USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1916-1918 > Part 72
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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 samo 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," unqualificd, is indefinite) ; Tuber-
culosis of lungs, meninges, peritonaeum, etc., Carcinoma, Sar- coma, etc., of. ... (name origin: "Cancer" is less definite; avoid usc of "Tumor" for malignant neoplasms); Mcaslcs; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (second- ary or intercurrent) affection need not be stated unless im- portant. Example: Mcasles (disease causing death), 29 ds .; Broncho-pneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "An- aemia" (mercly 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 ascertaincd as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL scpticaemia," "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 duc to Alcoholism, etc.
4. Deaths under circumstances unknown, as A person found dcad, etc.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See instructions on back of certificate.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH Winthrop (No. 35 Gral QUE St. : Ward)
Doris & Horadon
"FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.] .... 35 Totalt Cvr
@RESIDENCE
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
¿ SEX
4 COLOR OR RACE
5 SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
Single
· DATE OF BIRTH
July
(Month)
(Day)
........
1917
(Year)
· AGE
If LESS than 1 day ......... hrs.
3 - yrs. .................
.nos ... . ....
23 ds.
or ........ min. ?
& 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)
Hanetkrop Pars
10 NAME OF
FATHER
PARENTS
11 BIRTHPLACE
OF FATHER
(State or country)
"Saco THE
12 MAIDEN NAME
OF MOTHER
Anna & L'ailier
13 BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Fratture (Informant) (Address)
16
Filed
191
REGISTRAR
1ª DATE OF DEATH
Se lit
1917
(Month)
(Day)
(Year)
17
I HEREBY CERTIFY that I attended deceased from
Left 4
1917
........
1917, to
......
that I last saw h
4
alive on
5
1917
and that death occurred, on the date stated above,a
HA
m
The CAUSE OF DEATH* was as follows :
Gastro Intest, wennle
(Duration)
.............. yrs.
.......
mos. .
1
ds.
Contributory. (SECONDARY)
(Duration) .yrs. ............... mos. ....... ds
M.D
(Signed) 20//3
191) (Address)
18 mil cally
* If death followed injury or violence the certificate of death must be made out hy the Medical Examiner.
18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS). At place In the
of death ............ yrs. ............ mos. .............
ds.
State ............ yrs.
..........
.mos. ............ ds .. ............. Where was dlsease contracted, If not at place of death ?. Former or usual residence ...
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL
Commons Watertown Sept 7, 1917
20 UNDERTAKER
ADDRESS
Poter X LShaham. Naterlouw
WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
Herthrop
Registered No.
12
Valkam to Hooda don
Sept. 5, 1917 . 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, e. g., Farmer or Planter, Physician, Compositor, Architect, Loco- motive engineer, Civil engineer, Stationary fireman, ete. But in many eases, 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," ete., without more precise specification, 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 oceu- 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 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, ete., 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 eausing 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," "Shoek," "Uraemia," "Weakness," ete., 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 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 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 eaused 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 circumstances unknown, as A person found dead, etc.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH -1917.
CITY OF BOSTON
FULL NAME
MARY A. CONWAY
Registered No. 8931
Place of Death } and Residence
Boston
CITY HOSPT.
Date of Death
SEPT . 7
1917,
Age
years
months 18
days.
STATISTICAL DETAILS.
SEX
COLOR.
SINGLE, MARRIED, WID., DIV.
F
W
W
Maiden Name
MERRIFIELD
Husband's Name
WILLIAM CONWAY
PATD
TRAR IBUS Primary Er (Duratipro
SIROK
Birthplace
NORWOOD
Name of Father
JAMES MERRIFIELDO
Birthplace of Father
·ME
Contributory: (Duration )
TUB. OF INTESTINES - MONTHS
Maiden Name of Mother
ISABELLA
Birthplace of Mother
(Signed)
E . W. WILSON
M.D.
Occupation
1917
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
ADMITTED TO HOSPT. AUG. 30. 1917
Place of Burial or removal
MAL DEN (HOLY CROSS )
Usual Residence WINTHROP (8 STURGIS ST )
SEPT. 12
Undertaker
W. H. GRAHAM
Filed
1917.
A true copy. Attest : ErMSlenen
Registrar.
