Town of Winthrop : Record of Deaths 1853-1885, Part 11

Author: Winthrop (Mass.)
Publication date: 1853
Publisher:
Number of Pages: 592


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1853-1885 > Part 11


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).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16


In ease of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death oeeurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTIIWITH GIVE NOTICE thereof - or report these facts -to said Clerk. Penalty for neglect, twenty dollars.


Blank forms for Returns of Deaths may be obtained from the Town Clerk.


1


A


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


To the Clerks or Registrar of the Town or City in which the Death occurred.


re and Sex of Deceased,


Richard


Read


male.


Date and Place of Death, .


Sea Slune Home, Mutrop, mass. aug 6- 1884


Disease, pr Cause of Death,


First or Primary,


Heart Disease


Duration of,*


3 mos.


Secondary, . 11


Duration of, 11


I certify that the above is a true Return, to the best of my recollection and belief.


Name, Professional Title, and Residence,


Suod Fwilliam MLD. Backing. Duton


Dated at


aug ók 1384.


[Be very particular to fill all Blanks.]


* Reckoned to the time of death.


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthicith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [EXTRACT FROM CHAPTER 21 OF THE GENERAL STATUTES, 1859. ]


The attending Physician is requested to make out his Certifieate as promptly as possible, for the information and use of the Undertaker, or other person making return of the ease to the Town Clerk.


Physicians may obtain BLANK CERTIFICATES from the Town Clerk or Registrar.


Copies of the STATISTICAL NOSOLOGY, adopted for the purposes of Registration, may be obtained on application to the SECRETARY OF THE COMMONWEALTH.


Fill out in ink.


When married erase "single" and "widow"; when widowed, erase "single" and "married."


RETURN OF DEATH TO THE CITY REGISTRAR. CITY HALL, BOSTON.


Date of Death,


ang. 188 th


1884


Color, t


Age.


years.


Namc, ariel Blodgett 60 Months 20 days


Place of death Ocean Spray.


WARD


Street and No.


Residence 25 Union PK


Sex,


Single,


Married.


Occupation, Gentleman


Boston


Wife of


Widower


Birthplace* Whitingham Ut. Widow of


Name of Father,


Perben


Name of Mother,


Esther


Birthplace of Father,


Vermont


Birthplace of Mother, *


Cause of ) Primary, Duration,


Death Secondary, Place of Interment, Bakersfield A. Duration,


Date of Interment or Removal,


aug 20ª 18/4


Undertaker or Informant,


*Insert Town and State.


tState whether white or black.


Quy 18- 84 V


Printing Department, Deer Island, Boston Harbor.


JOS S. WATERMAN UNDERTAKERS. Boston,


1884


This Certifies, That


ariel Blodgett


died on the


1.8 M day of Cinq 1884,aged 81 years,


months, 20 days.


Cold. Duration $


CAUSE OF) Primary,


DEATH. Secondary, Congestional liver Duration 3 days.


L. Jackson


Physician.


106 Cours to


No.11


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


(Tucanos 24 "1884


2. Name,


(Maiden Name),


3. Sex, and whether single. Married, or Widowed,


) alex Unmarried)


Ditile.


4. Color, t


5. Age,


~ 3 Years, Months,() Days. 1


6. Disease or [ First or Primary


Cause of { Secondary (if any)


Death, [ By whom certified


7. Residence,


ن


8. Place of Death,


9. Occupation, . Аллив Палова


10. Place of Birth, .


11. Name of Father,


12. Name of Mother, 2.1


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Signature of Undertaker -or other person making the Return,


silver rota.


DATED at .. LE :


, on Lug 1et 25 18/1


* If a Married Woman or Widow.


t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]


O


22.1


114100


7


101. 1 .. ×


The Undertaker, or other informant, is requested to report the faets-together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE TIIE INTERMENT.


In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Iuterment must FORTHWITH GIVE NOTICE thereof-or report these facts -to said Clerk. Penalty for neglect, twenty dollars.


Blank forms for Returns of Deaths may be obtained from the Town Clerk.


-


PHYSICIAN'S CERTIFICATE.


Vame of Deceased,*


Date and Place of Death, - died at


44.


1884,


.


usease or Cause of Death, - of


21 % AVDuration of Sickness (). 1.12€


I certify that the above is true, to the best of my knowledge and belief.


me and Residence of Certifying Physician


Date of Certificate, fus 88 1


11


187


......


