Town of Winthrop : Record of Deaths 1919-1921, Part 16

Author: Winthrop (Mass.)
Publication date: 1919
Publisher:
Number of Pages: 1192


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1919-1921 > Part 16


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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pure of the American Medical Association.) Cases for the Medical Examiners. - Under the provi- sions 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, Exposure, 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.


ADDITIONAL SPACE


FOR FURTHER STATEMENTS BY PHYSICIAN.


R 15. 1-'18. 100,000.


A R-301


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


1 PLACE OF DEATH


County.


Suffolk.


... State Me se schule Regis


City or Town


Winthrop


No. 78 Simple ve;


St .. Ward


( If death occurred in a hospital or institution, give its NAME instead of strect and number)


2 FULL NAME


Altedia Sursey Johnson


(If in the Army or Navy of the United States, give rank, organization, etc.)


(a) Residence.


No.


78 Temple Are St.


(Usual place of abode)


Length of residence in city or town where death occurred


12


years


8


months


days.


How long in U. S., if of foreign birth? 15


years


2


months


X


days


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Female White


4 COLOR OR RACE


5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) Single Diversos 17 Somerville William Johnand Mark.


5a If married, widowed, or divorced HUSBAND of (or) WIFE of


6 DATE OF BIRTH


( Month)


1870 (Year)


If LESS than ! day, hrs.


or min.


Influenza,


(duration)


yrs.


mos.


ds.


CONTRIBUTORY


(SECONDARY)


(duration)


yrs


mos.


ds.


18 Where was disease contracted


if not at place of death ?


Did an operation precede death ? ...


.......


Date of.


Was there an autopsy ? .


What test confirmed diagnosis ?


(Signed)


, M.D.


(Address)


Ych


Date


(Month)


(Day)


( Year)


14 Phas. R. Bennison). Informant


(Address) Wirthadd M.11


15


Filed


Mich. 24, 1919


(Month) (Day) (Year)


REGISTRAR


19 PLACE OF BURIAL, CREMATION, OR, REMOVAL


Winthrop (1metery


(Cemetery)


(City or town)


20 UNDERTAKER


hat. R. Rennestu


-


DATE OF BURIAL Mati-21911


ADDRESS


21 | HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued


Official position


1.12


22 Date of issue of burial or transit permit


rial March 221914


instructions and extracts from the laws on back of certificate.


PARENTS


11 BIRTHPLACE OF FATHER (City) (State or country)


12 MAIDEN NAME OF MOTHER


New Foundland? EL Cheazul, Bursey


13 BIRTHPLACE OF MOTHER (City) (State or country)


New Foundland


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH


mich.


(Month)


19.


(DES) ^


1919.


(Year)


I HEREBY CERTIFY, That I attended deceased from


, 19/s, to


mah. 14.


, 19 / .....


Mehi.


19.


that I last saw h alive on , 19 / , and that death occurred, on the date stated above, at 7 m.


7 AGE 34 Years


Months Days


If STILLBORN, enter that fact here If STILLBORN, state period of uterogestation mos.


8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kind of work (b) General nature of industry, business, or establishment in which employed (or employer)


14aid


(c) Name of employer Louis


i & Rost


9 BIRTHPLACE (City)


(State or country)


Ild Perlican


New Foundland.


10 NAME OF


FATHER


Elijah Burdey


Old Perlican


Chicas


Minchiate


2/2,


1911.


. 100,000.


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


Unknound


(Day)


The CAUSE OF DEATH was as follows :


Ward.


(If non-resident give city or town and State)


non. IT. ITLY


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


[Approved by U. S. Census and American Public Health Association!


Statement of occupation. - Precise statement of occupation 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, Locomotive engineer, Civilengineer, Stationary fireman, etc. Butin 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) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Lahorcr," "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 dutics of the house- hold only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has heen changed or given up on account of the DISEASE CAUSINO DEATH, state occupation at beginning of illness. If retired from husiness, that fact may he 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: Cere- brospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (ncver report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, 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 (secondary or inter- current) affection need not he stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (sccondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse,""Coma,""Convulsions,""Dehility" ("Congenital,""Senile," ete.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childhirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.


State cause for which surgical operation was undertaken.


