Town of Winthrop : Record of Deaths 1925-1927, Part 151

Author: Winthrop (Mass.)
Publication date: 1925
Publisher:
Number of Pages: 1340


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1925-1927 > Part 151


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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Registered


No.


City or Town


Boston


No.


72 Cottage Park Road


St., _Ward


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


2 FULL NAME


Samuel a. Burns


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


(a) Residence. No.


(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


3 SEX


Male White


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


Married


5a If (harried, widowed or divorced


HUSBAND of


(or) WIFE of


Ida . Burns


6 AGE


Years


68


Months


Days


If LESS than 1 day, __ hrs. of_min.


I STILLBORN, enter that fact bere


7 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work


(b) Name ol employer


Boston Elevated


Conductor


(duration)


yrs.


mos.


ds.


CONTRIBUTORY


(SECONDARY)


(duration)


_yrs.


.mos.


ds


17 Where was disease contracted


if not at place of death?


FOR WHAT?


Did an operation precede death?


Date of


Was there an autopsy?


If under one year, was infant Breast Fed ?..


What test confirmed diagnosis?


(Signed)


M. D.


(Address)


9 1126.


Data


(Month)


(Day)


(Year)


13


Informant


Ida Burns


( Address)


Winthrop.


14 Filed 18/26 (Month) (Day) (Year)


REGISTRAR


20 | HEREBY CERTIFY that a satisfactory stan- dord cartificate of death was filed with me BEFORE the burial or transit permit was issued ONm. D. Childress


Official position


Hearth office


Data of issue 10/11/26


Permit NO. 1144


Instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH


-N. U.WAITE PLAINLY, WITH UNFADING BLACK INK- THIS IS A PERMANENT RECORD. Every item of information 2 00.000


MEDICAL CERTIFICATE OF DEATH


15 DATE OF DEATH


(Month)


9 1426


(Day)


(Year)


16


I HEREBY CERTIFY, That I attended deceased from


Saftig


192


to


19


26


19


that I last saw h


mealive on


Cant ?


26,


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


6.30Am.


The CAUSE OF DEATH was as follows:


Dugnano historio


8 BIRTHPLACE (City)


(State or country)


Boston


Mass


9 NAME OF


FATHER


Unknown


PARENTS


10 BIRTHPLACE OF


FATHER (City)


(State or country)


Unknown


11 MAIDEN NAME


OF MOTHER


Unknown


12 BIRTHPLACE OF


MOTHER (City)


(State or country)


Unknown


18 PLADE AF BURIAL CREMATION OR REMOVAL


MH auburn Cambridge


(Cemetery)


(City or town)


DATE OF BURIAL


Jet 12,26


19 UNDERTAKER


el. Hollins


ADDRESS


6. Boston


72 Cottage Park Rob.


Ward.


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


4 COLOR OR RACE


REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


(Approved by U. S. Census and American Public Health Association)


Statement of occupation .- Precise etatement of occupation ie very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first line will be eufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, 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 etatement; it ehould be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second etatement. Never return "Lahorer," "Fore- man," "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 House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care ehould be taken to report specifically the occupations of pereons engaged in domestic service for wages, ae Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion at beginning of illness. If retired from business, 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. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite) ; Tuberculosis of lungs, meninges, 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 intercurrent) affection need not he stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Uremia,". "Weakness," etc., when a definite disease can he ascertained as the cause. Always qualify all diseases resulting from childbirth or miecarriage, as "PUERPERAL septicemia," "PUERPERAL peritonitis," etc.


State cause for which surgical operation was undertaken.


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


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


Certificates will be 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, miscarriage, necrosis, peritonitis, phlebitis,


pyemia, septicemia, tetanus.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized pereon or of any member of the family of the deceased, furnish for registra- tion a standard certificate of death, stating to the best of hie knowl- edge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ....- Gen. Laws, Chap. 46, Sec. 9.


No undertaker or other pereon ehall bury a human body, .. until he has received a permit from the board of health or its agent. .. or ... from the clerk of the town where the person died ;. . . No such permit shall be issued until there shall have been 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, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the pur- pose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. . . The pereon to whom the permit is so given and the physician certifying 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 re- quire .- Gen. Laws, Chap. 114, Sec. 45.