* Or Sex of Infant (not named).


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the dcccase of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and he date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]


Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Registration of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, until a proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performing t. e burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have been returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Cause of Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of said clerk or local registrar."


If there has been no Physician in attendance, or in case of death by dangerous contagious disease, or in any other event where the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Board of Health, or any Physician employed by any city or town for such purpose, shall sign the Certificate of the Cause of Death, to the best of his knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.


No. 12


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


.


3. Sex, and whether single. Married, or Widowed,


Male (Stillbe (1)


gubite


4. Color, t


5. Age, .


Years, ..


Mouths,


Days.


6. Disease or [ First or Primary


Cause of Secondary (if any)


Death, Į By whom certified


7. Residenee,


8. Place of Death,


9. Occupation, .


10. Place of Birth, . Pauline De Muitay


11. Name of Father,


Charle 6.


11


13. Birthplace of Father. .


14. Birthplace of Mother, .


15. Place of Interment,


Signature of Undertaker or other person-making the Return,


Gunner, Hyd.


DATED at f. C.


/2, on august 38 184.


* If a Married Woman or Widow.


t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]


re.


(Maiden Name),*


auquel 27" 1884


12. Name of Mother, mix


The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THIE INTERMENT.


In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death ocenrred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE NOTICE thereof - or report these facts -to said Clerk. Penalty for neglect, twenty dollars.


Blank forms for Returns of Deaths may be obtained from the Town Clerk.


PHYSICIAN'S CERTIFICATE.


ime of Deceased,*


....


Mate


187. 4,


ute and Place of Death, - died at.


sease or Cause of Death, - of WL- 22 Duration of Sickness


I certify that the above is true, to the best of my knowledge and belief.


'e and Residence of Certifying Physician


H. f.


Date of Certificate,


fif + 32


187


* Or Sex of Infant (not named).


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]


Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Registration of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, until a proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performing the burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have been returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Cause of Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of said clerk or local registrar."


If there has been no Physician in attendance, or in case of death by dangerous contagious disease, or in any other event where the certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Board of Health, or any Physician employed by any city or town for such purpose, shall sign the Certificate of the Cause of Death, to the best of his knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


Seht 19 -1884 leo 8. Taft


(Maiden Name),*


3. Sex, and whether single, Married, or Widowed,


mail


1


4. Color. t .


5. Age. 27 Years,


Months.


Days.


Disease or Cause of Death,


Duration of Sickness,


By whom certified, .


7. Residence, .


Point conley


Wenttrip


8. Place of Death,


9. Occupation,


10. Place of Birth,


11. Name of Father, .


12. Name of Mother, è lé ability "


13. Birthplace of Father,


14. Birthplace of Mother,


15. Place of Interment. .


Signature of Undertaker or other person making the Return, .


Denj 61 Smith


DATED at on 18


* If a Married Woman or Widow.


t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.


[Be very particular to fill all Blanks.]


11 11


Winthrop. Grrau ch l'art 1


( Roxbury han C


Morest Neil


The Undertaker, or other informant. is requested to report the facts -together with the Physician's Certificate of the Causes of Death - to the Town Clerk, BEFORE THE INTERMENT.


In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred, (or the deceased resided.) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE NOTICE thereof- or report these facts - tu said Clerk. Penalty for negleet, twenty dollars.


Blank forms of Returns may be obtained from the Town Clerk.


sz bibi jeps


7


st. 188


Boston,


This Certifies, That George of Can't


died on the 13 day of Seht 1884, aged 27 years,


months,


days.


CAUSE OF ) Primary,


hal yeter Duration


DEATII. Secondary, 1 ... .... Duration /2


Benjamin. F. Smith, Undertaker. No 251 Tremont St,


Boston, Mass


Printing Department, Deer Island, Boston Harbor.


r.


/ Physician.


Ar Dansin


:


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


(Maiden Name),


Jak 21 1 1884 Pinche of Parter Baker


3. Sex, and whether single. Married, or Widowed.


4. Color, t


62.


Years


Months, ..


Days.


5. Age, .


6. Disease or [ First or Primary


Ovarian


Cause of { Secondary (if any)


Death, By whom certified


Truth Brand M. D


milford that


7. Residence,


8. Place of Death,


9. Occupation, .


Thusic Leuche


10. Place of Birth, . No Salan UM 4


11. Name of Father,


12. Name of Mother, . .


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Signature of Undertaker or other person making the Return,


wave y Pse


DATED at Julhosafe, on Jul 22 1875 ₺


* If a Married Woman or Widow.


