USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1913-1915 > Part 37
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75 | Part 76 | Part 77 | Part 78 | Part 79 | Part 80 | Part 81 | Part 82 | Part 83 | Part 84 | Part 85 | Part 86 | Part 87 | Part 88 | Part 89 | Part 90 | Part 91 | Part 92 | Part 93 | Part 94 | Part 95 | Part 96 | Part 97 | Part 98 | Part 99 | Part 100 | Part 101 | Part 102 | Part 103 | Part 104 | Part 105 | Part 106 | Part 107 | Part 108 | Part 109 | Part 110 | Part 111 | Part 112 | Part 113 | Part 114 | Part 115 | Part 116 | Part 117 | Part 118 | Part 119 | Part 120 | Part 121
important. See instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
(No. 4
..
Belcher
St. :
Ward)
2 FULL NAME
Freds, ich It, Butcher
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 4. Belcher, At, Westtrafi
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
12
(Month)
(Day)
14
, 1917.
(Year)
$ DATE OF BIRTH
12
31
(Month)
(Day)
1828| 17
(Year)
7 AGE
If LESS than
| day ......... hrs.
84 Yr
yrs. 11 mos. / 4 ds.
or ...
... min. ?
$ OCCUPATION
(a) Trade, profession, or
particular kind of work
Retired
.
(b) General nature of Industry, business, or establishment which employed (or employer)
9 BIRTHPLACE
(State or country)
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
"Minthaof Ina12.
12 MAIDEN NAME
OF MOTHER
Mary Whiting.
1110.
13 BIRTHPLACE
OF MOTHER
(State or country)
Maine
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
it) Limanda Aavisar.
(Address)
4 Bel lus it.
..........
REGISTRAR
I HEREBY CERTIFY that I attended deceased from
191.2 .. , to
Dec- 14, 1913,
....
that I last saw hun alive on
Du 14
1913.
and that death occurred, on the date stated above, at 200
.m.
The CAUSE OF DEATH* was as follows : Cerebral Hemorrhage
1 (Aquilegia)
(Duration)
X
... yrs.
X
mos.
4
ds.
Contributory.
(SECONDARY)
(Duration)
yrs.
mos.
ds.
(Signed)
M.D.
Du 15, 1913
(Address).
Heretigt mass
?
* If death followed injury or violence the certificate of death must be made out by the Medical Examincr.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
In the
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.
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
12 /7.
1913.
UNDERTAKER
ADDRESS
4
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
3 SEX
M.
' COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Widowed
16 DATE OF DEATH
Filed 191
10 NAME OF
FATHER
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of occu- pation is very important, so that the relative healthfulness of various pursuits ean be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, c. 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 needed. As examples: (a) Spinner, (b) Cotton mill; (a) Sales- man, (b) Grocery; (a) Foreman, (b) Automobile factory. The inaterial worked on may forin part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," ete., without more precise specification, as Day laborer, Farm laborer, Laborer - Cool 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 serviee for wages, as Servont, Cook, Housemaid, cte. If the occupation has been changed or given up on aeeount of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that faet may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no 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 "Epidemie ecrebro-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 cargo, membre
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 (diseaso causing death), 29 ds .; Broneho-pncumonia (sceondary), 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," "Uraemia," "Weakness," ete., when a definite disease ean be ascertaincd as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicacmia," "PUERPERAL peritonitis," cte. State eause 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 eaused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, ete.
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, ete.
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. 125 Bartlett Road) St. ;
Ward)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
$ SEX
4 COLOR OR RACE
5 SINGLE,
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word)
16 DATE OF DEATH
12
(Month)
(Day)
(Year)
" DATE OF BIRTH
2
11 1840 17
(Month)
(Day)
... (Year)
7 AGE
If LESS than [ day ......... hrs.
67 .... yrs. mos. ds.
Or ......... 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)}/
Woodstock Ut-
10 NAME OF
FATHER
Louis Hawkins
PARENTS
11 BIRTHPLACE OF FATHER (State or country) woodstock vt.
12 MAIDEN NAME
OF MOTHER
1$ BIRTHPLACE
OF MOTHER
(State or country)
"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address)
125 Bartlett Rand
REGISTRAR
(Duration)
.. yrs.
... mos.
ds.
Contributory
My a carditis
(SECONDARY)
(Duration)
3
yrs.
mos. ds.
(Signed)
Edward & Granger.
M.D.
Dec.16, 1913
Bartlett Road.
* 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
12-18, 1918
30 UNDERTAKER
W.O. S/20102
0
ADDRESS
Filed. 191
(City or town.)
1 Larchener 2, Sfar furie
2 FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] aRESIDENCE 125 Bartlett Road Winchuck
Registered No.
15- 1913-
I HEREBY CERTIFY that I attended deceased from
DEC. 11
, 191.3., to
Dec. 15
1913
......
that I last saw h len
alive on
DEC.
15
1913.
and that death occurred, on the date stated above, at.
6:15 Pm.