(Recommendations on statement of cause of death approved hy Com- mittce on Nomenclature of the American Medical Association.)


Bronchopneumonia: If primary cause, write the word "pri- mary " ; if secondary, give primary cause.


Certificates will he returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physician shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and helief the name of the deceased, his supposed age, the discase of which he died [defined so that it can he classified under the international classification of causes of death], where contracted, the duration of his last illness, when last seen alive by the physician, and the date of his death. . . . - Revised Laws, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chap. 322.


No undertaker or other person shall bury a human body . . . until he has received a permit from the board of health or its agent, . . . or . . from the clerk of the city or town in which the person died; . . . no such permit shall be issued until there shall have heen delivered to such board, agent or clerk, . . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which ... shall he accompanied hy a satisfactory certificate of the at- tending physician, if any, as required by law, or in lieu thereof a certifi- cate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, the chairman of the board of health, if a physician, or any physician employed by said board or by the selectmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner only shall make such certificate. . . . The person to whom the per- mit is so given and the physician who certifies to the cause of death shall thereafter furnish for registration any other necessary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Revised Laws, Chap. 78, Sec. 38.


Medical examiners shall, in all cases, certify to the city or town clerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise a description of such person as full as may he, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are supposed to have come to their death hy violence. - Revised Laws, Chap. 24, Sec. 8.


RULES OF PRACTICE


The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from discase unrelated to any form of injury.


(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.


(3) Medical examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


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.


& SEX In 7 AGE 69 8 OCCUPATION (b) General nature of industry, business, or establishment In which employed (or employer) 12 MAIDEN NAME OF MOTHER PARENTS 13 BIRTHPLACE OF MOTHER (State or country) CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very ... .. yrs.


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


1 PLACE OF DEATH


Winthrop


......


(No.


3.3


'St. ;... ........... .Ward)


Wentup (City or town.)/ [If death occurred in a hospital or institution, give ita NAME instead of street and number.]


2 FULL NAME


George Stephens


[If married or divorced woman or widow


give maiden name, also name of husband.]


@RESIDENCE


33 Acean


Que: Vinterde mace,


Registered No.


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE


W.


5 SINGLE,


MARRIED,


WIDOWED,


OR DIVORCED


(Write the word)


a) Married


· DATE OF BIRTH 10 -25


(Month)


(Day)


If LESS than [ day ......... hrs.


mos.


6


ds.


or ........ min. ?


(a) Trade, profession, or


particular kind of work.


Paper hanger & Painter


9 BIRTHPLACE


(State or country)


Germany


10 NAME OF


FATHER


Henry Stephens.


11 BIRTHPLACE


OF FATHER


(State or country)


Germany


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


11hrs Stephens


(Address)


33 Crean (Live)


16 File mich. 24, 1919.


REGISTRAR ...


...


1849


17


1 HEREBY CERTIFY that I attended deceased from


(Year)


nov.


1.


1918


más. 11.


, 191_2 ....


that I last saw h come alive on


, 1912 ...


mal


17.


......


and that death occurred, on the date stated above, at


m. The CAUSE OF DEATH* was as follows :


·


(Duration)


........... yrs.


................ mos. ................


ds.


Muito


Contributory


(SECONDARY)


.(Duration)


yra.


mos. ........ ds.


(Signed)


M.D.


201.1917 (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. .........


ds.


State


....... yrs.


In the


mos. ........


da ..........


Where was disease contracted, If not at place of death ?


Former or usual residence.


19 PLACE OF BURIAL OR REMOVAL Webster Muss.


DATE OF BURIAL


Mar. 23. 1911


ADDRESS


20 UNDERTAKER Chad. R. Bennison


WRITE PLAINLY, WITH UNFADING INK -THIS IS A PERMANENT RECORD.


MEDICAL CERTIFICATE OF DEATH


18 DATE OF DEATH


Mar.


(Month)


19, 1919


......


(Day)


(Year)


Wirtho of Mass.


C


uch. 19, 1919


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 ncedcd. 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 dutics 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 time and causation), using always the same accepted term for the same discase. Examples: Cerebro-spinal fever (the only (lefinite 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., Careinoma, Sar- coma, etc., of ... ........... ............ (name origin: "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms) ; Measles; Whooping cough; Chronie 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," ctc., 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, 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, etc.


