USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 53
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Registered No ..... 7.9.92.
§ (If death occurred in a hospital or institution, St.
give its NAME instead of street and number)
2 FULL NAME
Katherine
R Goetz
(If deceased is a married, widowed or divorced woman, give also maiden name.)
91 Winthrop
St.
Winthron
(If nonresident, give city or town and state)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
fem
4 COLOR OR RACE 5 SINGLE
MARRIED
white
WIDOWED
DIVORCED married
(write the word)
18 DATE OF
DEATH
Sept 15 1940
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
9/14/40
That I attended deceased from
19 ........ , to .....
9/15/40
19
I last saw h.C ......... alive on ..
9/15/40
19 ...
..... ,
death is said
to have occurred on the date stated above, at.
4/45A
m.
Duration
Immediate cause of death.
post partum hemorrhage
8 hrs ....
3
ÅGE.2.9.
Years
Months.
Days
If less than 1 day Hours Minutes
Usual
9 Occupation:
housewife
Industry 10 or Business:
II Social Security No ..
12 BIRTHPLACE (City)
Somerville Mass.
(State or country)
13 NAME OF
FATHER
John P O 'Neil
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Margaret F Murphy
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant.
(Address)
A TRUE CORY Francis
ATTEST:
8. Tay
(Registrar of city or town where death oederred)
DATE FILED
....... 9/19/40 19
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to occupation of deceased ? If so, specify
(Signed)
J Carangelo
M. D.
(Address)
Boston
Date/15/1940
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Calvary
Boston
DATE OF BURIAL
(Cemetery ept 18 1948
19
22 NAME OF
FUNERAL DIRECTOR
R C Kirby
ADDRESS.
Boston
Received and filed.
19
(Registrar of City or Town where deceased resided)
de wo wy titta of the city of town in which the deceased resided as soon as possible
50m-10-'39. No. 8427-f after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
(or) WIFE of
(Husband's name in full)
32
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
Due to
Due to
Underline the cause to which death should be charged sta- tistically.
husband
Relation, if any
No ............
Carney .... Hospital
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ..
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wile in fly t-z
MEDICAL CERTIFICATE OF DEATH
Town)
OCT10745M
-302
50m-10-'39. No. 8427-f after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
TRUE
ATTEST:
(Registrar of city of town where death occurred)
9/26/40
DATE FILED 19
18 DATE OF
DEATH.
Sept 21 1940
(Month)
(Year)
19 I HEREBY CERTIFY,
$/29/40
19
.. , to ..
9.1.21.4.1.0
19
I last saw h ........ m.alive on ..
9/21/40
, 19.
death is said
to have occurred on the date stated above, at.
7/05P.m.
Duration
Immediate cause of death.
arteriosclerotic .... heart .... disease
8
82
AGE
Years
Months.
Days
If less than I day Hours Minutes
Usual
9 Occupation:
boilermaker
Industry
10 or Business:
retired
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Chelmsford Mass
13 NAME OF
FATHER
Thomas Gray
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Ellen Corrigan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant
(Address)
Relation, if any
1
PLACE OF DEATH
SUFFOLK BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No ....
8167.82
§ (If death occurred in a bospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
John F
Gray
(If deceased is a married, widowed or divorced woman, give also maiden name.)
226 ... Main
.....
.......
.St.
.Winthrop
(If nonresident, give city or town and state)
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorce Mary J .Clancy
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full) 63
years
Due to
Due to
(old cerebral hemorrhage-
Paralysis
5-yrs PHYSICIAN
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to occupation of deceased ?
If so, specify.
C C Franseer
(Signed)
(Address)
Boston
Date.
9/22/9 40
M., D.
Holy Cross Malden
DATE OF BURIAL
Sept 24 1940
19
22 NAME OF
FUNERAL DIRECTOR
F.J Magrath
ADDRESS.
Boston
Received and filed 19
(Registrar of City or Town where deceased resided)
-
No.
Palmer Memorial Hosp
(If U. S.
War Veteran,
specify WAR)
(2) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
(Day)
That I attended deceased from
Underline the cause to which death should be charged sta- tistically.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL.
(Cemetery)
(City or Town)
wife
OCT101 票
F1 R.303
(County)
1
(City or Town)
No ...
2 FULL NAME
3 SEX
female
White
(or) WIFE of
7 IF STILLBORN, enter that fact here.
8
AGE 80
Usual
At Home
9 Occupation:
Industry
10 or Business:
Il Social Security No ...
None
14 BIRTHPLACE OF
15 MAIDEN NAME
OF MOTHER
PARENTS
MOTHER (City)
(State or country)
of Death. See reverse side for extracts from the laws relative to the return of certificates of death.
FATHER (City)
(State of country)
DEATH in plain terms, so that it may be properly classified under the International Classification of Causes
information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
Rut land
4 COLOR OR RACE; 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
Henry [Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive .Years
Yoars
10
25
Days
If less than 1 day
Hours
Minutes
12 BIRTHPLACE (City)
(State or country)
Mass.
13 NAME OF
FATHER
Samuel T. King
Rut land
Sarah Bancroft
16 BIRTHPLACE OF
Northfield
17 Mrs. Ethel Burnap Deltiontif any V
Informant.
(Address)
8 Pleasant St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: William D. Childress (Signature of Agent of Board of Health or other) agent- Sept. 24/40 (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Seat 23, 1440
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.)
20 Accident, suicide, or homicide (specify) Recibes
Date of occurrence.,.
7 ...
9/15
YO
19.
Where did
Injury occur?
(City or town and State)
Did injury occur it or about home, on farm, in industrial place, in
public place ?
"(Spetify type of place)
Injury
Manner of
fall. .
