USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1913-1915 > Part 91
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MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
Mute
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
$ DATE OF BIRTH
Saft
17
1902
(Month)
(Day)
(Year)
7 AGE
If LESS than i day ........ hrs.
12 .yrs. 6
....... ..... mos. 26 ds.
or ........ min. ?
· OCCUPATION
Schock bin
(a) Trade, profession, or
particular kind of work
(b) General nature of industry, business, or establishment in which employed (or employer).
3 BIRTHPLACE
(State or country)
Chelun. Mars
PARENTS
12 MAIDEN NAME
OF MOTHER
Hany . W. Bucker
1ª BIRTHPLACE
OF MOTHER
(State or country)
Barrington U.S.
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
18 Bimini
(Address)
16
Filed
191
......
REGISTRAR
16 DATE OF DEATH
afw
Y., 1915
(Month)
(Day)
(Year)
17
I HEREBY CERTIFY that I attended deceased from
March 10
. 19115, to
Ihr 7.
that I last saw h ...
alive on
Opr 6., 1915
and that death occurred, on the date stated above, at
9,9.m.
The CAUSE OF DEATH* was as follows :
Septie Endo candita
(Duration)
.. yrs ..
4
.mos.
ds.
Contributory
Cardiac Dropeu
(SECONDARY)
(Duration)
yrs.
ds.
(Signed)
He Partir
M.D.
Cifer-9, 1015 (Address)
Winthrop
. 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.
In the
Where was disease contracted, If not at place of death ?.
Former or usual residence
18 PLACE OF BURIAL OR REMOVAL Minthaes
DATE OF BURIAL
and 10.
1915.
" UNDERTAKER
le R Beminin
ADDRESS
Winther
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
important. See instructions on back of certificate.
St. : Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME instead of street and number.]
10 NAME OF
FATHER
avery. I. Parul
11 BIRTHPLACE
OF FATHER
(State or country)
Bargin U.S.
apr. 7, 1915
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, Architeet, Loeo- 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 needcd. 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 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, 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- 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; Broneho- pneumonia ("Pneumonia," unqualified, is indefinite); Tuber-
culosis of lungs, meninges, peritonaeum, ctc., 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 (discase 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 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, Homieide, etc.
2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Ex- posure, etc.
3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dead, etc.
N. B. - Every Item of Information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
Important. See instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
(No. 124 Pleasant
St. :
..........
Ward)
(City or town.) [If death occurred In a hospital or institution, give its NAME Instead of street and number.]
2FULL NAME
Wilhelmina G. Haigh.
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
Winthrop 124 pleasant
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
$ SEX
4 COLOR OR RACE
LV
6 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
1
10 DATE OF DEATH
ah.
(Month)
8. , 1955
.......
(Year)
(Day)
· DATE OF BIRTH
4
(Month)
75~
(Day)
1916
(Year)
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)
Winthrop
PARENTS
12 MAIDEN NAME
OF MOTHER
13 BIRTHPLACE
OF MOTHER
(State or country)
Cal -
" THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Genuine Mc Donald.
(Address)
124 Pleasant St
14 Filed
191
REGISTRAR
11
I HEREBY CERTIFY that i attended deceased from
til . . .
1915, to.
apr. 8.
1915
that 1 last saw
Lalive on
apr. 8.
1915
and that death occurred, on the date stated above, at
99.m.
The CAUSE OF DEATH* was as follows :
acute nephritis
.(Duration)
2
mos.
ds.
Contributory.
Par analitin
.
..........
(SECONDARY)
(Duration) ....... yrs. ..............
mos.
ds
7
Chr. 9.1953 (Address)
Winthe of Mars
....
....
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
16 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
of death ........... yrs.
„ mos.
ds.
Stato ........... y's.
mos.
In the
Where was disease contracted, if not at place of death ?
Former or usual residence
1 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
16-10-
1916
D UNDERTAKER
W.C. flex970
ADDRESS
.
7 AGE
If LESS than
1 day ......... hrs.
..... yra.
mos.
1.5.00
10 NAME OF
FATHER
Claude Haugh
11 BIRTHPLACE
OF FATHER
(State or country)
(Signed)
N.l. Partin
M.D.
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 cach 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 linc is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salcs- man, (b) Grocery; (a) Forcman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager,", "Dcaler," etc., without more precise specification, as Day laborcr, Farm laborer, Laborer - Coal minc, etc. Women at home, who are engaged in the duties of the houschold 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, 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 (retircd, 6 yrs.). For persons who have no occu- pation whatever, write None.
Statement of cause of death. - Name, first, the DIS- BASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same discase. Examples: Cerebro-spinal fcver (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) ; Tubcr-
culosis of lungs, meninges, peritonacum, etc., Carcinoma, Sar- coma, ctc., of .. ... (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant ncoplasıns) ; Measles; Whooping cough; Chronic valvular heart discasc; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection necd not be stated unless im- portant. Example: Measles (discase causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere syinptoms or terminal conditions, such as "Asthenia," "An- acmia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hacmorrhage," "Inanition," "Marasmus," "Old agc," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken.
Cases for the Medical Examiners. - Under the 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 strect, or onc 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-1915.
CITY OF BOSTON.
FULL NAME
FRANK DAFFIN
Registered No.
3557
B. C. H. RELIEF STA.
1915. Age 47
years 3
months
28
days.
STATISTICAL DETAILS.
SEX.
COLOR.
SINGLE, MARRIED, WID., DIV.
M
N
MAR.
Maiden Name
STIE
PATRIBIS. SIT DI , Primary (Duration !!
NATURAL CAUSES - PRESUMABLY
Birthplace
BALTIMORE.MD
Name of Father
FRANK D. DAFFIN
Birthplace of Father
BALTIMORE.MD.
