USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1934 > Part 76
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No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made ... . Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment 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 un- related to any form of injury, have died without recent medical attend- ance or whose physician is absent from home when the certificate 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.
Copy of the Record of a Death filed in the Clerk's office of the
City or Town of
Springfield
during the month of .. October 19 34
STANDARD CERTIFICATE OF DEATH
1. PLACE OF DEATH
STATE OF VERMONT
184
County.
Windsor
State ... Vermont
Registered No.
Township
Springfield.
or
Village
or
St., Ward (If death occured in a hospital or institution, give its NAME instead of street and number)
Length of residence in city or town where death occurred .... yrs ..... .mos. ds. How long in U. S. if of foreign birth? .. yrs .. . mos ........ ds.
2. FULL NAME
William Theodore Shannon
Winthrop; Mass
(a) Residence: No ..
25 Harbor View Ave
St.,
Ward.
Winthrop, .. Mass
(If non-resident give city or town and State)
(Usual place of abode.)
PERSONAL AND STATISTICAL PARTICULARS
3. SEX
male
4. Color or Race | 5. Single, Married, Widowed,
or Divorced (write the word)
white
married
5a. If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Melvina Desordia
6. DATE OF BIRTH (month, day, and year) Jan. 13, 1865
7. AGE
Years
65
Months
9
Days
5
If LESS than
.hrs.
OCCUPATION
8. Trade, profession, or
particular
kind of work done, as spinner,
sawyer, bookkeeper, etc., ...
salesman
9. Industry .. or .. business
.. in .. which
work was done, as silk mill,
saw mill, bank, etc., ..
deceased
last
worked
at
11. Total time (years)
spent in this
40
10. Date
this occupation
(month
and
year) Oct. 10. 1934
occupation
12. BIRTHPLACE (city or town)
Somerville, Mass.
Mass.30
(State or country)
13 .. NAME
James Shannon
14. BIRTHPLACE (city or town)
Ireland
(State or country)
MOTHER {
15. MAIDEN NAME
CatherineClegg
16. BIRTHPLACE (olty or town).
Ireland
(State or country)
17. INFORMANT
James Shannon
(Address)
Somerville, Mass.
18. BURIAL, CREMATION, OR REMOVAL
Medford, Mass.
Place
Oak Grove
Date
Oct. 21 1934
19. UNDERTAKER
David Fudge & Son
(Address) 46 Summer St., Somerville, Mass.
20. FILED Oct. 19 1 ... 34 Zada Kendall
21. DATE OF DEATH (month, day, and year) Oct. 18, 19 34
22. I HEREBY CERTIFY, That I attended deceased from
O.c.t ..... 12
19.3.4., to.
O.c.t ....... 18.
19.3.4
1 last saw h .. @T. alive on
Oct ... 18
.
19.3.4, death is sald
to have occurred on the date stated above, at.9 .:. 45 Pm
The principal cause of death and related causes of Importance In order of onset were as follows:
1 day, or ........ min. coronary ..... thrombus
Date of onset O.c.t .. 12. 1934
Contributory causes of importance not related to principal yrs .cause:
chronic ... endocardites.
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy? NO.
23. If death was due to external causes (violence) fill in also the following:
Accident, suicide, or homicide?
Date of Injury.
19
Where did Injury occur? (Specify city or town, county, and State) Specify whether Injury occurred in industry, in home, or In public place.
Manner of Injury
Nature of Injury
ACT 20 1934
24 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
B. A. Chapman
M. D.
(Address)
Springfield, Vt.
is very important. FATHER
ment of OCCUPATI
MEDICAL CERTIFICATE OF DEATH
City
No.
I hereby certify that the foregoing is a true copy.
act.19 1934
Rada Kendall Quit. Town Clerk.
Section 3777. NON-RESIDENTS; CERTIFIED COPIES.
Certified copies when parties are non-residents. Said clerk shall, on the first day of each month, make a cer- tified copy of all births, marriages and deaths filed in his office during the preceding month, whenever the parents of a child born, or a bride or a groom or a deceased person was a resident in any other town at the time of such birth, marriage or death, and shall transmit such certified copies to the clerk of the town in which such parents of a child born, the bride or the groom or the deceased was a resident at the time of such birth, marriage or death; and the clerk receiving such copies shall file the same.
These blanks may be obtained of the Secretary of the State Board of Health.
