USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1913-1915 > Part 8
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11 BIRTHPLACE OF FATHER (State or country) incluate mars.
16 DATE OF DEATH
(Mopch)
(Day)
28
1913
(Year)
-
Feb. 28, 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 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 caborer, 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.
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
Hinthoop
(No.
176. Bancaria
St. :
Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Im
4 COLOR OR RACE
W
WIDOWED,
OR DIVORCED
(Write the word)
6 DATE OF BIRTH
5 (Month)
28
(Day)
1829
(Year)
7 AGE
If LESS than
{ day ......... hrs.
83 yrs.
....
9
mos.
..._ ds.
„min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Retired
0
7
(b) General nature of industry, business, or establishment in which employed (or employer).
9 BIRTHPLACE
(State or country)
East Port. Dr.
PARENTS
12 MAIDEN NAME
OF MOTHER
Sarah
1ª BIRTHPLACE
OF MOTHER
(State or country)
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address)
174 Boudown
REGISTRAR
17 I HEREBY CERTIFY that I attended deceased from 1
Jan
1913
Feb 28
1913
....
that I last saw him alive on
Feb 28
1913
and that death occurred, on the dato stated above, at
9.30 Km
The CAUSE OF DEATH* was as follows :
Premonia
artisti Delmis General. (age)
Intral Regurgitate Duration)
.. yrs.
2 mos.
Contributory.
(SECONDARY)
.. (Duration)
yrs.
mos.
.......
ds.
(Signed)
31 Mulcall
M.D.
milit, 1913 (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.
In the
ds.
State ............ yrs.
mos.
d8.
.........
Where was disease contracted,
If not at place of death ?.
Former or
usual residence.
19 PLACE OF BURIAL OR REMOVAL Winthrop Quan.
DATE OF BURIAL
3-2-
.,
1918
* UNDERTAKER
H.C. Skaggs
ADDRESS
1. Filed 191
...
(Month)
(Day)
1913
(Year)
1º DATE OF DEATH
Feb
20
.........
......... .ds.
10 NAME OF
FATHER
John Mooney
11 BIRTHPLACE
OF FATHER
(State or country}
2FULL NAME James hun [If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE
5 SINGLE,
Manuel
U
Feb. 28, 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 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: Mcasles (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.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1913.
CITY OF BOSTON.
FULL NAME
Carrie B. Gurney
.........
Registered No. 2115
Place of Death
Boston
Emerson Hospt.
and Residence
Date of Death
Mar. 1
1913.
Age
years .
months.
.days.
STATISTICAL DETAILS.
SEX
COLOR
F
W
SINGLE, MARRIED, WID., DIV. M
Maiden Name
Green
ST
GI
REC
UT PATRIE
CITY'
: 321%
Operation for Ventral Hernia
BOSTONTA
1822
and Multiple Adhesions of Bowel
Birthplace
of Father
----
Contributory : (Duration)
2 ds.
Surgical Shock
2 ds.
(Signed)
John A.Morgan
M.D.
Mar. 1 1913
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Place of Burial
Everett (Woodlawn)
Usual Residence
Winthrop, 69 Sargent St.
or removal
Undertaker
Bromm & Rollins
Filed .
Nar. 4
1913.
A true copy.
Attest :
EromSeinen
Registrar.
MARGIN RESERVED FOR BINDING.
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
1913,
from 1913, 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 : R AR. Surgical Shock following S.SITO 's Primaryo (Duration ) .-
Husband's Name
James Gurney Jr.
Shelburne Falls
Birthplace
Name of
Father Henry B. Green BỘ
CIVITATISREC
831. ING. DONATA A
N. MASS
Maiden Name of Mother ...
---
Burrough
Birthplace of Mother.
---
Occupation
Housewife
Informant
......
46
2
25
CONCITAA
---
по 50 0 50 1 5
mar.
١٫١٩13
٧
C
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.
2
Limerick Op
...
St. :
....... .Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
a SEX
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
6 DATE OF BIRTH
2
5
19/3
(Year)
(Month)
(Day)
7 AGE
If LESS than
I day, ........ hrs.
or ...
„min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
2000
(b) General nature of industry,
business, or establishment in
which employed ( or employer).
9 BIRTHPLACE
(State or country)
WinthropMais
(Duration)
......
...... yrs.
mos.
20
ds.
Contributory.
Marasmus
(SECONDARY),
... (Duration)
........
„.yrs.
mos.
ds.
(Signed)
Mamma & Soul
M.D.
Mar 2, 1913 (Address).
Willing Mass
.....
* 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.
1º PLACE OF BURIAL OR, REMOVAL
DATE OF BURIAL
3-5
3
191
.......