The CAUSE OF DEATH* was as follows :
Heamorlogic Pancreatitis
4
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 cngincer, 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) Salcs- man, (b) Groccry; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foremau," "Manager," "Dealer," etc., without more precise specification, as Day laborcr, Farm laborcr, Laborer - Coal minc, etc. Women at home, who are engaged in the duties of the household only (not paid Housc- kcepers who receive a definite salary), may be entered as Housewife, Houscwork, 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, ctc. 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. - Namc, 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 re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Dar- coma, etc., of .... .. (name origin: "Cancer" is less definite; avoid usc of "Tumor" for malignant neoplasms) ; Mcaslcs; Whooping cough; Chronic valvular hcart discasc; 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 agc," "Shock," "Uracmia," "Weakness," etc., when a definite disease can be ascertaiued 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 discase, as A death upon the strcet, or onc supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
3 SEX Male 7 AGE PARENTS Important. See Instructions on back of certificate. (Address) 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 particular kind of work Filed
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
Winthrop
(No. 15 Mermaid Ave.
St. ;................ Ward)
2FULL NAME
addison B Winch
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
I5 Memnaid Ave., Winthrop Mass.
.... Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE
White
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Widowed.
18 DATE OF DEATH
Дус.
16
3
(Month)
(Day)
191
(Year)
6 DATE OF BIRTH
December 1841.
(Month)
(Day)
(Year)
8 OCCUPATION
(a) Trade, profession, or pet ji
(b) General nature of industry,
business, or establishment in
which employed (or employer) ..
Restmant Keeper
9 BIRTHPLACE
(State or country)
Alexandria Va.
10 NAME OF
FATHER
David B. Winch.
11 BIRTHPLACE
OF FATHER
(State or country)
Providence R. I.
12 MAIDEN NAME
OF MOTHER
Sarah Lincoln.
13 BIRTHPLACE
OF MOTHER
(State or country)
Taunton Mass .
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Ir Winch.
.
J.
REGISTRAR
(Duration).
... yrs.
mos. ................
ds.
Contributory.
(SECONDARY)
(Dubaion).
ds
(Signed)
Arc 16
1912 (Address)
Exercer Mas
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
1ª LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR
RECENT RESIDENTS).
At place
In the
of death ............ yrs.
mos.
.ds.
State.
ds .............
Where was disease contracted, If not at place of death ?.
Former or usual residence
1 PLACE OF BURIAL OR REMOVAL
Taunton Mas.
DATE OF BURIAL
Dec.I3
191
D UNDERTAKER
Of Facince
ADDRESS
Chelsea
191
Winthro
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
17 I HEREBY CERTIFY that I attended deceased from 191.1 ... , to Arc 16 1913 191 that I last saw her alive on Arc 16 3 and that death occurred, on the date stated above, at 2 Pm The CAUSE OF DEATH* was as follows :
€9
yrs. mos. ................ .. ds.
1
If LESS than
1 day .......... hrs.
Or ....... .. min. ?
M.D.
Dec. 16, 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 every person, irrespective of age. For many occupations a single word or term on tho 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. Nover return " Laborer," " Foreman," " Manager,""Dealer," etc., without moro 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 employcd, 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.
1
Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discase. Examples : " 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 indefinitc) ; 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) ; Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection ncod 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," " All- aemia " (mcrely symptomatic), "Atrophy," "Collapse," " Coma," "Convulsions," "Debility" ("Congenital," " Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Haemorrhage," " Inanition," " Marasmus," " Old age," " Slrock," "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 tho following conditions must be referred to the Medical Examincrs:
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.
8. 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. 41
Washington Che
St. : Ward)
Ellen@Battelle
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 41 Washington Que
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
(Year)
If LESS than
I day ......... hrs.
or ........ min. ?
10 NAME OF
FATHER
Michael Battelle
12 MAIDEN NAME
OF MOTHER
Margaret Cunleen
(Address)
41 Washington Que
Filed
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
Lec
(Month)
(Day)
16
19143
.....
(Year)
1878 17 I HEREBY CERTIFY that I attended deceased from Oct
191.3 _. , to.
Lec 16
913
that I last saw h EM
alive on
Lec 14
1913.
and that death occurred, on the date stated above, at ..
... m.
The CAUSE OF DEATH* was as follows :
Cancer of sectum
.(Duration)
1
yrs.
6 mos.
nos.
ds.
Contributory
(SECONDARY)
(Duration)
mos. .
........
.ds.
(Signed)
William Stetrainger
M.D.
Decry, 1913 (Addres)
108 71 leindian 5 1
* 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 pisce
of death.
... yrs.
.mos.
In the
ds.
Stste
.yrs.
moa.
. ds ............
Where was disease contracted, If not at place of death ?.
Former or usual residence.
DATE OF BURIAL
19 PLACE OF BURIAL OR REMOVAL Holy Cross, Inalden
D UNDERTAKER
John J. O. maley
ADDRESS
79. Allante St.
Winthrofi (City or town) [If death occurred in a hospital or institution, give its NAME instead of street and numbar.]
Registered No.
2 FULL NAME
3 SEX
Female
4 COLOR OR RACE
White
6 DATE OF BIRTH
June
22
(Month)
(Day)
7 AGE
8 OCCUPATION
(s) Trade, profession, or
particular kind of work
At Home
(b) General nature of industry,
businass, or establishment in
which employad (or employer).
· BIRTHPLACE
(State or country)
Ireland
11 BIRTHPLACE
OF FATHER
(State or country)
Ireland
PARENTS
13 BIRTHPLACE
OF MOTHER
(State or country)
Ireland
(Informant)
mary a Daly
important. See instructions on back of certificate.
1.
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
35
„yrs.
5
mos.
24
ds.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
6
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 Ilouse- 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 usc 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 Examinors:
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)
Ban queME
12 MAIDEN NAME
OF MOTHER
Ella. M. Cove-
13 BIRTHPLACE
OF MOTHER
(State or country)
Bango-ine
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.