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


...............


(City or town)


1 PLACE OF DEATH


County.


Suffolk.


State


Mans.


.Registered No.


Township


or Village.


or


.Ward


(If death occurred in a hospital or institution, give its NAME instead of street and number)


Ella.H. Taylor


2 FULL NAME


(If in the Army or Navy of the United states, give rank, organization, ctc.)


(a) Residence.


No. 180 Some


(Usual place of abode)


Length of residence in city or town wbere death occurred


months


days.


How long in U. S., if of foreign birth ?


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Widowed


5a If married, widowed, or divorced


HUSBAND of


(01) WIFE of


Capt


Ella Baker


Taylor


6 DATE OF BIRTH (month, day, and year)


1851-12-23


7 AGE


Years


Months 2


Days


28


If LESS than I day, ........ brs. or ........ min.


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work


athome


(b) General nature of industry, business, or establishment in which employed (or employer) (c) Name of employer


.(duration)


-


.yrs ..............


.mos.


ds.


.


CONTRIBUTORY


(SECONDARY)


Andei


(duration)


.yrs


.mos.


ds.


18 Where was disease contracted


if not at place of death ?.


Did an operation precede death?


no


Date of.


Was there an autopsy ?.


no


What test confirmed diagnosis ?


(Signed) ...


M.D.


3/2. 19 19 (Address)


* State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional spacc.)


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


Swan Lake Cent.


DATE OF BURIAL 3-2/2019


(Address)


180 Somerset Tavs


15


File Ich. 26, 1919 Eulalie Churchill aist REGISTRAR


20 UNDERTAKER


q.C. Skaggs.


ADDRESS


grinthiof


N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. 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


PARENTS


9 BIRTHPLACE (city or town).


Demusport


(State or country)


mass


10 NAME OF FATHER


Forph K. Baker


11 BIRTHPLACE OF FATHER (city or town).


(State or country) Mais.


12 MAIDEN NAME OF MOTHER Nanna J. Smal


13 BIRTHPLACE OF MOTHER (city or town) Jemet (State or country) march


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH (month, day, and ycar)


19 /4


17 I HEREBY CERTIFY, That I attended deceased from


., 19.[ .......... , to.


Munk 21, 19/5


4


that I last saw h.


alive on


19.46


and that death occurred, on the date stated above, at 5 m. The CAUSE OF DEATH* was as follows :


5


67


of certificate.


14 Halten Taylor


Informant


City


grmethod


No. 181)


aux St.,


Ward.


(If non-resident give city or town and State)


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH [Approved by U. S. Census and American Public Health Association]


Statement of occupation. - Precise statement of oceupa- tion 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, Compos- itor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, ete. . 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) Salesman, (b) Grocery; (a) Forcman, (b) Automobile factory. The ma- terial worked on may form part of the second statement. Never return "Laborer,"


"Foreman," "Manager," "Dealer," ete., without more precise specifieation, as Day laborer, Farm laborer, Laborer -Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically 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 inay be indi- cated 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: Cerebrospinal fcver (the only definite synonym is "Epidemie cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- ficd, is indefinite); Tuberculosis of lungs, meninges, peri- toncum, etc., Carcinoma, Sarcoma, etc., of.


(naine 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 (secondary or inter- current) affection nced not be stated unless important. Example: Measles (disease causing death), 29 Gs .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toins or terminal conditions, such as "Asthenia," "Anemia" (mcrely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions,"""Debility" (“Con- genital," "Senile," ete.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- inus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease ean be ascertained as the cause. Always qualify all diseases resulting from ehild- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL 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 de- termine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoned by carbolic acid - probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may be stated


under the head of "Contributory." (Recommendations - on statement of eause of death approved by Committee on Nomenclature of the American Medical Association.)


Cases for the Medical Examiners. - Under the provi- sions 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 Crimina. abortion, Poisoning, Starvation, Suffocation, Exposure, etc.


1


3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or onc supposed to be due to Alcoholism, etc.


4. Deaths under circumstances unknown, as A person found dead, etc.


ADDITIONAL SPACE


FOR FURTHER STATEMENTS BY


PHYSICIAN.




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