USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 52
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by section ten or 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 neces- sary 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., (Tercentenary Edition).
Medical examiners 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 his 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.
No undertaker or other person shall bury a human body or the asbes thereof which have been brought into the commonwealth until he bas re- ceived 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., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for tbe observance of the following rules of practice:
(1) Attending physicians will certify to sucb 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 unrelated to any form of injury, have died without recent medical attendance or whose pby- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably 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.
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.
Statement of Occupation .- Precise statement of occupation is very im- portant, 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 bad 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, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION Service No 29138
Inlisted in the United States Navy in August 13, 1907 Honorably discharged on Sept 17. 1915
Not a veteran of World War 1 or 2
+
M R-302
PLACE OF DEATH
(County)
1
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return) 156
Registered No.
6022
(If death occurred in a hospital or institution, St. give its NAME instead of street and number)
2 FULL NAME
(If deceased ia a married, widowed or divorced woman, give also maiden name.)
59 Cottage Px hd
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
.... years
months
12 days.
In this community
yr8.
mos.
12 days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if allve years
7 IF STILLBORN, enter that fact here.
8
AGE ... 7.7
... Years.
Months.
Days
If less than 1 day Hours. .... .Minutos
Usual
9 Ocoupation :
Watchman- Retired
industry
10 or Business :
Boston Lockport Co
11 Soolal Security No ..
0:37-05-7903.
12 BIRTHPLACE (City)
(State or country)
Rockland Me
13 NAME OF
FATHER
Orlando Brown
14 BIRTHPLACE OF
FATHER (City)
(State or country)
-
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 informant {Address)
daughter
(
Relation, If any
A Ty Copy. Land Filownsup
ATTEST :
(Registrar of city /or town where death occurred)
DATE FILED
Que 7/17
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Aur 4/47
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
7/23/07 19.
to
That I attended, deceased from
8/1/17, 19.
....
I last saw h .... m ....... alive on.
8/1/17
, 19
death Is said to
have ooourred on the date stated above, at.
... m.
Duration
Immediate cause of death. Embolism ... pulmonary .... recurrent
15 ... mins
Due to Thrombophlebitis loft ler
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Underline
Major findings :
Of operations
lication of veins femoral
bilateral
Date
07/23/47
which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ? autongr.
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify
(Signed)
J Jichty
M. D.
(Address)
Boston.
Daté1 /17
..... 19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
(Cemetery)
inthrop
"int' ron
(City or Town)
DATE OF BURIAL
1.
-
1/17
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
"inthron
h reynolds
Received and filed. AUG 1-21947 .19
(Registrar of City or Town where deceased resided)
50m. (b).6.44-14607
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
No. ...... 885 Conora] Hospital
Edward O Brown
{
(If U. S.
War Veteran,
specify WAR)
no
(a) Residenoo. No.
(Usual place of ahode)
PARENTS
M R-302
1
Stoneham
(City or Town)
No. 12 .... Ben.ton
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Stone ham (City or town making return)
157
S (If death occurred in a hospital or inatitution, give ita NAME instead of street and number)
2 FULL NAME
Lillie Eliza Everbeck nee' Manwaring
(If deceased ia a married, widowed or divorced woman, give also maideu name.)
(If U. S.
War Veteran,
speolfy WAR)
(a) Residence. No.
217 Lincoln
SŁ
Winthrop
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution .... rest home
(Before death)
(Specify whether)
months
37 days.
In this community
yra.
moa.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
female
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED Widowed
or DIVORCED
(Month)
(Year)
19 | HEREBY CERTIFY,
Feb.
25
19.
47
to
Aug.
7
1947
(or) WIFE of George ..... A.
(Husband's name in full)
6 Age of husband or wife If allve
years
7 IF STILLBORN, enter that fact here.
AGE
8 78 Years 11 Months 17 .. Days
If less than 1 day Hours ....... .Minutes Due to.
