USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 72
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If disease or injury was related to occupation, specify. If investigation shows the death to have heen due to disease, specify: (1) Under cause, its known or presumahle nature; and (2) under manner, indicate the cir- cumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the hrain (hasal ganglia) (found dead in hed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
0
NOTICE TO UNDERTAKERS: No coming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have net 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
A R-302
PLACE OF DEATH
c.ffoli- (County)
The Commontoralth of Massachusetts OFFICE OF THE SECRETARY DIVISION'OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Chels a
(City or town making return) 2.3
Registered No. S (If death occurred in a hospital or institution, St.
give its NAME instead of street and number)
2 FULL NAME
Thongs F. Baylor
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Resldenoe. No.
503 ...... 162sont ....... ₺
(Usual place of abode)
hospital
years
month's
days !!
In this community
yrs.
mos.
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
white
5 SINGLE
(write the word)
widowed
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of
Ellen l'ackin Bagley
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
30 Years
1 Months.
10 Days
AGE
If less than 1 day Hours .Minutes
Usual
9 Occupation:
Chief ochinist rate (rot.).
Industry
10 or Business :
11 Social Security No ..
12 BIRTHPLACE (City)
Boston
(State or country)
lass.
13 NAME OF
FATHER
Hugh Bagley
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Ireland
(State or country)
15 MAIDEN NAME
OF MOTHER
Sarah Storey
16 BIRTHPLACE OF
MOTHER (City)
Ireland
(State or country)
17 Sarah barley
Relation; if any
Informant
(Address) 503 Pleasant ....
winthrop
A TRUE COPY.
ATTEST :
(Registrar of city or town where death toccurred erk
DATE FILED
Nov. 13.
19
42
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
19
19 ............. 2
I last saw h ......
...... alive on.
3.2. ..... , 19.
death Is sald to
have occurred on the date stated above, at
11:402
m.
Duration
Immediate cause of death.
Taget's itsease
Due to.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Hone.
Date of
Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?
20 Was disease or injury in any way related to ocoupation of deceased ? no
If so, specify
(Signed)
(Address) Jon B. Torchall Date
.19.
M. D.
21 "PLACE OF BURIAL, ChoLsta,. ass.
CREMATION OR REMOVAL ...
(Cemetery)hic;
Ce(City, or Town) MIS.
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
resided in another eity or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
1
(City or Town)
No.
(If U. S.
War Veteran,
specify WAR) ..... ord-I ....
Spanish
St.
intimo:
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution.
13. 2012
Physician
R-301 A
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) Winthrop Communit No ..
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Hospital St.
To be filed for burial permit with Board of Health or its Agent ..
Registered No.
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
(If U. S. War Veteran. apacify WAR)
Wollaston 200 2
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
(write the word)
5 SINGLE
MARRIED
WIDOWED
Or DIVORCED make
Sa If married, widowed, or divorced HUSBAND of ..
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
8 AGE Years. Months.
If less than 1 day .Days ......... Hours .Minutes
Usual
9 Occupation:
none
Mone
11 Social Security No.
Mene
12 BIRTHPLACE (City)
(State or country)
A throw Mass
13 NAME OF
FATHER
Edward Boter Bottenews
14 BIRTHPLACE OF
FATHER (City) ......
New york
(State or country)
n.21
15 MAIDEN NAME OF MOTHER
Mildred g. BU Raynor
16 BIRTHPLACE OF Freeport MOTHER (City) ....... 7 (State or country)
Island h
17 Edward Boten
Relation, if any (faltar)
Informant. (Address) 165 Everett D. Willaster
I HEREBY CERTIFY that a satisfactory standard certificate of death way filed with me BEFORE the burial or transit permit was issued: Www.S. Children (Signature of Agent of Board of Health, or other)
Health officer 110/16/42
(Official Designation)
(Date of Issue of Permit)/ 16/12
18 DATE OF
DEATH.
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. 12 .19. to.
That I attended deceased from
I last saw halive on .15 19 ... f .; death is said to
40.M
m.
Duration MIPORTAMI
C
Due to.
Due to.
Conchital
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify.
(Signed)
(Address) ....
00 Date 12-16 19 ..
21. Ihr Michael
(City or Towny
Place of Burial, Cremation or Removal. DATE OF BURIAL nov 17 1942
22 NAME OF FUNE
DIRECTO la harles 14 reamer ADDRESS East Boston
Received and filed.
