USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1919-1921 > Part 62
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5
mos ..
-. ds.
PARENTS
11 BIRTHPLACE OF FATHER (city or town)
(State or country)
Eng la nd
What test confirmed diagnosis ?.
Michael J O'Meara
(Sigoed)
M.D.
City of Town
Worcester
No.
Worcester State Hospital
St.
Length of residence in city or town where death occurred
2
years
10
mooths
7
days
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH Approved by U. S. Census and American Public Health Association]
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, Compos- itor, Architect, Locomotive 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) Salesman, (b) Grocery; (a) Foreman, (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 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 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 homc. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, cte. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATII, state occupation at beginning of illness. If retired from business, that fact may be indi- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.
Statement of cause of death .- Namc, first, the DISEASE CAUSING DEATII (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toncum, 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 be stated unless important. Example: Measles (disease causing death), 29 ds .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Comna," "Convulsions,"" "Debility" ("Con- genital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- Inus," "Old age," "Shock,"Uremia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from child- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," cte. 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 hcad - 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 cause 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 Criminal abortion, Poisoning, Starvation, Suffocation, Exposure, etc.
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.
R 303. 6-'18. 50,000.
so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back
of certificate.
14
Informant
Ruth Clack Gordon.
(Addr
36 Semmit Tev2.
15
Filed Dec. 26., 199.
REGISTRAR
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Single
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 DATE OF BIRTH (month, day, and year) Feb. 4,1917
7 AGE
Years
Months
10
Days
If LESS than 1 day, ........ hrs. or ........ min.
8 OCCUPATION OF DECEASED
(a) Trade. profession, or
particular kind of work
nong
(b) General nature of industry, business, or establishment in which employed (or employer) (c) Name of employer
CONTRIBUTORY
(SECONDARY)
(duration)
yrs ...
......
... mos ...............
ds.
18 Where was disease contracted
if not at place of death?
at home
Did an operation precede death ?
mi Date of
Was there an autopsy ?
no
What test confirmed diagnosis ?
Chacal
(Signed)
Birmet calf
M.D.
12/0, 19/9 (Address) 174 Worldup at Der Rap Tors
* State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, jetate (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, · SUICIDAL, or HOMICIDAL. (See reverse side for additional space.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
Lancaster, Mars12-10-19/
20 UNDERTAKER
H.C. Skaggs
ADDRESS
Wielkos
carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,
The Commonwealth of Massachusetts STANDARD CERTIFICATE OF DEATH
(City or town)
1 PLACE OF DEATH
County.
suffolk
State Mark
Registered No.
Township
Winthrop
No. 36
.or
VAlage
Mucethiop
........... or
City
(If death occurred in a hospital or institution, give its NAME instead of street and number) Harald novio Gordon.
2 FULL NAME
fif to the Armypr Navy ofthe United States, give rank, organization, etc:)
(a) Residence.
No. 36 Suas of the Un
(Usual place of abode)
Length of residence in city or town where death occurred
1
years
months
days.
How long in U. S., if of foreign birth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
16 DATE OF DEATH (month, day, and year)
12-8-
19/ 9
17
HEREBY CERTIFY, That I attended deceased from
19.19,to ..
19
19
that I last saw
alive on
1919
and that death occurred, on the date stated above, at
130
30 pr.
The CAUSE OF DEATH* was as follows : acedores
(duration)
.......
.... yrs .............
mos ..
2
ds.
9 BIRTHPLACE (city or town)
(State or country)
10 NAME OF FATHER
11 BIRTHPLACE OF FATHER (city or town) YAchestr (State or country)
12 MAIDEN NAME OF MOTHER Ruth Clark
PARENTS
13 BIRTHPLACE OF MOTHER (city or town).
newton?
(State or country) 2MgAR
mit aus
St.,
.......
Ward
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 occupa- 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, Architcet, Locomotive 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 statcinent; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial worked on may forin part of the second statement. Never return "Laborer,"
"Foreman," "Manager," "Dealer," etc., without inore 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 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 spc- 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 may 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 fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pncuinonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toncum, etc., Carcinoma, Sarcoma, etc., of_
(name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart discase; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; 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," ctc.), " Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite discase can be ascertained as the cause. Always qualify all discases resulting from child- 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 HIOMICIDAL, 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 (c. g., sepsis, tetanus) may be stated
under the head of "Contributory." (Recommendations on statement of cause 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 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.
The Commomoralth of Massachusetts STANDARD CERTIFICATE OF DEATH
(City or town)
Registered No.
or Village
or
No.
37%, Ficelhugo
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
ichard Stanley Moody
(a) Residence.
No. BY/ Wiecho
Length of residence io city or town where death occurred
years
8
months
25 days.
How long in U. S., if of foreign birth ?
years
months
days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year) 12-9-
19/9
17 I HEREBY CERTIFY, That I attended deceased from
19
19
to bem 9 .1919
that I last saw h
2
alive on
1919.
and that death occurred, on the date stated above, at 6300 m. The CAUSE OF DEATH* was as follows :
(duration)
1
.yrs ....
4
.mos ..
mads.
CONTRIBUTORY
(SECONDARY)
(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 ?.
& Ray Plates
What test confirmed diagnosis ?
2 rueete Elacinsan
(Signed)
M.D.
, 19
(Address)
Wieluof mass
* 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. (Sce reverse side for additional space.)