OCT201034 M
RM R-302
OCCUPATION | tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE important. OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very 50m-9-'31. No. 3385-ơ N. B .- WRITE PLAINLYWITH UNFADING INK-THIS IS A PERMANENT RECORD. Everyt sem of informa- PARENTS
PLACE OF DEATH
.SUFFOLK BOSTON
(City or Town)
No. N. E.Deaconess ... Hospital
St.,
Ward {
SUFFOLK (Cit) BOSTil Lin)
Registered No. 9022
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Angelo
Jannini
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No
(Usual place of abode)
450 ... Pleasant
.St.,.
..........
. Ward,
Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
утв.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
W
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
married
5a If married, widowed, or divorced
HUSBAND of
Florinda Marotto
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
AGE
69
Years Months .Days
Minutes
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc.
undertaker.
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ..
10 Date deceased last worked at
11 Total time (years)
this occupation (month and
year)
Oct 19 1934
spent in this
occupation .... 1.894.
12 BIRTHPLACE (City)
(State or country)
Italy
13 NAME OF
FATHER
Raffaele Jannini
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Rosa Lepore
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Wipe
Informant
(Address)
A TRUE COPY. dedations Quirke (Rugi death occurred)
DATE FILED
Oct
.. 23
.... 19 ... 34.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Oct 19 1934
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. That I attended deceased from
Oot
9
19.3.4, to.
Oct
19
19.
.3.4
1 last saw h ....
imalive on
Oct
18
.....
., 1934 ... , death is said
to have occurred on the date stated above, at3 ... 15A ... m. The principal cause of death and related causes of importance in order of onset were as follows:
Dateofoaset
carbuncle of neck
Sept 1934
diabetes mellitus
Nov 1923
Contributory causes of importance not related to principal cause:
Inc. & drainage of carbung?
10/18 /Af neck
Name of operation .
PE & exam of blood " Date of!
What test confirmed diagnosi ?..... & .... urine
Was there an autopsy ?.......
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
A Marble
M. D.
(Address)
Boston
Date 10/ 19/19.3.4 ..
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Holy Cross
Malden
(Cemetery)
(City or town)
DATE OF BURIAL
Oct
22
34
19
22 NAME OF
UNDERTAKER
M.J .Porcella
ADDRESS
Boston
Received and filed
193!
19
(Registrar of City or Town where deceased resided)
-
(IF U. S.
War Veteran,
specify WAR)
185
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
1
If less than 1 day
.Hours
is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
PLACE OF DEATH
Suffolk (County),
Winthrop. (City or TowA) 51 Loving Red.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
1935
(If death occurred in a hospital or institutic ...
give its NAME instead of street and number)
186
2 FULL NAME
Zabie Harriette (ColV) Dumbar.
(If deceased/is a married, widowed or divoreed woman, give also maiden name.)
(a) Residence.
No ..
51 Joung
Rd.
St., ..............
.. Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
₮.
4 COLOR OR RACE
white.
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
wachowed.
5a If married, widowed, or divorced HUSBAND of andGive maiden name of wife in F.
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE
7
77
Years
8
Months
22
Days
If less than 1 day
Hours
Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.
at home.
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation.
this occupation (month and
year)
12 BIRTHPLACE (City)
(State or country)
Crown Point.
new york.
13 NAME OF
FATHER
Reuben zt, Coff
PARENTS
15 MAIDEN NAME
OF MOTHER
nancy m. allen
Fort ann
16 BIRTHPLACE OF MOTHER (City) (State or country) new york.
17 Clarance W. filmbac.
Informant . (Address) 464 Wein at Taunton. Mais
| HEREBY CERTIFY that a satisfactory standard certificate of death was filed With me BEFORE the bunal or transit permit was issued: WMD-Childress (Signature of Agent of Board of Health or other)
Health Auch Official Designation). (Date of Issue of Permit)
10/20/34
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
act.
20
1934
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY, That I attended deceased from
Oat, 10
19.3.9. to ..
200
, 1934
I last saw alive on 19 .......... , death is said
to have occurred on the date stated above, ab m.
The principal cause of death and related causes of importance in order of onset wore ao follows: Bionic myocarditis Date of Onset
artesiaveterans
1998
Contributory causes of importance not related to principal cause:
Name of operation.
Keinical
Date of.