19
(Registrar)
100m-2-'40-D-729-a
.... 1 3 SEX male (or) WIFE of .. cker birth Cart. PARENTS 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. information should be carefully supplied. AGE should be stated LasciLl. FITISICIANS should state Industry 10 or Business:
2 FULL NAME
Edward Botenaus Bitte
(If deceased is a married, widowed or divorced woman, give also maiden name.) 165 Everett Dl
St
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
2 hrs
MEDICAL CERTIFICATE OF DEATH
13
1942
- 15 .. , have occurred on the date stated above, at. Immediate cause of death .. atre
Major findings: Of operations.
.Date of ........
Of autopsy
atresia
What test confirmed diagnosis ?.
Ca
M. D.
19
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, 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 hy section one, where same was contracted, the duration of his last illness, when last seen alive hy 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 hody which has not been buried, until he has received a permit from the hoard 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 hody and remove it froin a town, from one cemetery to another, or from one grave or tomh other than the receiv- Ing tomh to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the body is huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required hy law to be returned and recorded, which shall be accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy law, or in lieu thereof a certificate as hereinafter provided. If there Is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the hoard of health, or em- ployed hy it or hy the selectmen for the purpose, shall upon application make the certificate required ofthe attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, 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 ahove 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 he 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 re- moval of such hody has been sooner ohtained hereunder. If the death certificate contains a recital, as required hy 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 he obtained as to the deceased, or as to the manner or cause of the deatlı, which the clerk or registrar may require .- Chap. 114, Sec. 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 he 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., (Tercentenary Edition).
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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent 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 deathis caused directly or indirectly hy traumatism (including resulting septicemia). and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized dlsease, and those of persons found dead.
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 morhid conditions, if any. related to the principal cause and any important complication of the principal cause.
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 usual occupation prior to Illness. If the deceased had retired from business, report the usual 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. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-302
PLACE OF DEATH
Middlesex (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Cambridge
(City or town making return) 215
Registered No.
1459
( If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
William H. Mahoney
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
90 .... Lowell-Road
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
3
days.
In this community40
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Ma le
4 COLOR OR RACE!
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDMarried
5a If married, widowed, or divorced
HUSBAND of
.. Margaret ... A ...... Riley
( Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE
.7.8 .. Years.
Months.
.Days
If less than 1 day
Hours.
.Minutes
Usual
Merchant
9 Occupation :
Industry
10 or Business :
Potatoes
11 Social Security No. ....
none
12 BIRTHPLACE (City)
(State or country )
Boston, Mass.
13 NAME OF
FATHER
Joshua Mahoney
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Ellen Harrington
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informant.Margaret .... Mahoney. ( Address) 90 Lowell Rd. Winthrop
A TRUE COPY.
Frederick H. Burke
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
.November ...... 16, ...... 1942 ...
........
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
November
13
19.42
(Month)
(Dẩy)
(Year)
19 | HEREBY CERTIFY,
Nov. 10
19 .... 42., to ...
Nov .......... 13
19 ... 42.
That I attended deceased from
last saw
him ........ allve on.
Nov.
13.
19.42 death is sald to
have occurred on the date stated above, at. 4:40PM .. m.
Duration
Immediate cause of death.
Intestinal Obstruction
of bowels
Due to ...
Probable Malignancy
Due to
Other conditions.
(Include pregnancy within 3 months of death)
Physician
C
Major findings :
Of operations
Date of
Underline the cause to which death should be charged sta- tistically.
What test confirmed diagnosis ?
20 Was disease or injury in any way related to ocoupatlon of deceased?
no
If so, specify.
M. D.
(Signed)
L. J. Louis
(Address) Boston,Ma.s.s ...
Date 11/13/ 42
21 "PLACE OF BURIAL,
Holy Cross- Malden
CREMATION OR REMOVAL
(Cemetery)
(City or Town)
DATE OF BURIAL
November 16, 1942 19
22 NAME OF
FUNERAL DIRECTOR
John F. O'Maley
ADDRESS
inthrop , .... Ma.s.s ....
Received and filed 19
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
resided in another city or town at the time of death should be made forthwith and transmitted on Form R2-302 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
t
1
Cambridge (City or Town) lyman House
No.
St.
(If U. S.
War Veteran,
specify WAR)
none
St.
winthrop Mass
........
73
r
7 da. ,
Of autopsy
Relation, if any
R-301 A
1
Vinteron
(City or Town)
116 Hermon St
The Commontoralth 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. 216
Registered No. ( If death occurred in a hospital or institution, { give its NAME instead of street and number) St.