...
18
Filed
191
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH
March 2ª
1913
...
(Month)
(Day)
(Year)
37
I HEREBY CERTIFY that I attended deceased from
Jeeb 16
1913 to
March 2ª
191
3'
....
that I last saw her
alive on
March 2
3
191
and that death occurred, on the date stated above, at
11 am.
The CAUSE OF DEATH* was as follows :
Marasmus
Brucho- Pneumonia
10 NAME OF
FATHER
PARENTS
11 BIRTHPLACE
OF FATHER
(State or conntry)
Fuch.
12 MAIDEN NAME
OF MOTHER
.
13 BIRTHPLACE
OF MOTHER
(State or conntry)
P.E. J.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Forphine Foremans
(Address)
Urincheck mars
annie Estella Horeman.
2FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE Hincheops
20 UNDERTAKER W.C. skaggs
ADDRESS
In the
4
„yrs.
mos.
25 ds.
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-
mar . 2, 1913
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.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1913.
CITY OF BOSTON.
FULL NAME
Lydia E. Small
Registered No. 2319
Place of Death ¿ and Residence S
Boston
Winchester Home for Aged Women
90
5
months.
12
days.
STATISTICAL DETAILS.
SEX
COLOR
SINGLE, MARRIED, WID., DIV.
F
Maiden Name
Hobart
Francis Small
Husband's Name
Boston
Birthplace
Name of Father
David H. Hobart
5.98
Birthplace
of Father
Hanson
Maiden Name
Sarah N.Pratt
of Mother ..
Birthplace of Mother .. .
Cohasset
Occupation None
Informant
Place of Burial or removal
No.Truto
Geo.H.Gregg & Son
Undertaker
(Watertown)
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from 1913, to. 1913, 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:
RAR'S
IS SIT
Arterio-sclerosis
Primaryo (Duration)
TA A. 1822:
E DUNATA A.
N. MA'S. S
Contributory : 3
Catarrhal Enteritis
(Duration)
1 yr.
(Signed)
Nelson M. Wood
.M.D.
Mar. 6
1913 .. ......
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent- Residents.
Usual Residence.
Winthrop
Mar. 11
Filed
A true copy. Attest : Eromheenen 1913.
Registrar.
MARGIN RESERVED FOR BINDING.
RE JT PATR
SICUT
CITY
CTVTTATIS RE
CODITAA
Date of Death
Mar. 6
1913.
Age ...
years
mar. 6, 1913
WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Winthrop (No 44 Cliff are St. : Ward)
4922
(City or town [If death occurred in a hospital or institution, give its NAME instead of street and number.]
2 FULL NAME
Sen R. Johnstone
[If married or divorced womanor widow give maiden name, also name of husband.] @RESIDENCE 44 Cliff are.
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE
white
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Married
16 DATE OF DEATH
march 8, 1913
(Month)
(Day)
(Year)
17 I HEREBY CERTIFY that I have investigated the death of the deceased.
The CAUSE OF DEATH* was as follows : natural Causes :- arteno Sclerais. probable cardio-renal disease
(Found divide insisted ).
ds.
Contributory (SECONDARY)
(Duration)
.yrs.
mos.
ds.
(Signed)
Liz Burgers Magnat
M.D.
1913
(Address)
3:10Pm MEDICAL EXAMINER
* State the DISEASE CAUSING DEATII, or, in deaths from VIOLENT CAUSES, state (1) MEANS of INJURY; and (2) whether ACCIDENTAL, SUICIDAL or HOMICIDAL.
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
9/11, 193
20 UNDERTAKER
ADDRESS
Filed , 191
REGISTRAR
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
:
(Informant)
(Address)
-
mos.
ds.
.. min. ?
8 OCCUPATION
(a) Trade, profession, or particular kind of work
Booksuper
(b) General nature of industry,
business, or establishment in
which employed (or employer).
Salesman
9 BIRTHPLACE
(State or country)
Dunoon Lolland
10 NAME OF
FATHER
Geo. Johnslan
PARENTS
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME
OF MOTHER
18 BIRTHPLACE OF MOTHER (State or country)
8. 1844
(Month)
(Day)
(Year)
7 AGE
If LESS than I day, ........ hrs.
69
6 DATE OF BIRTH
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
STANDARD CERTIFICATE OF DEATH.
1
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 cxamples: (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 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., C'arcinomu, Dur- 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. For VIOLENT DEATHS state MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, Or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train - accident ; Revolver wound of head -homicide ; Poisoned by carbolic acid - prob- ably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis tetanus) may be stated under the head of " Contributory."
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:
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