Town of Winthrop : Record of Deaths 1913-1915, Part 106

Author: Winthrop (Mass.)
Publication date: 1913
Publisher:
Number of Pages: 1094


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1913-1915 > Part 106


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).


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BOSTON


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


2 FULL NAME


Nathaniel Ellendaleon


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


41 Pinchurch cur N.M.


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


& SEX


' COLOR OR RACE


cubitte


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


married


* DATE OF BIRTH


(Month)


(Day)


1


(Year)


If LESS than


( day ......... hrs.


.yrs. ..................... ds.


or ......... min. ?


& OCCUPATION


(a) Trade, profession, or


particular kind of work


Buyer.


(b) General nature of industry,


business, or astablishment In


which employad (or employer).


· BIRTHPLACE


(State or country)


N. Y.


PARENTS


11 BIRTHPLACE


OF FATHER


(State or country)


Formany


12 MAIDEN NAME


OF MOTHER


Roza. Lazbier;


1ª BIRTHPLACE


OF MOTHER


(State or country)


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant).


S. M. Jackkeane


(Address)


2446 There Dra Mientras


Filed


191


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


aleauch


2. 2ª 1915


(Month)


(Day)


(Year)


17


I HEREBY CERTIFY that I attended deceased from


191


Qua, 2nd


5.


to


that I last saw h plc alive on


and 2nd


1915


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


... m.


The CAUSE OF DEATH* was as follows :


Ingina Centrais


Did a surgical operation precede death ? no Date


Die deter it


(Duration)


.......


.yrs. ................ mos.


.......


Contributory ....


Pulursupry Cedeuna


(SECONDARY)


.(Duration) ..


1


..... yra. ............... mos.


ds.


(Signad)


Nielira A Ñ Mes


M.D.


luca. vr., 1955 (Address) Venetrop Hinko


* 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 placa


of death ..


.yrs.


... mos.


in tha


ds.


Stata ............ yra.


.mos.


.........


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


Former or usual residence


1º PLACE OF BURIAL OR REMOVAL H1 l'un. heret (WE N.Y.


DATE OF BURIAL


191


20 UNDERTAKER


ER JACaro ficastundas Du


ds.


10 NAME OF


FATHER


David FillEndElease


7 AGE 41


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precise statement of occu- pation is very important, so that the relative healthfulncss 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, Architeet, 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 necded. 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 houschold 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 occu- pation whatever, write Nonc.


Statement of cause of death. - Name, first, the D18- EASE 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 usc of "Croup"); Typhoid fever (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broneho- 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- acmia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions,"" ""Debility" ("Congenital," "Scnilc," 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 septieaemia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.


Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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.


.


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


1 PLACE OF DEATH


Winthrop


(No.


24 Fair View


St. :


Ward)


Winthrop BOSTON (City or town.)


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


Catherine Josephine Hasson


'FULL NAME


[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 24 Fair View


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Female White


4 COLOR OR RACE


5 SINGLE,


Single


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


· DATE OF BIRTH


(Month)


(Day)


1


(Year)


, AGE


29


... yrs.


- mos. - ds.


or ....... min. ?


& OCCUPATION


(a) Trade, profession, or


particular kind of work


Home


(b) General nature of industry,


business, or establishment


in


which employed (or employer)


-


9 BIRTHPLACE


(State or country)


East Boston Mask


PARENTS


12 MAIDEN NAME


OF MOTHER


Elizabeth Hasson


18 BIRTHPLACE


OF MOTHER


(State or country)


Ireland


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


John Hasson


(Address)


24 Stair View


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


5


(Month)


29


(Day)


1913-


....


17


I HEREBY CERTIFY that I attended deceased from


aug 28


1915, to.


am 29'


1910 ...


....


that I last saw ht


alive on


ami29


1915'


....


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


6 30 m.


-


The CAUSE OF DEATH* was as follows : Bronchopneumonia Capillary Bron chitin


Did .. a.surgical.operation .. precede .. death.2


.. Date


(Duration)


........ yrs.


...........


... mos.


5


ds .


Contributory


(SECONDARY)


(Duration)


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


mos.


.........


ds.


(Signed)


any za, 191


5


(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 deatn.


. yrs.


mos. .


ds.


State


.yrs.


.mos.


ds .............


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


Former or usual residence.


17 PLACE OF BURIAL OR REMOVAL Holy Cross


DATE OF BURIAL


Sept 1, 1915


20 UNDERTAKER


m.g. Kelly


11


ADDRESS


Meridian S.


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.


Filed


191


10 NAME OF


FATHER


John Hasson


....


1


M.D.


I1 BIRTHPLACE


OF FATHER


(State or country)


Ireland


If LESS than


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


(Year)


....


In the


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precise statement of occu- pation 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 houschold 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 occu- pation whatever, write None.