2 FULL NAME
George Joseph Icouillen
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
776 van or ok
St.
(If nonresident, give city or town and State)
Length of stay: In nosoltal or Institution
(Before death)
yeara
months
days.
In this community
25 yrs. ~ mos. .
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE|
Thite
5 SINGLE
( write the word)
DEATH
MARRIED
WIDOWED
or DIVORCED
Married
5& If married, widowed, or divorced
Jonny
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Husband's name in full)
years
9 IF STILLBORN. enter that fact here.
8 AGE 79 Years Months
-
Days
If less than 1 day
Hours
Minutes
Usual
Interior Decorator
Industry
Painting : banerhan-i ....
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( State or country)
18.1.000
Other conditions.
( Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
Clinical Signs
20 Was disease or injury in any way ralated to oooupation of deoeasad ?.. If so, specify.
('Signed)
, M. D.
(Address)
Winthrop, Jamais
Date 1/01/4 1942
21 -
Place of Burial, Cremation or Removal.
DATE OF BURIAL . overher
.....
42
19
22 NAME OF
FUNERAL DIRECTOR
John F. O maley
ADDRESS
Hintiron Ia's
Received and Aled.
.19
( Registrar)
100M-G -2-42-8855
I HEREBY CERTIFY that a satisfactory standard oartifioate of death was filed with me BEFORE, the burial of traitsit permit was Issued : Amo Cheldicas
(Signature of Agentebt Board of Health or other)
affe
Nov 16/42.
(Official Designation) (Date of Issue of Permit)
18 DATE OF November
14
1942
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That ! attended decaasad from
Nov. 12,
19212, to
Not
14
1942
I last saw him
.. allve on.
Nov. 13
19 42, death Is said to
have occurred on the date stated abova, at
9.40 A.M.m.
Duration
IMPORTANT 4 days
Due to.
Hypertension
Due to
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Frances "ouillen
Relation, if any
(City or Town)
Informant.
( Address}
ir on st Pintaron
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a reoitai to that effeot. extracts from the laws on back of certificate. tomain, de that it may be property classified. exact statement of decorAtion is very important. See instructions and PARENTS
PLACE OF DEATH
Suffolk (County)
No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
(Specify whether)
6 Age of husband or wife if alive
Immedlate cause of death.
Cerobral Hemorrhage
9 Occuoation :
13 NAME OF
FATHER
John Ve millen
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whoin he has attemuled during his last illness, at the request of sn undertaker or other authorized person or of any member of the family of the deceased, furnisb for registration a atandard certificate of death, stating to the best of his knowlinge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired 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, Chiap. 46, Sec. 9.
A' physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the decessed, to the best of his knowledge and helief, aerved in the army. navy or marine corps of the I'nited States in any war in which it has been engaged, insert in the certificate a recital to thai effect, speci- fying the war. and shall also certify in such certificate both the primary and the secondary or immerliate cause of death as nearly as he can state the saine. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of thia sec- tion and of sections forty-five, forts-six and forty-seven of said chapter one bumired and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred aud sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a buman 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 ita 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 undertsker or other person shall exhume a buman body and remove it fromn a town, from ote cenietery 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 bosrd of health or its agent aforexsid or from the clerk of the town where the boily is buried. No such permit shall be issued until there shall have been delivered to sucb hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned andl recorded, which shall be accompanied. in case of an original internient, by a satisfactory certificate of the attending physician, if any, as required by law. o1 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 ia insufficient, a physi- cian who ia a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence. tbe medl- cal examiner ahaii make such certificate. If sucb a permit for the removal of a liumsu body, not previously interred, froin one town to another within the commonwealth cannot be obtained esrly enough for the purpose, tbe certificate of desth 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 wbich It was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has been sooner obtained hereunder. If the death certificate contains a recital, aa 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 transmi it to the clerk of the town for registration. The person to whom the permit Is so giveu and the physician certifying the cause of death shall thereafter furnish for registration any uther nece+ sary information which can be obtained as to the deceased, or us to the manher or canse of the death, which the clerk or registrar may require .- Cbap. 114. Sec. 45. G. L., ( Tercentenary Edition).
No undertaker or other person shall bury a human hody or the ashee thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the board of health or its agem appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the boily 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 ibe interment is made .... Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the body of such a fierson, he shall forthwith go to the place where the toody lies aud take charge of the same; ... - General Laws, Chap. 38, Suc. 6.
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