B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


.


Oct. 22, 1912


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 (6) 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 taborer, 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-


U


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 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


PLACE OF DEATH,


Velington


(No


Oakmont, Merriam st


Jekington (City for town.) Ward) [if death occurred in a hospital or institution, give its NAME instead of street and number.]


Eleanor Mary Wright


2 FULL NAME


[If married or divorced woman or widow give maiden name, also nayje of husband.] @RESIDENCE 41 Cutler St Winthrop Mais.


Omery-archibald D. Wright


Registered No.


64


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


October


(Month)


(Day)


2292


(Year)


17


I HEREBY CERTIFY that I attended deceased from


Sept 25.


1912 to


Oct 23


1912


If LESS than


I day,


hrs.


that I last saw her alive on


or ..


min. ?


Oct 22, 192


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


The CAUSE OF DEATH* was as follows:


Chimie Nephritis


about


.(Duration) ..


/


yrs.


.mos.


ds.


Contributory


anaemia


(SECONDARY)


Fred A. Pijuer


. yrs.


( Ducation)


6


mos.


.. . ds.


(Signed)


1912 (Address)


Delington


M.D.


* 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. .


mos.


ds .....


Where was disease contracted, If not at place of death ?.


Former or usual residence


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


Mrs. Hallie C. Blake


( Add


(1) Dalmak, Merriam Ir


is Filed Vet 23 1912 Charles W. O wan


REGISTRAR


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


Widow


6 DATE OF BIRTH


apr. 3. 1849


(Month)


(Day)/


1


(Year)


7 AGE


63


yrs.


6


mos.


19


ds.


(a) Trade, profession, or


particular kind of work


at home


(b) General nature of industry, business, or establishment in which employed (or employer).


9 BIRTHPLACE


(State or country)


Cambridge n. M.


PARENTS


12 MAIDEN NAME


OF MOTHER


Matilda Russell


18 BIRTHPLACE


OF MOTHER


(State or country)


Scotland


19 PLACE OF BURIAL OR REMOVAL Clinton, Mass


DATE OF BURIAL


Der 25


1912


D UNDERTAKER


Anhn Bryant' Sous


ADDRESS


15 dustru St


Charleston Man.


3 SEX


Female


4 COLOR OR RACE


White


6 OCCUPATION


10 NAME OF


FATHER


David Emery


11 BIRTHPLACE


OF FATHER


(State or country)


Scotland


In the


Oct. 22. 1913.


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 evory 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- mun, (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 tho 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, Sur- 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 septicemia," " 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


...


(No.


St. :


.......


Ward)


William Walker Case


'FULL NAME


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


74 allantes 5% Wanthet


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


1 SEX


mall


4 COLOR OR RACE


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


7


,1914


(Year)


7 AGE


X


yrs.


mos.


17


ds.


or .....


„min. ?


& 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)


(Duration) ..


... mos.


........... yrs.


.........


18


ds .


Contributory


(SECONDARY)


(Duration) .


......... yrs.


mos.


.........


ds.


(Signed)


(21) mul cay)


M.D.


vitz 4, 1912 (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.


18 ds.


In the


State ........... yrs.


mos.


ds.


18


Where was disease contracted, desease If not at place of death ?.


Former or


usual residence


19 PLACE OF BURIAL OR REMOVAL


D UNDERTAKER


C.P. Ver.


ADDRESS


IS Filed .. 191


REGISTRAR


1ª DATE OF DEATH


23


, 1912.


(Month)


(Day)


(Year)


6 DATE OF BIRTH


Cech


(Month)


(Day)


17 I HEREBY CERTIFY that I attended deceased from Barth


191.2. to


04 23.


......


191 2


that I last saw him alive on ..


12+ 2 30


1912


and that death occurred, on the dato stated above, at 1/6m.


The CAUSE OF, DEATH* was as follows :


Premating Bank of moss


back of Ullit,


10 NAME OF


FATHER


Walter W. Case


11 BIRTHPLACE


OF FATHER


(State or country)


PARENTS


12 MAIDEN NAME


OF MOTHER


Bealien Durant


13 BIRTHPLACE


OF MOTHER


(State or country)


marquetovice


n.S.


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


(Address)


Warentest mais


DATE OF BURIAL


CCcf 25


191.


2


...


(City or town.)


[If death occurred in a hospital or institution, give its NAME instead of street and number.]


....


If LESS than


[ day ......... hrs.


Oct. 23, 1912


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 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, Sur- 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 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


1PLACE OF DEATH


(No.


85


......... Ward)


(City or town.) [If death occurred in a hospital or institution, give its NAME Instead of street and number.]


FULL NAME 10) 122120 [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 85 Bartlett Road


Vignale-Frederick It Walsh.


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


COLOR OR RACE


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


Indound


6 DATE OF BIRTH


6


(Month)


(Day)


1831


(Year)


7 AGE


If LESS than


day,


... hrs.


(a) Trade, profession, or


particular kind of work


athinne-


(b) General nature of industry,


business, or establishment in


which employed (or employer).


9 BIRTHPLACE


(State or country)


Englands.


10 NAME OF


John Hiquale


PARENTS


/11 BIRTHPLACE


OF FATHER


(State or country)


10


england


12 MAIDEN NAME


OF MOTHER


Jane Walsh


18 BIRTHPLACE


OF MOTHER


(State or conntry)


Europlang.


" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant) /1220


Halsh.


(Address)


85 Bartlett Road


18


Filed


191


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


18 DATE OF DEATH


Oct.


(Month)


26h-


(Day)


1912


(Year)


17


1 HEREBY CERTIFY that I attended deceased from


Qet 1er


1912 to


Oct 26h


1912


that I last saw her alive on


Oct 26h


1912


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


4


m.


The CAUSE OF DEATH* was as follows : artem Sclerosis


mitral Stenosis


Cerebral Hemorrhage


5


(Duration)


5


Contributory.


(SECONDARY)


(Duration)


2


mos.


.........


ds.


yrs ..


(Signed)


Oct 27, 1912 (Address)


Winthrop, Mas


* If death followed Injury or violence the certifleate of death must be made ont by the Medical Examiner.


1$ LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).


At place


In the


of death.


.yrs.


mos. .........


ds.


Stato .......... yrs.


mos. ............


Where was disease contracted, If not at place of death ?.


Former or usual residence.


1º PLACE OF BURIAL OR REMOVAL .


DATE OF BURIAL


10-25


191 1


" UNDERTAKER


If.C. Skagen


ADDRESS


...


8 OCCUPATION


81


yrs.


6


mos.


21)


ds.


.. min. ?


... yrs.


............ mos. ..


ds.


Rheumatism


M.D.


Oct. 26, 1912


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 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 (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. 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.




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