NO
What test confirmed diagnosis? Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify Bude & Dicknissan
(Signed)
isthat wasto Date Ent, 2019
(Address)
to
21 PLACE OF BURIAL,
CREMATION OR REMOVAL au figuren) huis. Taunton mass .:
(Cemetery)
DATE OF BURIAL
Oct. 22
(City or town) 1984
22 NAME OF
M. H. Farley + son.
UNDERTAKER
ADDRES
49 Winthropst. Taunton. mars.
Received and filed
OCT 2 2 1954
....... 19.
A TRUE COPY, ATTEST:
(Registrar)
. .
1 R-301
Every item of
1
No
St., ..........
Ward
(If U. S.
1
War Veteran,
specify WAR)
(Usual place of abode)
bar.
UIT ADING BLACK INK-TINS TO A FEAMANGNI KELUNE
:
14 BIRTHPLACE OF
FATHER (City)
alstead
(State or country) 41.20.
100m-12-'32. No. 7070-h
Revised Unit'' States Standard Certificate of Death
EXTRACTS FROM THE LA COMMONWEALTH OF MA GOVERNING THE
OF THE ACHUSETTS
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as houseke 'per-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," "worker." "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store, "factory." "mill," etc. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, cotton mill, etc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who sells goods should be called a salesman and not a clerk.
Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes! of importance in order of onset were as follows: Arteriosclerosis
Date of onset
1915
Chronic interstitial nephritis
1021
Cerebral hemorrhage
July 5, 1027
Contributory causes of importance not related to principal cause:
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
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 registration a standard certificate of death, stating to the best of his knowledge 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 or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits. or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satis- factory written statement containing 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 purpose, 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. If such a permit for the removal of a human body, not previously interred from one town to another within the common- wealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as re- quired by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. 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 require. - Chap. 114, Sec. 45. G. L., as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.
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. 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.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L. as amended.
RULES OF PRACTICE
The fulfillment 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 un- related to any form of injury, have died without recent medical attend- auce or whose physician is absent from home when the certificate 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 A
PLACE OF DEATH
Suffelle (County) Winthrok (City or Town) 386 Starten
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No ..
....
182
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Casper Singerman
(If U. S.
specify WAR).
(a) Residence.
No.
386 Shirley
.St.,
......
.Ward,
(If nonresident, give city or town and state)
(Usual place of abode)
Length of residence in city or town where death occurred
11
yrs.
days.
How long in U. S., if of foreign birth? / 7 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
Male White
5 SINGLE
MARRIED
WIDOWED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
Rebecca
Lebovidge
(Give maiden name of wife ip full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
58
Years
Months
Days
If less than 1 day
.Hours.
.. Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc .... 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
Cap Putter
10 Date deceased last worked at
this occupation (month and
year) august !
19348
1
Total time (years)
spent in this
occupation ....
38
12 BIRTHPLACE
cich Manchester
(State or country)
England
13 NAME OF
FATHER
Solomon Singen
15 MAIDEN NAME
OF MOTHER
Dora Gladstone
16 BIRTHPLACE OF MOTHER (City) (State or country) Russia
17
Informa My. C. Singerman Recife)
(Address)
386 Shelley
St.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the Burial or transit permit was issued: W.w. X. Children
(Signature of Agent of Board of Health or other) Health officer 10/12/34 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
18 19.3.9., to .. wetter 20, 1934
I last saw h. And .. alive on .. 19.3.4 ... , death is said to have occurred on the date stated above, at 10 , m. The principal cause of death and related causes of importance in order of onset were as follows:
Date cf Onset IMPORTANT
Cancer 4 Bladder
Cardias Omapay
Contributory causes of importance not related to principal cause:
Cardiaz Begunitation
4
Name of operation.
-
Date of
What test confirmed diagnosis?
-
Was there an autopsy?
No
20 Was disease or injury in any way related to occupation of deceased? No
If so, specify.
Dr. A. Samuel Ningenstay
(Signed)
, M. D.
(Address)
193 Hammar St
. Dat
vet On 1934
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Maximutual (Monitori) 3
(Cemetery) (City or town)
DATE OF BURIAL
Otwier
22
19 3 4
22 NAME OF
Benjamin 56!
UNDERTAKER
Salomons.
ADDRESS
920 Saward it Brookline
Received and filed 19
(Registrar)
1934
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St., .................
.Ward
1 No. 3 SEX (or) WIFE of OCCUPATION 14 BIRTHPLACE OF FATHER (City) PARENTS is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 100m-9-'33. No. 9321-a' N. B .- WKIIL PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECOR ... \ Every item of (State or country)
Factory
Revised Usted States Standard Certificate of Death
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.
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