1 If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]


Winthrop


Harrace


Bake


These


of Bas/00


cuen


2


Jefe 2%.


8


The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THE INTERVIENT.


In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHWITHI GIVE NOTICE thereof -or report these facts -to said Clerk. Penalty for neglect, twenty dollars.


Blank forms for Returns of Deaths may be obtained from the Town Clerk.


I


PHYSICIAN'S CERTIFICATE.


Name of Deceased,* -


Date and Place of Death, -


died al Finitions - Chicas, de setembre 2/25 1884.


of Queriaro Junio Duration of Sickness - Disease or Cause of Death, - 1 1


L


I certify that the above is true, to the best of my knowledge and belief.


Vame and Residence of Certifying Physician, F.N.L. Brand. 115 Boylston at. 18ration I was


Date of Certificate he - 2200 18 43


*Or Sex of Infant (not named).


[Extracts from Chapter 32 of the Public Statutes, 1882.]


" SECT. 3 .- A Physician who has attended a person during his last illness, shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same."


"SECT. 5 .- No human body shall be buried, or removed from any city or town, until a proper certificate has been given, by the clerk or registrar, to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the Physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar."


[ If there has been no physician in attendance, or in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the Board of Health, or any physician employed by any city or town for such purpose, shall, upon application, sign the certificate of the cause of death, to the best of his knowledge and belief. In case of death by violence, the medical examiner attending shall furnish the requisite certificate.]


te


To the Clerk of the Town in which the Death occurred.


1. Date of Death,


0th1.84


2. Name.


Hannah; auger


(Maiden Name) ,*


Hanna 2 Lille


3. Sex, and whether single, Married, or Widowed,


1. Color. t .


5. Age,


72 Years,


.... Months,


Days,


Disease or Cause of Death,


6.


Duration of Sickness,


By whom certified, .


alecratique of Heart From days He. J. Frze te . 11.(1 +tvabon thames


7. Residence, .


S. Place of Death,


9. Occupation,


10. Place of Birth.


11. Name of Father,


12. Name of Mother, ·


13. Birthplace of Father.


14. Birthplace of Mother, .


.


15. Place of Interment, .


Signature of Undertaker or other person making the Return, .


DATED at


1877


* If a Married Woman or Widow.


t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.


[Be very particular to fill all Blanks.]


1


mains


e


-Nov- 30.84


Lg The Undertaker, or other informant, is requested to report the facts - together with the Physician's Certificate of the Causes of Death - to the Town Clerk. BEFORE THE INTERMENT.


In case of an interment taking place. without the Certificate of Registry of the Clerk of the Town in which the Death occurred. (or the deceased resided.) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE NOTICE thereof- or report these facts - to said Clerk. Penalty for neglect. twenty dollars.


Blank forms of Returns may be obtained from the Town Clerk.


PHYSICIAN'S CERTIFICATE.


re of Deceased,


€ ..


and Place of Death,


died at . 1


use or Cause of Death, -


of rabaise 'tis Duration 1


4. 187


I certify that the above is true, to the best of my knowledge and belief.


und Residence of Certifying Physician


rile 1st €


* Or Sex of Infant (not named).


Date of Certificate, .L.


187 .


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]


Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Registration of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, until : proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performing the burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have beer returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Cause o Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of sai clerk or local registrar."


If there has been no Physician in attendance, or in case of death by dangerous contagious disease, or in any other event where th certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Board o Health, or any Physician employed by any city or town for such purpose, shall sign the Certificate of the Cause of Death, to the best o his knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.


No. 1


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death, ·


2. Name,


(Maiden Name),


February 20 " 1885, arthur /H alword


3. Sex, and whether single. Married, or Widowed,


male


Ithite


4. Color, t .


5. Age,


6. Disease or First or Primary


Cause of Secondary (if any)


Death, By whom certified


7. Residence,


8. Place of Death,


9. Occupation, .


Stenthrop mass


Pleasant Sheet


10. Place of Birth, .


Sindtrop mass


11. Name of Father,


arthur H, aliword


mary


a. atwood


12. Name of Mother, .


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


bridwell -Jonas


Walton,


MAR2


Stuntof Town Cemetery


Signature of Undertaker or other person-making the Return,/


Dummes Floyd


DATED at. Mentiroso


6


on.