Statement of cause of death. - Name, first, the DIS- EASE 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 rc- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber .


culo losis of tungs, 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 nced 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 provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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.


PARENTS


11 BIRTHPLACE


OF FATHER


(State or country)


12 MAIDEN NAME


OF MOTHER


Maria Froya


18 BIRTHPLACE


OF MOTHER


(State or country)


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


(Address)


16


Filed


. 191


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


$ SEX


4 COLOR OR RACE


5 SINGLE,


MARRIED.


WIDOWED,


OR DIVORCED


(Write the word)


16 DATE OF DEATH


aug


(Month)


30, 1915


(Day)


.....


(Year)


$ DATE OF BIRTH


10 -1844


(Month)


(Day)


(Year)


7 AGE


70


m.y.s.


.yrs.


10 mos.


MO.


20%


or ........ min. ?


& OCCUPATION


(a) Trade, profession, or


particular kind of work


al thomas


(b) General nature of industry,


business, or establishment in


which employed (or employer).


Euphrates


Uncertain


.(Duration)


... yrs.


Contributory.


(SECONDARY)


(Duration) ............. yrs. ............ mos. ds.


(Signed)


M.D.


1 lug. 31, 195 (Address)


mittunt


* 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.


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


Former or usual residence


1 PLACE OF BURIAL OR REMOVAL


DATE OF BURIAL


Sift 1t- 1915


20 UNDERTAKER


ADDRESS


L


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


mary


Jana, Flagler


? FULL NAME


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


wils of Allaway. K. flagler


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


1 PLACE OF DEATH Kachel Piano (No.


56 Parts and St. ....... Ward)


Wucht


17 I HEREBY CERTIFY that I attended deceased from March 1. 1919, to alex. 31., 19115, that I last saw he alive on


and that death occurred, on the date stated above, at a.m. The CAUSE OF DEATH* was as follows :


Chance Interstitial


9 BIRTHPLACE


(State or country)


medford mars


10 NAME OF


FATHER


- Jagmit


....


mos. ...


ds.


2


3


.


If LESS than


i day ......... hrs.


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precise statement of occu- pation 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 laborcr, 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 occu- pation whatever, write None.


Statement of cause of death. - Name, first, the DIS- DASE 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 fcvcr (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-


culosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- coma, etc., of .... ..... (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Mcaslcs; 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 septicacmia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.


Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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


Winckrot Man (N.


68 Shower-1PK


St .. ......... Ward)


:


Solomon Harding Barnack


? FULL NAME


[If married or divorced woman or widow


give maiden name, also name of husband.i


@RESIDENCE


6.8


non- Park


....... Registered No.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


$ SEX


Male


' COLOR'OR RACE


White


& SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


Hamid


$ DATE OF BIRTH


...


(Month)


(Day)


1


(Year)


7 AGE


54


yrs.


mos.


ds.


If LESS than


I day ......... hrs.


or ....... min. ?


17


I HEREBY CERTIFY that I attended deceased from


1915


march


Seff 5


191%., to


..........


that I last saw h wwwalive on


Suht 5


1915


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


90 m.


m.


The CAUSE OF DEATH* was as follows : Cerebral apohledy


(repeated attached post 1 1/2


quais )


Final one


mos.


ds.


arteriosclerosis


Contributory.


(SECONDARY)


general.


(Duration).


Seguecabos years


(Signed)


Jeff7


1915 (Address).


W inthek


......


* 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 plsca


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


1$ PLACE OF BURIAL OR REMOVAL Well tech !Her


DATE OF BURIAL


9/5


1915


" UNDERTAKER


E.R. Bezum-


ADDRESS


Filed ., 191


REGISTRAR


16 DATE OF DEATH


September 5


(Month)


(Day)


1915 (Year)


· OCCUPATION


Wholesale Merchant


(a) Trade, profession, or


particular kind of work


(b) General natura of Industry,


business, or establishment In


which employad (or employar) ..


9 BIRTHPLACE


(State or country)


Wellfleck Mass


10 NAME OF


FATHER


Solomon H. Barnard, Cr.


PARENTS


11 BIRTHPLACE


OF FATHER


(State or conntry)


Wellfleet Mars


12 MAIDEN NAME


OF MOTHER


Susan . am Stills


1ª BIRTHPLACE


OF MOTHER


(State or country)


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


C.R. Bem


(Address)


(City or town.)


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


STANDARD CERTIFICATE OF DEATH.


Statement of occupation. - Precise statement of occu- pation 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, c. 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 occu- pation whatever, write None.


Statement of cause of death. - Name, first, the DIS- CASE 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 scpticacmia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.


Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the fol- lowing 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 ofc 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 Vonthron (No 226Hain Joseph Abraham Wilson. 2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 26 Main St




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