Nature of Injury
While at work?
.....
....
.Was there an autopsy?
21 Was disease or Injury In any way related to occupatloo ol deceased ?
If so, specify
CERE M. D.
(Signed)
(LAde Creed @Low Date 9/20/40
Rut land
22
Rut land
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Sept. 25, 1940
19
..........
23 NAME OF
FUNERAL DIRECTOR
Richard HOWthuto
ADDRESS
147 Winthrop St., Winthrop
Received and filed SEP 2 0 1040 19
A TRUE COPY ATTEST:
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
MARGIN RESERVED FOR BINDING
50m-10-'39. No. 8427-h
PLACE OF DEATH
Che Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
(City or town making return)
Registered No.
occurred in a hospital or institution,
AME instead of street and number)
(M U. S. War Veteran, specify WAR)
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution
Hospital
years
months
days. In this community
yrs.
mos.
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
(If deceased is a married, widowed or divorced woman, give also maiden name.) 8 Pleasant .st
.St.
Winthrop
6
(If nonresident, give city or town and state)
....
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 regis- tration 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 secn 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 de- livered to such board, agent or clerk, as the case may bc. a satisfac- tory 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 pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 commonwealth 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 removal : 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 required 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 fur- nish 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.
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 cemetery or burial ground in which the interment is made. ... Chap. 114, Sec. 46, G. L. as amended.
Medical cxaminers shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within liis county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
... He shall in all cases certify to the town clerk or registrar in the place where the deceased dicd his name and residence, if known : otherwise a description as full as may be, with the cause and man- ner of death .- General Laws, Chap. 38, Sec 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ. ance 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 ill- ness from disease unrelated to any form of injury.
(2) Board of Heaith physicians will certify to such deaths only as those of persons who, though disabled by recognized discase un- related to any form of injury, have died without recent niedicai attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examinere will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and by the action of cheinical (drugs or poisons). thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences ; and (2) under manner. the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway ac- cident." "Pistol shot wound of the chest with associated hemor- rhage, homicidai." "Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of. ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If inves- tigation shows the death to have been due to disease, specify : (1) Under cause, its known or presumable nature ; and (2) under man- ner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal gangiia) (found dead In bed)." "Heart disease, presumably coronary sclerosis. (Sudden death) ."
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
RI R-301 AJ
Sufflok
(County)
Winthrop
(City or Town)
No. 5 Bellevue Terrace
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. 184
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Carrie May Hetherington neelBrooks
(If deceased is a married, widowed or divorced woman, give also maiden name.)
5 Bellevue Terrace
......... .St.
(If nonresident, give city or town and state)
years
months
days.
In this community
15yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widow
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Dr. Gilbert E. Hetherington
(Husband's name in full)
6 Age of husband or wife if alive 7 IF STILLBORN, enter that fact here.
AGE
Years
Days
If less than I day
Hours
Minutes
Usual 9 Occupation:
no occupation
Industry
at home
Due to
10 or Business:
11 Social Security No.none
12 BIRTHPLACE (City)
Stark
(State or country) Maine
13 NAME OF
FATHER
Benjamin Brooks
14 BIRTHPLACE OF
FATHER (City)
Unknown
(State or country) Maine
15 MAIDEN NAME
OF MOTHER
Theresa Maxim
16 BIRTHPLACE OF MOTHER (City) (State or country) Maine
Relation, if any
17 Informant. Gilbert Hetherington son (Address)5 Bellevue Terrace Winthrop
100m-10-'39. No. 8427-e
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial on transit permit was issued: Wm. Ilchildrens (Signature of Agent of Board of Health or other)
Sept. 26/1940.
0 (Official Designation) (Date of Issue of Permif)
(Registrar)
Information should be carefully supplied. AGE should be stated EXACILY. 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 and extracts from the laws on back of certificate.
PARENTS
20 Was disease or lojary In any way related to occupation ef deceased?
If so, specify.
....
(Signed)
M. D.
Date
19/20 1940.
(Address)
21 Thorntown, Cody, New Brunswick. Place of Burial, Cremsiest'ember 26ity or Town) DATE OF BURIAL .19 40
2. Pavlova
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
300 Meridian St. , E. Boston.
19
Received and filed SEP 60 1940
PHYSICIAN
Major findings :
Of operations
.Date of ..
Of autopsy
What test confirmed diagnosis ?
-
.... to have occurred on the date stated above, at ..................... m. Immediate cause of death Linguia
Duration IMPORTANT
Years
18 DATE OF
DEATH
sept
(Month)
23
(Day)
1440
(Year)
19 I HEREBY CERTIFY. . That I attended deceased from
19.62., to ...
Jeny 23 , 19 40 ...
Jast saw h.n ....... alive on ....... 19.5 ..... , death is said
Due to
Other conditions .....
(Include pregnancy within 3 months of death)
Underline the cause to which death should be charged sta- tistically.
Unknown
PLACE OF DEATH
1
St.
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
(write the word)
Female
8
78
1
Months.
28
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwitb, 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 regis- tration 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 therc shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 hoard of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence. the medical exam- iner 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 commonwealth 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 removal ; provided, that such body shall be returned to the town froin 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 required 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 appcar 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 fur- nish 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, See. 45, G. L., (Tercentenary Edition.)
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 funcral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance 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 ill- ness 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 dicd without recent medical attendance 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 septice- mia), 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 occupa- tion, the sudden deathis of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death. not the mnode of dying. e. g., heart failure, asphyxia, asthenia. etc. As principal cause name the disease causing death. As related causes, name carlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .-- Precise statement ef 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 usual occupation prior to illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whowe only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekooper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
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