February 21 1885.


* If a Married Woman or Widow.


t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]


Certified


Month's, ...


E mccarthy


Leo


The Undertaker, or other informant, is requested to report the facts -together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THE INTERMENT.


In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE NOTICE thereof- or report these facts - to said Clerk. Penalty for neglect, twenty dollars.


Blank forms for Returns of Deaths may be obtained from the Town Clerk.


PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.


To the Clerks or Registrar of the Town or City in which the Death occurred.


arthur H. alurad ).


Tame and Sex of Deceased,


ate and Flace of Death, . · isease, First or Primary, - Cause


Feb 20 1885.


Afin Cloud


Maza


aspligcia


Duration of,*


(2till/mms)


Death, Secondary, .


Duration of,


I certify that the above is a true Return, to the best of my recollection and belief.


ve, Professional Title, and Residence, . ..


Dated at Veneverof, Dass Feb. 23,


13FS.


very particular to fill all Blanks.]


* Reckoned to the time of death.


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of such person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as ho can stato the same .- [EXTRACT FROM CHAPTER 21 OF THE GENERAL STATUTES, 1859.]


The attending Physician is requested to make out his Certificate as promptly as possible, for the information and use of the Undertaker, or other person making return of the case to the Town Clerk.


Physicians may obtain BLANK CERTIFICATES from the Town Clerk or Registrar.


Copies of the STATISTICAL NOSOLOGY, adopted for the purposes of Registration, may be obtained on application to the SECRETARY OF THE COMMONWEALTH.


RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.


1. Date of Death,


2. Name,


March 25"1895, Chandler Crocker


(Maiden Name),*


3. Sex, and whether single. Married, or Widowed.


4. Color, t


male ( Married)


White


78


. Years, ...


Months,


Days.


5. Age,


6. Disease or First or Primary


Cause of Secondary (if any)


Death, By whom certified


7. Residence,


8. Place of Death, Ocean Vicio Sheis


9. Occupation, . Valser maker carmineler mais


10. Place of Birth, .


11. Name of Father,


12. Name of Mother, .


13. Birthplace of Father, .


14. Birthplace of Mother, .


15. Place of Interment,


Szalon,


Marek


7


Signature of Undertaker or other person making the Return,! .


Summer atland


DATED at .... Vinaturale


, on .. mich 2 6 18.). ........


* If a Married Woman or Widow.


t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Bades, specify what. [Be very particular to fill all Blanks.]


Daniel Croefter Comfort Caracter


The Undertaker, or other informant, is requested to report the facts -together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THIE INTERMENT.


In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased rd 1) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE JOTI thereof -or report these facts -to said Clerk. Penalty for neglect, twenty dollars.


Blank forms for Returns of Deaths may be obtained from the Town Clerk.


PHYSICIAN'S CERTIFICATE.


¿ of Deceased,*


and Place of Death,


1 at Drehoch, Mai 2 24


1873


se or Cause of Death, - of ( Jourshus Iyleces Dura


Ancertar


I certify that the above is true, to the best of my knowledge and belief.


nd Residence of Certifying Physician


He Storele Withchurch


Date of Certificate,


cate, 11 /04/28


187. 5.


* Or Sex of Infant (not named).


Any Physician having attended a person during his last illness, shall-when requested within fifteen days after the decease of suc person-forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same .- [Extract from Chapter 21 of the General Statutes, 1859.]


Without repealing the foregoing requirements of the General Statutes, the recent " Act to provide for the more Accurate Registrad of Vital Statistics," passed April 23, 1878, provides that "no human body shall be buried, or removed from any city or town, until proper Certificate has been given by the clerk or local registrar of statistics, to the Undertaker or Sexton, or person performing burial or removing the body. This certificate shall state that the facts required by chap. 21 of the General Statutes have be returned and recorded; and no clerk or local registrar shall give such certificate or burial permit until the Certificate of the Cause Death has been obtained, (from the Physician, if any, in attendance at the last sickness of the deceased), and placed in the hands of s clerk or local registrar."


If there has been no Physician in attendance, or in case of death by dangerous contagious disease, or in any other event where certificate of the attending Physician cannot, for good and sufficient reasons, be early enough obtained, the chairman of the local Board Health, or any Physician employed by any city or town for such purpose, shall sign the Certificate of the Cause of Death, to the best his knowledge and belief. In case of death by violence, the medical examiner shall furnish the certificate.




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