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness, from 1917, to
1917, 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 :
PULMONARY TUBERCULOSIS - YRS
R
CITY
OFFICE
CTYTTAT
BOSTONIA CONDITAA
A 1822
S
REGIMINE DONATA A TON. MASS
-
HOUSEWIFE
Informant
42
1
Sept. 7, 1917
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
" ... inthron .. (No ....... W. ........... Jr.os.s
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
4 COLOR OR RACE
white
Aug
TF
(Month)
(Day)
(Year)
7 AGE
if LESS than
1 day ......... hrs.
...... ... yrs. mos.
.ds.
Or ........ min. ?
& OCCUPATION
(a) Trade, profession, or
particular kind of work
(b) General nature of industry, business, or establishment which employed (or employer).
9 BIRTHPLACE
(State or country)
winthrop
(Duration)
............. yrs.
...........
mos.
10
ds.
Contributory
......
......
(Duration). yrs. ....... mos. „ds.
(Signed)
M.D. SOM G. 1914 (Address) 200 Pleasant Se-
Mf 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
For Hill billerica
20 UNDERTAKER John J. Lina ley
ADDRESS
191 .......
...... REGISTRAR
....
16 DATE OF DEATH
Syst
(Month)
(Day) 8
1917 .....
(Year)
17
I HEREBY CERTIFY that
Jattended deceased from
Lang
15
1917
to
191
V
that I last saw halive on
191
.. .
and that death occurred, on the date stated above, at
The CAUSE OF DEATH* was as follows ;
acute Entero Colitis
..........
10 NAME OF
FATHER
Francis
PARENTS
11 BIRTHPLACE OF FATHER (State or country) Concord liges.
12 MAIDEN NAME
OF MOTHER
Tortha Ioklo
13 BIRTHPLACE
OF MOTHER
(State or country)
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Francia Fruman
(Address)
5. 04
191
15
Filed
Walter Franklin Formen
2 FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 20 Crore Gt.
§ SINGLE,
MARRIED,
WIDOWED,
OR DIVORCED
(Write the word)
· DATE OF BIRTH
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
....... m.
(SECONDARY)
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 naturc 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 forin part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, ctc. 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- EASE CAUSING DEATH (the primary affection with respect to tiine 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," unqualificd, is indefinite); Tuber-
culosis of lungs, meninges, peritoneum, etc., Carcinoma, Sar- eoma, 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, ctc. The contributory (second- ary or intercurrent) affection nced 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 age," "Shock," "Uraemia," "Weakness," etc., when a definite disease can be ascertaincd 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 discase, 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, ctc.
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1917.
CITY OF BOSTON
9093
Registered No.
Place of Death { and Residence S
Boston
CITY HOSPT.
Date of Death
SEPT.12
1917, Age 55
years
months
days.
STATISTICAL DETAILS.
SEX.
COLOR.
SINGLE, MARRIED, WID., DIV.
M
W
M
Maiden Name
Husband's Name
Birthplace
WEST ROXBURY
Name of Father
WILLIAM WELLINGTON
Birthplace of Father
DORCHESTER
Contributory : (Duration)
Maiden Name of Mother
MARIE A.T.JACOBS
Birthplace of Mother
BARNSTEAD.N.H.
(Signed)
T.LEARY MED.EX. M. D.
SEPT . 12917
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents.
Place of Burial or removal
Undertaker
FOREST HILLS
J.D.FALLON
Usual Residence
WINTHROP (23 OCEAN AVE)
Filed
SEPT.17
1917.
A true copy.
Attest :
Registrar.
1917, 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 :
TRAR
PATRIBUS
Primary
ICUT (Duration)
CITY
COBISA
OFFICE
( SUICIDAL DURING TEMPORARY INSANITY )
BOSTONIA
CONDITAA
1 A. 1822
STON.
MASS.
Occupation PULLMAN CONDUCTOR
Informant
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness, from 1917, to
PISTOL SHOT WOUND HEAD & CHEST
FRANK WELLINGTON
FULL NAME
Sept. 12, 1917 U
COMMONWEALTH OF MASSACHUSETTS
RETURN OF A DEATH-1917.
CITY OF BOSTON
9401 Registered No.
Place of Death l and Residence
Boston
MASS.CHAR.EYE & EAR INF.
Date of Death
SEPT .21
1917,
Age 61
years
months
days.
STATISTICAL DETAILS.
SEX.
COLOR.
SINGLE, MARRIED, WID., DIV.