Medical examiners shall make examination upon the view of the dead bodies of only such persone as are supposed to have died hy violence .- Gen. Laws, Chap. 38, Sec. 6.


.. . He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.


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 deathe only as those of persone to whom they have given bedside care during a last illnese from disease unrelated to any form of injury.


(2) Board of Health Physicians will certify to euch deaths only as those of pereons who, though disabled by recognized disease unre- lated to any form of injury, have died without recent medical at- tendance or whose physician is absent from home when the certificate of death is needed.


(3) Medical examiners will investigate and certify to all deathe supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including reeulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, 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.


RM R-301


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


I PLACE OF-DEATH County


Suffolk


Massachusetts


(City or town)


City or Town


No.


Registered No.1/ 86 Jemmet Thu Siantexto


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


2 FULL NAME


2 w/L


Lehman


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


(a) Residence. No.


(Usual place of abode)


86 Simul Chez


St.,


Ward.


Length of residence in city or town whera death occurred


20 years


months


days.


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


years


months days


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Female


4 COLOR OR RACE


5 SINGLE, MARRIED, WIDOWED, DR


DIVORCED (write the word)


5a If married, widowed or divorced


HUSBAND of


(or) WIFE of


Noah


6 AGE


83


Years


Months


Days


If LESS than 1 day ..._ hrs. or ___ min.


If STILLBORN, onter that fact hore


7 OCCUPATION OF DECEASED


(.) Trade, profession, or


particular kind of work


(b) Name of empløyer


8 BIRTHPLACE (City)


(State or country)


New York City


PARENTS


10 BIRTHPLACE OF


FATHER (City)


(State or country)


11 MAIDEN NAME


OF MOTHER


12 BIRTHPLACE OF


MOTHER (City)


(State or country)


Tuland


(Month)


(Day)


(Year)


13


Informant


Que Saddia Flynn


18 TLACE Of BURIAL, CREMATION DR REMOVAL


MY auburn Cambridge


(Cemetery)


(City or town)


19 UNDERTAKER


ADDRESS 1409 /Kostet


Betro


20 | HEREBY CERTIFY that o satisfactory stan- deré certificate of death was filed with me BEFORE the burial or transit permit was issued


Nam. A. Childress


Official Health oficer of promit


Date of issue 10/11/26


DATE OF BURIAL Cal 11.2.6


( Address)


86 Sementi Chia


14


Filed_


Cal. 18/26


(Month) (Day) /(Year)


REGISTRAR


PAR


2


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


BOSTON


MEDICAL CERTIFICATE OF DEATH


15 DATE OF DEATH


8ct


9


1926


(Month)


(Day)


(Year)


16 I HEREBY CERTIFY, That I attended deceased from Sept. 16 1926 1926 - to Ccl=9.


that I last saw har


alive on


@ct. 8


, 1926


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


S. A.


m.


The CAUSE OF DEATH was as follows:


Brauche- Que LA .


(duration)


yrs ._


.mos.


ds.


arteriosclerosis .


CONTRIBUTORY


(SECONDARY)


?


(duration)


+yrs ..


.mos.


ds


Did an operation precede death?


Date of.


Was there an autopsy?


If under one year, was infant Breast Fed ?.


.......


What test confirmed diagnosis?


(Signed)


Edward . Franger.


M. D.


(Address)


7 JAia SI.


Dat


9 .


1926.


Permit NO. 11x3


200,000 9-25 NO. 2662 - 3.


instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH HLI WILI, WIIn UNFADING BLACK INK- THIS IS A PERMANENT RECORD. Every item of information


10


17 Where was disease contracted


if not at place of death ?.


FOR WHAT?


9 NAME OF


FATHER


Camathe Gang Gallagher


(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 occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, 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 material worked on may form part of the second statement. Never return "Laborer," "Fore- man," "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 House- wife, Housework, or At home, and children, not gainfully 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 CAUSINO DEATH, state occupa- tion at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death .- Name, first, the DISEASE CAUSINO DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, meninges, 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 intercurrent) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "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 childbirth or miscarriage, as "PUERPERAL septicemia," "PUERPERAL peritonitis," etc.