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
DATE OF BURIAL
12-11 1919
20 UNDERTAKER
ADDRESS
Withist
Township Cit 2 FULL NAME (Usual place of abode) 3 SEX 4 COLOR OR RACE 5a If married, widowed, or divorced HUSBAND of (or) WIFE of 7 AGE Months 8 1 Years 8 OCCUPATION OF DECEASED (b) General nature of industry, business, or establishment in which employed (or employer) (c) Name of employer (State or country) 12 MAIDEN NAME OF MOTHER PARENTS Informant 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. 15 Filed Dec. 26, 1919. N. B. - WRITE PLAINLY, WITH ONFADING INK - THIS IS A PERMANENT RECORD. Every item of information should be 9 BIRTHPLACE (city or town) (State or country) Mark
10 NAME OF FATHER Richard C. Morda
11 BIRTHPLACE OF FATHER (city or town).
Bestor
13 BIRTHPLACE OF MOTHER (city or town) Laeken) (State or country) 7.1.0-
14 Richard B. Mr
(Address)
371 milk St
REGISTRAR
.
6 DATE OF BIRTH (month, day, and year) March 15.1918
Days
24
If LESS than 1 day, ........ hrs. or ........ min.
(a) Trade, profession, or
particular kind of work
nous
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
Single
(If in the Army or Navy of the United States, give rank, organization, etc.)
St., Ward.
(If non-resident give city or town and State)
1 PLACE OF DEATH
County.
Suffolk
State
Mark
[Approved by U. S. Census and American Public Health Association]
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 cach and every person, irrespective of age. For many occupations a single word or terin on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compos- itor, Architect, Locomotive 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) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial 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 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 may 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 DEATII (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemie ccrebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toncum, 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 be stated unless important. Example: Measles (disease causing death), 29 ds .; Broncho- pneumonia (secondary), 10 ds. Never report mere symnp- toms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col-
lapse," "Coma," ""Convulsions,"""Debility" (" Con-
genital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from child- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," ctc. 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 (c. g., sepsis, tetanus) may be stated
under the head of "Contributory.
on statement of cause 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 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.
R-302
The Commonwealth of Massachusetts
CERTIFICATE OF DEATH OF NON-RESIDENT
----
( City or town)
10940
County
Suffolk
State
Massachusetts
Registered No.
(Place of death)
City or Town
Boston
No.
ST .ELIZ .HOSPT.
St., Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
CORNELIUS O CALLAGHAN
(If in the AFIRIPENSref the United States, give rank, organization, etc.)
City or Town
No.
28 IRWIN AVE
St.
(a) Residence. State.
(Usual place of abode)
Length of residence in city or town where death occurred
years
months
days
How long in U. S., if of foreign birth?
years
months days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
16 DATE OF DEATH (month, day, and year)
DEC.10 1919
17
I HEREBY CERTIFY, That I attended deceased from
ост.26
19.19 ....... , to
DEC.10
19 .. 1.9
...
that I last saw h
IM
DEC .10
......
19.19
and that death occurred, on the date stated above, at
1.30 A m. The CAUSE OF DEATH* was as follows :
* 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 space.) PYELITIS -- SEPTICAEMIA
(duration).
2'
.. yrs ..
mos .............. . ds.
CONTRIBUTORY
(SECONDARY)
(duration)
yrs ...
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
L.A.NORMANDIN
M.D.
, 19 19 (Address)
14 J.J. SULLIVAN. 76 OAK ST
19 PLACE OF BURIAL, CREMATION, OR REMOVAL
BROOKLINE (HOLYHOOD)
DATE OF BURIAL
DEC.12
19 19
Filed
DEC . 12 1919
Registrar of city or town where death occorred
Filed
DEC. 17. 1919
Winthrop
Registrar of city or town where deceased resided
3 SEX
M
7 AGE
63
PARENTS
Informant
(Address)
15
so that it may be properly classified. Exact statoment of OCCUPATION is very important. See instructions on back
of certificate.
carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,
I. D. WHILE PLAINLY, WITH CITADINO INN TID IN A PERMANENT SECOND. Every Item of information should be
(State or country)
4 COLOR OR RACE
₦
5 SINGLE, MARRIED, WIDOWED, OR
DIVORCED (write the word)
S
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
6 DATE OF BIRTH (month, day, and year)
Years
Months
Days
If LESS than
1 day, ........ brs.
Or ....... mic.
If STILLBORN, enter that fact here
8 OCCUPATION OF DECEASED
(a) Trade, profession, or
particular kind of work.
NONE
(b) General nature of industry,
business, or establishment in
which employed (or employer)
(c) Name of employer
IRELAND
9 BIRTHPLACE (city or town)
10 NAME OF FATHER
DENNIS
11 BIRTHPLACE OF FATHER (city or town)
(State or country)
IRELAND
12 MAIDEN NAME OF MOTHER
NOT STATED
13 BIRTHPLACE OF MOTHER (city or town) ...........- (State or country)
20 UNDERTAKER
W.J.CASSIDY
ADDRESS
BOSTON
1 PLACE OF DEATH
Registered No.
(Place of residence)
NASS.
REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH [Approved by U. S. Census and American Public Health Association]
Statement of occupation. - Prceise 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, c. g., Farmer or Planter, Physician, Compos- itor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial cinployments, 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," cte., without more precise specification, as Day laborer, Farm laborer, Laborer - Coal mine, etc. Women at home, who are engaged in the duties of the houschold 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, ete. If tlie 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 indi- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write Nonc.
Statement of cause of death .- Namc, 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 fever (the only definite synonym is "Epidemie cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar mmcumonia; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toneum, etc., Carcinoma, Sarcoma, cte., of.
(naine origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, cte. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Broneho- mmeumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as " Asthenia." "Ancinia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Con- genital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all discases resulting from child- birth or iniscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," ctc. State cause for which surgical operation was undertaken. For VIOLENT DEATHIS STATE MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, Or HOMICIDAL, or as probably such, if impossible to de- terinine 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 conscquenecs (e. g., sepsis, tetanus) may be stated
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