USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1913-1915 > Part 73
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Que Hemiplegia
(Duration)
............ yrs.
X
mos.
3
ds.
Contributory
aortic aneurisma
(SECONDARY)
(Duration).
7
yrs.
.mos.
X ds.
(Signed)
Quiere & Johnson
M.D.
No0 29, 1914 (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).
Åt 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
12 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
7200 30
1914
· UNDERTAKER
ADDRESS
Filed 191
REGISTRAR
17
I HEREBY CERTIFY that I attended deceased from
Fax 27, 1914, to
nov 27
191.4.
If LESS than
I day ........ hrs.
that I last saw h cercalive on
200 22
1914.
and that death occurred, on the date stated above, at.
7- Pm.
(b) General nature of industry,
business, or establishment In
which employed (or employer).
9 BIRTHPLACE
(State or country)
Souris P.E.A.
10 NAME OF
FATHER
John macgowan
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
England
12 MAIDEN NAME
OF MOTHER
Jane. E. Mac Callum
18 BIRTHPLAGE
OF MOTHER
(State or country)
So Pelão Bay P. E.G.
"THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
E-R-Bem
(Address)
.. yrs.
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 fircman, 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 laborcr, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housc- 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: Cercbro-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, peritonacum, etc., Carcinoma, Sar- coma, etc., of .. ..... (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant ncoplasms); Measles; Whooping cough; Chronic valvular heart discasc; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Mcasles (discase 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," "Scnile," ctc.), "Dropsy," "Exhaustion," "Heart failure," "Hacmorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uracmia," "Weakness," etc., which 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.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1914.
CITY OF BOSTON. 10686
ROBERT LAWTON
FULL NAME
Place of Death )
Boston
and Residence S
Date of Death
NOV.29
1914.
Age
53
years
months 8
days.
STATISTICAL DETAILS.
SEX.
COLOR.
SINGLE, MARRIED, WID., DIV.
M
MAR .
Maiden Name
Husband's Name
SHIRLEY
Birthplace
Name of Father
ABEL L LAWTON
CTYITATI R
CONIIT M.
8 REGIM
DONATA A.
MASS. Contributory : 2. (Duration)
SEPTICAEMIA - 5 DYS
(Signed)
HUGH CABOT M. D.
1914
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recen! Residents.
Place of Burial or removal
AYER E.C. BURKE
Usual Residence
WINTHROP ( 36 PROSPECT AV ) DEC.4
Filed
1314
A true copy. Attest :
Registrar.
O
2
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from 1914, 1914, to that to the best of my knowledge and belief death occurred, on the date stated above, and that the CAUSE OF DEATH was as follows :
GIST
RAR
R
T PATRIGIS
Primary
CANCER CAECUM - DRAINAGE OF
ICUT H ( Duration)
OFFICE
ABSCESS - 6 MOS.
Birthplace of Father
SHIRLEY
Maiden Name of Mother
SARAH HELENA
Birthplace of Mother
HARVARD
REAL ESTATE
Occupation
Informant
Registered No.
NEW ENG. BAPTIST HOSPT.
Undertaker
CITY
OSTON
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.
(
1 PLACE OF DEATH
Franklin
(No. 58
Main
St. :
Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
76
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Winthrop Mass
PERSONAL AND STATISTICAL PARTICULARS
$ SEX mal
4 COLOR OR RACE
artuta
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
rite the w
Odourch
6 DATE OF BIRTH
4
(Month)
(Day)
(Year)
7 AGE
If LESS than
1 day .......... hrs.
82
yrs. 5 mos. .........
30 ds.
.min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Carkruten Retired vara
(b) General nature of industry, business, or establishment in which employed (or employer) ..
BIRTHPLACE
(State or country)
Novia Scotia
PARENTS
12 MAIDEN NAME
OF MOTHER
Cynthia Fremman
18 BIRTHPLACE OF MOTHER (State or country) Novia Scotia
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Que Walter babett
(Address)
Franklin Mask
Filed Dan 4, 1915 Michau Y Gentille
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH
....
(Month)
(Day)
3
(Year)
1832 17 I HEREBY CERTIFY that I attended deceased from
to
.,
1914.
In-30
191
4
that I last saw him alive on
191
020- 30
4
and that death occurred, on the date stated above, at -500. m.
The CAUSE OF DEATH* was as follows :
Chronic Interstitial Nephritis
.(Duration)
...... yrs.
........... mos.
...... ds.
Contributory
Old age
(SECONDARY)
(Duration)
............ yrs.
............... mos.
.......... ds.
M.D.
DE047, 1914 (Address) Franklin Mask.
* 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.
Stato
... 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 Wirthok Masa
DATE OF BURIAL
SEC 6
1913
ADDRESS
2 UNDERTAKER Isalie is Wiggin Franklin
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
'FULL NAME
David D'unlok
Registered No. 2246
1914
10 NAME OF
FATHER
David Dunlop
11 BIRTHPLACE
OF FATHER
(State or country)
novia Scotia
(Signed)
a. Gallison
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., C'arcinoma, 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
1 PLACE OF DEATH
Winthink
(No. 39
Malélure
St. : Ward)
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
39 Wilshire dr Manchop
Weicherop
BOSTON
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Malinthite
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Marcos
$ DATE OF BIRTH
2.2.20, 180 52
(Month)
(Day)
(Year)
7 AGE
If LESS than i day ........ hrs.
61 yrs. 11 mos
1.2) ds.
or ......... min. ?
8 OCCUPATION
(s) Trade, profession, or
particular kind of work
Clarks
(b) General nature of industry.
business, or establishment
In
which employed (or employer)
· BIRTHPLACE
(State or country)
10 NAME OF
FATHER/
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
Fortlands
12 MAIDEN NAME
OF MOTHER
-
1ª BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address)
Filed
191.
