Town of Winthrop : Record of Deaths 1947, Part 52

Author: Winthrop (Mass.)
Publication date: 1947
Publisher:
Number of Pages: 544


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 52


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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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



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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