Maiden Name of Mother
IDA NOULTON
Birthplace of Mother
BALTIMORE. ME.
Occupation
COMPOSITOR
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Place of Burial or removal
WINTHROP ( WINTHROP CEM) Usual Residence WINTHROP (63 CHESTER AV)
Undertaker
W.C. SKAGGS
Filed
APR . 14 1915
WINTHROP
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness,
from
1915, to
1915, 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
Husband's Name
CITY
ILVULALO
BOSTONIA CONLAITA A MED.
CA AD. 1822.
HEART DISEASE ( ORGANIC)
6 SRE IMIN
: DONATA A
STO
1. MASS
Contributory : ( (Duration) SUDDEN DEATH
(Signed) G. B. MAGRATH MED. EX. M.D.
APR.9
1915
A true copy. A:test :
Emblemen
Registrar.
Place of Death ¿ and Residence S
Boston
APR.8
Date of Death
Informant
SICUT
apr. 8, 1915
$
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
......
(No. 35 menard als.
Emma Frances Bose Haite
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-
‘ COLOR OR RACE
Female Mute,
5 SINGLE,
MARRIED,
WIDOWED,
OR_DIVORCED
(Write the word)
manca
· DATE OF BIRTH
(Month)
(Day)
1
184
(Year)
7 AGE
If LESS than
I day ......... hrs.
67 yra. 2
9.
mos.
ds.
or ........ min. ?
* OCCUPATION
(a) Trade, profession, or
particular kind of work
At Home
(b) General nature of industry. business, or establishment In which employed (or employer)
· BIRTHPLACE
(State or country)
Judge Masa
Mask.
10 NAME OF
FATHER
PARENTS
11 BIRTHPLACE
OF FATHER/
(State of country)
Unknown.
12 MAIDEN NAME
OF MOTHER
Nancy Halden
18 BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Eloi Haute
(Address)
Filed 191
REGISTRAR
16 DATE OF DEATH
17
I HEREBY CERTIFY that I attended deceased from
Dec. 20
1914, to
após 10
1915
that I last saw h ... ...... alive on
apie 9
1915
....
and that death occurred, on the date stated above, a
3 A.m.
The CAUSE OF DEATH* was as follows :
Secondary Cancunnie ff Ley
(Duration)
.........
.. yrs.
.............
.. mos.
ds.
Contributory (SECONDARY)
.(Duration) .
............ yrs. .
.mos.
de.
(Signed)
M.D.
.......
. 19kč ..... (Address).
218 horas Huiles
* 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).
in the
At place
of death ............ yrs ..
. ............ mos.
ds.
Stete ............ y ... ............ mos.
Where was disease contracted, if not at place of death ?
Former or usual residence
1 PLACE OF BURIAL OR REMOVAL Forest Hills
DATE OF BURIAL
C/12001. 1915
20 UNDERTAKER
Holm Formally
ADDRESS
Mutter
(City or town.)
2 FULL NAME
[If married or divorced woman or widow
give maiden name, also name of husband.]
@RESIDENCE
35 Mermaid ave
....
Registered No.
(Month)
10
1915
....
(Day)
(Year)
....
apr. 101915
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 eacl and every person, irrespective of agc. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Loeo- 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 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. Carc 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 rc- 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," "Hacmorrhage," "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.
Varta 67 you.
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
Huittrap, Highlands (No.
88
Cliff are
St. :
....... Ward)
(City or town.) [If death occurred in a hospital or institution, give its NAME Instead of street and number.]
2 FULL NAME
diristiana Fleratutte. Wilson
[If married or divorced woman or widow give maiden name, also name of husband.] a RESIDENCE 88 Elefan
Hayder
Registered No.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
cette
5 SINGLE,
MARRIED,
OR DIVORCED
(Write the word)
DATE OF BIRTH
mar
17
18.30
(Year)
(Month)
(Day)
7 AGE
63
.yrs.
mos
26
ds.
If LESS than
day.
min.
* OCCUPATION
(a) Trade, profession, or
particular kind of work
at Home.
(b) General nature of industry,
business, or establishment in
which employed (or employer).
17 I HEREBY CERTIFY that I attended deceased from april 3 ..... 1916 ... , to april 11. 1915 that I last saw alive on april 10 1915 and that death occurred, on the date stated above, at 70 m. The CAUSE OF DEATH* was as follows : Sabar Primaria
.
Did a surgical operation precede death ? To Date
(Duration)
X
mos.
ds.
.yrs.
Hemiplegia
Contributory.
(SECONDARY)
(Duration)
1
„yrs.
.......
mos.
ds.
(Signed)
Qwille E. Haluyou
M.D.
april 11, 1915 (Address) Vernetuolo, Mais
* If death followed injury or violence the certificate of death must be made out by the Medical Examiner.
1$ LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS).
At place
In the
life
of death.
2
... mos.
ds.
State
.yrs.
mos.
ds.
Where was disease contracted, If not at place of death ?.
Former or usual residence.
18 PLACE OF BURIAL OR REMOVAL Zet Wollentar Jeunes
DATE OF BURIAL
Quil '4
1918
· UNDERTAKER
Filed
191
..... REGISTRAR
16 DATE OF DEATH
april
1915
(Month)
(Day)
(Year)
· BIRTHPLACE
(State or country)
Lucy Juans.
10 NAME OF
FATHER
Jakich Handen.
11 BIRTHPLACE OF FATHER (State or country)
12 MAIDEN NAME
OF MOTHER
13 BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
(Address)
88 Elec ave.
ADDRESS
110 Moralunter
PARENTS
BOSTON ...
apr. 10/1915
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 eacli 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 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, peritonacum, etc., Careinoma, Sar- coma, etc., of .... .. (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronie 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 ean 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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