State cause for which surgical operation was undertaken.


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


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


Certificates will be 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, miscarriage, necrosis, peritonitis, ph lebitis,


pyemia, septicemia, tetanus.


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical officer shall forth- with, 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 registra- tion a standard certificate of death, stating to the best of his knowl- edge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ....- Gen. Laws, Chap. 46, Sec. 9.


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 town where the person died ;. .. No such permit shall be issued until there shall have been 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 be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the pur- pose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. . . The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may re- quire .- Gen. Laws, Chap. 114, Sec. 45.


Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .- Gen. Laws, Chap. 88, Sec. 6.


... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.


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 bedside care during a last illness from disease unrelated to any form of injury.


(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unre- lated to any form of injury, have died without recent medical at- tendance or whose physician is absent from home when the certificatc of death is needed.


(3) Medical examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, 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.


M R-301


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


Wintheron


1 PLACE OF DEATH


County


Dufille


State Mare


Registered No.


St., Ward


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


2 FULL NAME


alm


(a) Residence. No.


(Usual place of abode)


Length of residence mn 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


3 SEX


male


4 COLOR OR RACE


Mute


5


SINGLE, MARRIEO, WIOOWEO, OR


DIVORCED (write the word)


married


Sa If married, widowed or divorced


HUSBAND of


(or) WIFE of


Maria


6 AGE


Years


72


Months


Days


that I last saw h


If LESS then


1 day ._.__ hrs.


or_min.


,19 21 5' The CAUSE OF DEATH was as follows:


Antino polisis


7 OCCUPATION OF DECEASED


(a) Trade, profession, or


particular kind of work


(b) Name of employer


Retired


8 BIRTHPLACE (City)


(State or country)


mass


PARENTS


11 MAIDEN NAME


OF MOTHER


Eleanor Dean


12 BIRTHPLACE OF


MOTHER (City)


(State or country)


It fotos


13 Mir. M. Murray


18 PLACE Of BURIAL, CREMATION OR REMOVAL


Calvary


Boston


(City or town)


DATE OF BURIAL Oct 14/26


14 03/18/26 Filed. (Month) (Day) (Year)


REGISTRAR


19 UNDERTAKER


John


. Omakey


ADDRESS


Withurk


20 | HEREBY CERTIFY that a satisfactory stant dard certificate of death was filed with me BEFORE the burial or trenait permit was issued


Im. D. Childrens T


Official in Health officer lecet at permit . 01/3/26


Date ol issue


Permet NO


1146


instructions and extracts from the laws on back of certificate.


in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See


200,000 9-25 NO. 2662 3.


should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH


"IILE LAINLI, WIIN UNFADING BLACK INK THIS IS A PERMANENT RECORD. Every item of information


MEDICAL CERTIFICATE OF DEATH


15 DATE OF DEATH


(Month)


(Day)


(Year)


16


I HEREBY CERTIFY, That I attended deceased from


19.20, to


Ceft 12


, 1926.


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


S.IVA m.


(duration) -yrs. ..... mos. ds.


CONTRIBUTORY.


(SECONDARY)


(duration)


-yrs.


mos. ds


17 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. O.


(Address)


Oato


(Month)


(Day)


(Year)


Informant


Have Mar avel


(Address)


(City or town)


City or Town


No.


Wave Way Que


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


Ward.


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


12 1926


If STILLBORN, enter that fact here


Besten


9 NAME OF


FATHER


Timothy


10 BIRTHPLACE OF


FATHER (City)


(State or country)


(Cemetery)


Ost 12. 1926 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, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, 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 material worked on may form part of the second statement. Never rsturn "Laborer," "Fore- man," "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 dsfinite salary), may be entered as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, ae Servant, Cook, Housemaid, stc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, meninges, peritoneum, etc., Carcinoma, Sarcoma, stc., 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 intercurrent) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Collapse," "Coma," "Convul- sions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Ex- haustion," "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 childbirth or miscarriage, as "PUERPERAL septicemia," "PUERPERAL peritonitis," etc.




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