Usual
9 Occupation :
.Housewife
Industry
10 or Business:
Own home
11 Soolal Security No.
none
12 BIRTHPLACE (City) .N.e.w.town
(State or country) Long Island, New York
13 NAME OF
FATHER
Manwaring
14 BIRTHPLACE OF
Unable to obtain
FATHER (Clty)
(State or country)
15 MAIDEN NAME
OF MOTHER
Unable to obtain
If so, specify ..
Paul Weinsaft
(Signed)
(Address) Winthrop, Mass.
Date
8/7
19
Everett
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Woodlawn Crematory,
(Cemetery )
(City or Town)
19 47
DATE OF BURIAL
August .... 9.,
22 NAME OF
FUNERAL DIRECTOR
Howard .... Reynolds
ADDRESS
Win throp., Mass.
Received and filed AUG 13 1947 .19
( Registrar of City of Town where deceased resided)
50m. (b) .6.44-14607
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk
of the city or town in which the deceased resided. (See Chap. 16, Sec. 12, G. L.)
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
?
?
17 (s.on Informant Geo. C. overbeck (Address) 217 Lincoln St. , Winthrop
Relation, if any
A TRUE COPY.
ATTEST :
DATE FILED August II,
Due toHypertension and
hypertensive heart dis.
? yrs .
Other conditions.
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Physician Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?.
clinical
20 Was disease or Injury In any way related to occupation of deceased ?..... no
Duration
have ooourred on the date stated above, at.12 .: 05 ........... m. Immediate cause of death Cerebro vascular accident
with left hemiplegia
5 wks.
I last saw her. .allve on Aug, 7
death Is sald to
18 DATE OF
DEATH
August
7,
1947
.
(Day)
That 1 attended deceased from
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
years
St.
Registered No.
-156-
PLACE OF DEATH
Middlesex
(County)
Copies of returne of deaths recorded during the previous month which occurred in your city or town in case the deceased
M.
47
RM R-302
Suffolk
(County)
BOSTON (City of Towny Ma.s.S ..... Gen ........ Hos.p
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON.
(City or town making return)
158
Registered No.
7056"
(If death occurred in a hospital or institution,
give its NAME instead of street and number) 1
2 FULL NAME
Sarah Charam
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Lewis Ave
St.
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution
hosp
years
months
3
days.
In this community
yrs.
mos.
3
daya.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widow
5a If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
Jacob Charan
(Give-maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If allve
year
7 IF STILLBORN, enter that faot here.
AGE.
8 68 Years Months Days
If less than 1 day .. Hours .. Minutes
Usual
9 Occupation :
Housework
Industry
10 or Business :
at home
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Benjamin Shneider
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Martha
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17
informant
(Addresa)
I.da ... Bernhardt
Relation, If any .. dau ...
Winthran
A TRUE COPY
Michael Fallonnur
ATTEST :
(Registrar pt city or korn where derth does
DATE FILED 8/13/47
........
19
18 DATE OF
DEATH
8/11/47
(Month)
(Day)
(Year)
19 1
8/8/47
CERTIFY,
19
to
8711/4/
19
I last saw h
er alive on
8/11/47
19
death Is sald to
have occurred on the date stated above, at
1 12A
.. M.
Duration
Immediate oause of death
Infarct of myocardium
3 da
Due to.
Coronary sclerosis
10 yr
Due to.
Other conditions.
diabetes .... mellitus
3. y Physician
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Date of
should be
charged sta- tistically.
What test confirmed diagnosis ?.
clinical
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, speolfy
(Signed)
J S Lichty
(Address)
Ma.s.s ..... Gen .... Hos
Date 8/11/647 M. D.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
No Russell St-Everett
8/11747
DATE OF BURIAL
(City or Town) 19
22 NAME OF
FUNERAL DIRECTOR
B Birnbach
Boston
ADDRESS
Reoelved and flied SEP 9 1947
.19
(Registrar of City or Town where deceased resided)
50m.(b) -6-44.14607
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased of the city or town in which the deceased resided. (See Chap. 46, Seo. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk
1
PLACE OF DEATH
No.
St.
(If U. S.
War Veteran,
specify WAR)
no
(a) Residence. No.