REGISTRAR
IS LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place of death. yrs. .... mos.
In the
ds.
Stato .........
.yes ..
Where was disease contracted,
mos. ......... di ..... ...... If not at place of death ?.
Former or usual residence
" PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
20 UNDERTAKER
ADDRESS
-
A
Did a surgical operation precede death ? hc, Date
.(Duration) .. yrs.
mos.
......
5
ds.
Contributory
Pulmonary Dedeuna
(SECONDARY)
.(Duration) .yrs.
mos.
/
ds.
(Signed)
Willian & Parte
M.D.
Dea 7., 1914 (Address)
Menthis
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
I HEREBY CERTIFY that I attended deceased from Dea Jak, 1917 to Dea 6th 1914 1 .... that I last saw h be alive on Dea 5th 191. and that death occurred, on the date stated above, at. 82,m. The CAUSE OF DEATH* was as follows :
(Month)
(Day)
1915 (Year)
16 DATE OF DEATH
Dec.
Registered No.
Davier
STANDARD CERTIFICATE OF DEATH.
Statement of occupation. - Precise statement of oecu- 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, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, etc. But in many eases, especially in industrial employments, it is neeessary 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) Solcs- 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 speeification, as Day laborer, Farm laborer, Laborer - Coal mine, ete. 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 domestie 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 DIS- EASE CAUSING DEATH (the primary affeetion with respect to time and causation), using always the same aceepted term for the same disease. Examples: Cerebro-spinal fever (the only definite synonym is "Epidemic eerebro-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 ncoplasms) ; Measles; Whooping cough; Chronic volvular heart disease; Chronic interstitial nephritis, etc. The contributory (seeond- ary or intercurrent) affection need not be stated unless im- portant. Example: Measles (disease causing death), 29 ds .; Broneho-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 eause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicaemia," "PUERPERAL peritonitis," ete. 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 eonditions 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, ete
4. Deaths under eircumstances unknown, as A person found dead, etc.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1914.
CITY OF BOSTON.
FULL NAME
MORRIS TENNENBAUM
Registered No.
10915
B.C.H. RELIEF
and Residence S
Date of Death
DEC. 7
1914.
Age
26
years
months days.
STATISTICAL DETAILS.
SEX.
COLOR.
SINGLE, MARRIED, WID., DIV.
M
W
SIN.
Maiden Name
Husband's Name
Birthplace
AUSTRIA
Name of Father
JOSEPH TENNENBAUM
Birthplace of Father AUSTRIA
Maiden Name of Mother
DORA
Birthplace of Mother AUSTRIA
Occupation
TAILOR
Informant
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from
1914, to
1914, that to the best of my knowledge and belief death occurred, on the date stated above, and that the CAUSE OF DEATH was as follows :
GI
UT PATRU
Primaryx! ( Duration)
POISONING BY ILL.GAS WITH CON-
SEQUENT BRONCHO-PNEUMONIA
BOSTONIA
CONTITA AL
E DONATA A.
MASS.
Contributory : 2 (Duration)
(Signed) G. B. MAGRATH MED.EX. M.D.
DEC.8 1914
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Place of Burial or removal
BETH ABRAHAM
Undertaker
J. STANETSKY
Usual Residence WINTHROP ( 51 CREST AV)
Filed
DEC.II 1914
A true copy. Attest : ErMSlenen
Registrar.
-
RAR'
CITY RE
ICUT PA
TVITATI
A /D. 1822.
CIRCUMSTANCES INDETERMINATE
TO
FFICE
Place of Death }
Boston
1
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
Winthrop
(No
15-
St. ;... ........... Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE,
MARRIED.
WIDOWED,
OR DIVORCED
(Write the word)
Manuel
· DATE OF BIRTH
Mach 23
(Month)
(Day)
184811
(Year) 4
" AGE
66 yrs.
8.
14 ds.
or ......... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Restauranteur
(b) General nature of industry.
business, or establishment in
which employed (or employer).
9 BIRTHPLACE
(State or country)
Shubook Can
10 NAME OF
FATHER
PARENTS
12 MAIDEN NAME
OF MOTHER
13 BIRTHPLACE
OF MOTHER
(State or country)
IS THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address)
Filed
191
REGISTRAR
Un definite
(Duration)
........... yrs.
mos. .............. ds.
Contributory.
Pulmonary Cedera
....
(SECONDARY)
(Duration)
.yrs.
......
mos.
ds.
(Signed)
William.
M.D.
Dee. g.
191 H (Address)
Wintheret.
* If death followed injury or violence the certificate of death must be made ont by the Medical Examiner.
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
1º PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
12-10. 1914
ADDRESS
D UNDERTAKER
W. C. Skaggs
12-
(Month)
(Day)
7
.... 1914
(Year)
Dec. 7 th.
19121
I HEREBY CERTIFY that I attended deceased from
nov.1ch
1914
to
.... ..............
If LESS than
1 day,
.. hrs.
that i last saw him
alive on
Die 7th
1914
and that death occurred, on the date stated above, at
3 Pm
„.m.
The CAUSE OF DEATH* was as follows :
arterio- acerca
2
11 BIRTHPLACE
OF FATHER
(State or country)
11
18 DATE OF DEATH
Registered No.
William S. Mc Donald- 'FULL NAME [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 15 Junkatury St. Winthrop
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, (6) Cotton mill; (a) Sales- man, (b) Grocery; (a) Forcman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at honie, 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 gaill- fully employed, as At school or At homc. Care should be taken to report specifically the occupations of persons engaged in domestie 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. - 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 "Epidemie 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, ete., Carcinoma, Dar- coma, etc., of. ... (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Mcasles; Whooping cough; Chronic valvular heart discase; 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," "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.
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