M
W
M
Maiden Name
Husband's Name
Birthplace
NEW YORK. N. Y.
Name of Father
ADOLPH WROEGER
Birthplace of Father
GERMANY
Contributory: ! (Duration )
LT.LATERAL SINUS THROMBOSIS -
1
LT.MASTOIDITIS - I MO. (?)
Birthplace of Mother
GERMANY
(Signed)
M.D.
SEPT.21
1917
SPECIAL INFORMATION from Hospitals, Institutions, Transients, or Recent Residents. IN HOSPT.I DAY
Place of Burial or removal
BROOKLYN.N.Y. (LUTHERAN Usual Residence
WINTHROP(238 SHIRLEY ST)
Undertaker
J.F . O MALEY
Filed
A true copy. Attest :
SEPT.26 1917.
WINTHROP
PHYSICIAN'S CERTIFICATE.
I HEREBY CERTIFY that I attended deceased during last illness, from 1917, to
1917, 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 :
TRAR
RIBUS. Primary
PA
R
CITY
SICU
OFFICE
BOSTONIA
CONDITAA.
1822.
B 1800. EGIMINE DONATAN
STON.MASS.
Maiden Name of Mother
EUGENE WALKER
Occupation
GENERAL MANAGER
Informant
CEREBRAL EMBOLISM - I DAY
Registrar.
CEM.)
HARMAN WROEGER
FULL NAME
Sept. 21, 1917
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)
England
12 MAIDEN NAME
OF MOTHER
Wany Strani
18 BIRTHPLACE
OF MOTHER
(State or country)
Geland
14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)
Willinstan Bond
16
Filed
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
3 SEX
m.
1 COLOR ÓR RACE
5 SINGLE.
MARRIED,
WIDOWED.
Hidower
(Write the word)
10 DATE OF DEATH
23
.....
1917
(Month)
(Day)
(Year)
" DATE OF BIRTH
nor
(Month)
10
(Day)
851
(Year)
7 AGE
65
.yrs.
10
mos.
13
ds.
or ....... min. ?
8 OCCUPATION
(a) Trade, profession, or
particular kind of work
Ibolesale Provision
(b) General nature of industry, business, or establishment in which employed (or employer) ..
Correio Interstitial Negalirates
.. (Duration)
1
yrs.
ds.
Contributory
artéria Sclerosis
(SECONDARY)
3
(Duration)
yrs.
mos. ..............
ds.
(Signed)
Edward). Tranger
M.D.
Seiner. 23, 1917 (Address)
49 Bartlett Rd.
* 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.
Where was disease contracted,
mos. ........ ds ...... If not at place of death ?.
Former or usual residence
19 PLACE OF BURIAL OR REMOVAL
DATE OF BURIAL Le6 2/1917
20 UNDERTAKER Sy BrownYou
ADDRESS
Boston
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
The Commonwealth of Massachusetts
STANDARD CERTIFICATE OF DEATH
1 PLACE OF DEATH
(No. 212 Woodende Ore Ward)
(City or town.)
[If death occurred in a hospital or institution, give its NAME instead of street and number.]
lunge
DI Bond
' FULL NAME
[If married or divorced woman or widow give maiden name, also name of husband.] @RESIDENCE 212 Woodside are Kinthos Registered No.
PERSONAL AND STATISTICAL PARTICULARS
17
I HEREBY CERTIFY that I attended deceased from
Sept.
4
1912, t
Sibb. 2 5, 1912.
that I last saw hu alive on
Sept. 22, 1917,
and that death occurred, on the date stated above, at
......
m. The CAUSE OF DEATH* was as follows :
9 BIRTHPLACE
(State or country)
") Boston Mass
10 NAME OF
FATHER
Thomas Bond
If LESS than
I day ......... hrs.
mos. ............
(Ad
3) 3 Subverzi de Costur theof Gardens and Chelsea
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 eaclı 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 minc, 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 (retircd, 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 discase. Examples: Cercbro-spinal fever (the only definite synonym is "Epidemic cerebro-spinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fcvcr (never re- port "Typhoid pneumonia"); Lobar pneumonia; Broncho- pneumonia ("Pneumonia," unqualified, is indefinite); Tuber-
culosis of lungs, meninges, peritonaeum, 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 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 scpticaemia," "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.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state important. See Instructions on back of certificate.
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