(Usual place of abode)
Winthrop
Standed deceased from
......
...
Underline the cause to which death
Of autopsy
..
SEP-81047 A.
M R-301 A
Winthrop
1
(City or Town)
(Usual place of abode)
3 SEX
4 COLOR OR RACE
female
white
Se If married, widowed, or divoroed
HUSBANO of
7 IF STILLBORN, enter that fact here.
Usual
9 Occupation :
14 BIRTHPLACE OF
(State or country)
15 MAIDEN NAME
OF MOTHER
PARENTS
16 BIRTHPLACE OF
MOTHEP. (City)
( State or country )
If decesssd was a U. S. War Vatsran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect.
extracts from the laws on back of certificate.
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain
Industry
10 or Business :
housewife
5 SINGLE
( write the word)
MARRIED
WIDOWEO
or DIVORCEOWidowed
Rendle
(Cive maiden name of wife in built)
(or) WIFE of
William .Spurgeon .... xem
( Husband's name in rull)
6 Age of husband or wife if allva years
8
AGE 84 .... Years ...
3 Months 11 Days
If less than 1 day
Hours
Minutas
retired
11 Social Security No. none
12 BIRTHPLACE (City)
Tyne .... Valley
( State or country)
Prince Edward Island
13 NAME OF
FATHER
William Johnston
FATHER (City)
unableto .... obtain
=
17 daughter
Informant 300 1alkat Se Winthrop Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was Aled with me BEFORE the bucket of transfy permit was Issued: Watter Kaker
(Signature of Agesafol Board of Health or other) 40
Wag. 13/4/7.
( Date of Inoue os Permail).
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
august
14
1947
(( Mfonth )
(Day)
(Year)
19.
19 | HEREBY CERTIFY.
That I attended deosased from
July 24
47
to
august 14
1947
Plast saw her
alive on
august 14, 19 47
death is said to
heve occurred on the data steted ebova, at.
4 ° P.
n.
Immadiate oause of death
IMPORTANT
Cerebral Empatione
3 weeks
Que to
arteriosclertic Heart
1 year
Disease with auricular fibrillation
Due to
generalized arteriosais
2 years
Other conditions
none
( Include pregnancy within 3 months of death)
IMPORTANT
Major Andings:
Of operations
Of autopsy
What test confirmed diagnosis ?
Clinical + LabaraCarna
Charged v ..
20 Was disease or injury in any way related to occupation of deceased ? 0 if so, specify.
(Signed) Mauricestrauss En
·
. M. D.
6Dats
(Address) 562 Stufey St.
VIAAND.
dus. 14 1947
21
Woodlawn.
Everett Mass.
Piace of Burial, Cremation or Removal.
(City or Town)
OATE OF BURIAL.
August, 16,1947.
19
22 NAME OF
Alfred 3. March
FUNERAL DIRECTOR
ADORESS
174 Winthrop St Winthrop, MASS
Received and flad
AUG 2010
19
( Registrar)
100m.(g).1.45.15510
PLACE OF DEATH
Suffolk (County)
No. Winthrop ..... Community ..... Hospital
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. 159
Registered No.
St & (If death occurred in a hospital or institution,
{ give its NAME instead of street and number)
2 FULL NAME
Sarah Matilda (Johnston) Rendle
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
3.00 .... Pleasant ..... St.
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution hospital
( Before death )
( Specify "whether)
Jeera
months 21
days.
in this community
33
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(Official Designation)
Physician
Underline the cause to which death should be
Oata of
Duration
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
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 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 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, Chap. 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 deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Cbap. 46, Sec. 10.
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 satisfactory 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 physi- eian who is a member of the board of bealth, 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, the medi- cal 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 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 bereunder. If the death certificate contains a recital, as required
by section ten or 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 neces- sary 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., (Tercentenary Edition).
Medical examiners 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 his 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.
No undertaker or other person shall bury a human body or the ashes 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 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., (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 disabled by recognized disease unrelated to any forin of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths eaused 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.
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.
Statement of Occupation .- Precise statement of occupation is very im- portant, 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 domestie service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-301 A
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