Q Eugenics Record Oeeice, Bulletin. 



South Fourth Street, Philadelphia. Other lettering may be done with 

 a typewriter. (Plates III, IV.) 



3. THE DESCRIPTION. 



The full description of an individual, as herein contemplated, 

 comprises the following thirteen points. It is obtained for each person 

 in the family so far as practicable. 



1. Name (maiden name of all married women ; method of spell- 

 ing surname preferred by the family to be ascertained and used. First 

 time field worker uses a surname in her report it is to be written in 

 Gothic capital letters, e. g., DE BOW). 



2. Sex, if not sufficiently indicated by name (Frances, Francis; 

 Jessie, Jesse; Marion, Marian; etc., frequently confused). 



3. Date of birth. (This gives order of birth, age at time of 

 interview, age at death, if dead, etc. Should be accurate to the month. 

 Useful for reference to town and vital records.) 



4. Place of birth. (Tells at least where mother was at given 

 date and probably locates entire family; frequently assists in helping 

 to connect with related families in same general locality; locates 

 town where birth records may be sought.) 



5. If dead, date of death or age at death approximately. (Essen- 

 tial in getting proportions of affected among those who reach the 

 age of incidence.) 



6. Cause of death. (Get the best diagnosis possible, inquiring 

 of family physician where practicable and learn if any autopsy was 

 performed. So far as possible use the terms employed in "Causes of 

 Sickness and Death," United States Census Bureau, 1910. Field 

 workers should study this list. Note directions given in paragraph 

 below entitled "Description of Traits and Causes of Sickness and 

 Death.") 



7. Place of death. (Useful in comparison with town and vital 

 records.) 



8. If immigrant, date of immigration (steamship and port of 

 entry where possible). 



9. Mental and physical condition of each person. (Note para- 

 graph, "Description of Traits and Causes of Sickness and Death.") 



10. If married, a description with full name of consort, or of 

 consorts, if married more than once; of the children, and of the con- 

 sort's parents. 



