USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 27
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(2) Boardof Health physicians will certify to such deaths only as those of
N( undertaker or other person shall bury or otherwise dispose of a human b in a town, or remove therefrom a human body which has not been buried, untip persons whd, though disabled by recognized disease unrelated to any form of has received a permit from the board of health, or its agent appointed to issue injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed. 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 (3) Medical Examiners will investigate and certify to all deaths supposably due to injury, These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation. the sudden deaths of persons not disabled by recognized disease, and those of persons found dead. 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 inter- ment, by a satisfactory certificate of the attending physician, if any, as required by Statement of Cause of Death .-- Physicians: see explanatory instructions on face side of standard certificate of death. law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. 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 by the appropriate terms, as housekeeper -- private family, cook-hotel, etc. For a person who had no occupation whatever write none. application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the 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
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
PLACE OF DEATH
Suffolk (County)
(City or Towny)
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 ite Agent.
88
Registered No.
"Nontrop Com Thash . Thomas 17 Cold
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Wirthoop 2499shore Dive
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years.
months
7days. In place of residence 36 years .. months. .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
ihale
9 COLOR OR RACE
Ahile
10 SINGLE
(write the word)
MARRIED
WIDOWED
4 I HEREBY CERTIFY.
4/8
19
53
to.
4/21
53
I last saw h.
umalive on
4/21
1953
death is said to
have occurred on the date stated above, at ...
10A .m. INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12 AGE Years
Months
Days
If under 24 hours
Hours .. ... Minutes
13 Usual
Occupation :
Mechanic
(Kind of work done during most of working life)
14 Industry
or Business:
intomobile
15 Social Security No.
033-07-2135
16 BIRTHPLACE (City).
(State or country)
17 NAME OF
FATHER
istbut E Cole
Major findings:
Of operations.
home
Date of operation
What test confirmed diagnosis ?.
Was autopsy performed? Electro cardiogram.
5 Was disease or injury in any way related to occupation of deceased? no
If so, specify ..
(Signed)
Mycon n. Kung M. D. (Addres6 222 Pleasant Stunthoop 4/2) 1053
6 Place of Burial or Cremation
(City or Town)
DATE OF BURIAL.
19
7 NAME OF FUNERAL DIRECTOR.
ADDRESS Macbook
Received and filed APR 2 8 1953
......... 19
(Registrar)
PARENTS
18 BIRTHPLACE OF FATHER (City) (State or country)
England
19 MAIDEN NAME OF MOTHER (Vaknar) Cuttel
20 BIRTHPLACE OF MOTHER (City) (State or country)
21 Informant. (Address) .
Mie Thomas Cale
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Bakery. (Signature of Agent of Board of Health or other)
Healit Office 4-23-53 X
(Official Designation) (Date of Issue of Permit)
CTIONS R RTIFICATE ving DEATH enter an one r each and (c)
s not mean dying, such e, asthenia, the disease, ions which
conditions, rise to the (a) stating ing cause
ns contrib- ath but not disease or sing death.
100M-(D)-10-48-24658
13 days
ANTE CEDENT (b) CAUSES
arteriosclerosis
Due To
(c)
-
OTHER SIGNIFICANT CONDITIONS
35ijus
10a
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
3 DATE OF
DEATH
(Month)
(Day) APRIL 21 1953 (Year)
j(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, [if so specify WAR)
(a) Residence. No. (Usual place of abode)
That I attended deceased
fros
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
acute coronary
occlusion
R-301A 1
2 FULL NAME ..
april 24
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 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- Chap. 114, Sec.46, G. L., (Tercentenary Edition). 7 diate 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 section and of sections forty-five, forty-six and forty-seven RULES OF PRACTICE of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall. for said purposes, bel The fulfillment of the purpose of these laws calls for the observance of the follow- deemed to have taken place between February fourteenth, eighteen hundred and ing rules of practice: ninety-eight and July fourth, nineteen hundred and two, and the Mexican border 12 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. service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 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 (31 Medical Examiners will investigate and certify to all deaths supposably person died; and no undertaker or other person shall exhume a human body and"/due to injury. These include not only deaths caused directly or indirectly by
remove it from a town. from one cemetery to another, or from one grave of tomy Craumatism ' (including resulting septicemia), and by the action of chemical dagsor poisons) thermal, or electrical agents, and deaths following abortion, but (so) deaths from disease resulting from injury or infection related to occupation, 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 dert of the town where the body is buried. No such permit shall be issued until there the sudden deaths of persons not disabled by recognized disease, and those of
ment, by a satisfactory certificate of the attending physician, if any, as requir APR Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
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 inter- law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the 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 registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L., (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 persons 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.
(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 injuryi have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
persons found dead.
Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. 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 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
%
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
25m-(c)-11-49-900.475
PLACE OF DEATH
Barnstable .-
(County) Falmouth
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Falmouth
(City or town making return)
Registered No.
26
89
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) No.
2 FULL NAME
FRANCIS E. MARSH
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
41 Bates Ave.
St.
inthrop,
Mass
(If nonresident, give city or town and State)
440. years.
Length of stay: In place of death.
...... years.
months.
2
.days.
In place of residence.
..... months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
April 23, 1953
DEATH
(Month)
(Day)
(Year)
9 SEX
Male
10 COLOR OR RACE
White
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
4 I 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.)
HUSBAND of
Maryse Flynn
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
64
13
AGE
Years
Months
Days
If under 24 hours
Hours
Minutes
5 Accident, suicide, or homicide (specify)
Accident
Date and hour of injury.
Apr.11 .... 2.3
19
5.3
Where did
Seacoast Shores
Injury occur?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
place?
Cottage
(Specify type of place)
Manner of
Injury
Inhalation of Gas
Nature of
(How did injury occur?)
Injury
Gas flame put out
While at work?
no
.Was autopsy performed?
no
6 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
E.P .Tripp
M. D.
(Address)
Falmouth.
Mass Dat+/24
19.5.3
MOTHER (City)
(State or country)
Newfoundland
Winthrop 7 Place of Burial, or Cremation. (City or Town)
DATE OF BURIAL.
April ........ 27
19.5.3
8 NAME OF
John F. O Maley
FUNERAL DIRECTOR
ADDRESS
in throp
Mass
MAY 6
-- 1955
Received and filed. 19
(Registrar of City or Town where deceased resided)
PARENTS
19 BIRTHPLACE OF
FATHER (City)
(State or country)
England
20 MAIDEN NAME
OF MOTHER
Catherine Murphy
21 BIRTHPLACE OF
St.Joh
Mary ... E ..... Flynn Marsh
A TRUE COPY~
ATTEST:
EuniceM aurence
(Registrar of City or Town where death occurred)
DATE FILED
A Jul 28
.19
3 K
R-305 T.
1
Asphyxiation by Gas-
Accidental
14 Usual
Occupation:
Retired
(Kind of work done during most of working life)
15 Industry
Boston Protective Co
or Business:
16 Social Security No.
-15-20-3230
17 BIRTHPLACE (City)
(State or country)
Boston Mans
18 NAME OF
FATHER
William Marsh
Winthrop
22
Informant
(Address)
41 Bates Ave Winthrop
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
11a If married,
(Give maiden name of wife in full)
(write the word)
RECEIVEO
OF
TOYVI
11 12
1
1).
OFFI
AN
3
...
B
7
6
TA
THR
P.
MAY-6 TAM
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
25m-(c)-11-49-900.475
PLACE OF DEATH
Barnstable
(County)
Falmouth
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Falmouth
(City or town making return)
Registered No.
25
90
J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME
Robert W. Myers
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
316 Bowder St.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
.. years.
2
months.
.days.
In place of residence 25
.years
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
Male
10 COLOR OR RACE
White
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
4 I 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.)
11a If married, widowed, or divorced
HUSBAND of
ifred J. Bruce
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE
65y
es.
- Months
Days
If under 24 bours
.. Hours.
.Minutes
14 Usual
Occupation :
Steam fitter
(Kind of work done during most of working life)
15 Industry
or Business:
Bldg. Trade
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
place?
(Specify type of place)
Manner of
Injury
(How did injury occur?)
Nature of
Injury
While at work?
no
Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased ?!!. O
If so, specify.
(Signed)
E.P.Tripp
Falmouth
Date.
4/24
ちゅ
19
Winthrop
in throp
7 Place of Burial, or Cremation. April 27
(City or Town)
DATE OF BURIAL
19
8 NAME OF
FUNERAL DIRECTOR
Maurice .... Kirby.
ADDRESS
210 Winthrop St. Winthrop
MAY 6 1959.
Received and filed
19
(Registrar of City or Town where deceased resided)
PARENTS
18 NAME OF
FATHER
(Cannot be learned)
19 BIRTHPLACE OF
FATHER (City)
(State or country)
Germany
20 MAIDEN NAME
OF MOTHER
Whilemina (Cannot be
learned )
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
Mrs. Winifred J. Myers
22
Informant
(Address)
316 Bowder St Winthrop
-
A TRUE COPY
ATTEST:
0
(Registrar of City or Town wbere death occurred)
DATE FILED
April 24
53V
19
3 DATE OF
DEATH
(Month)
(Day)
(Year)
April 23. 1953
Asphyxiation by inhalation of Gas Accidental
5 Accident, suicide, or homicide (specify)
Accident
Date and hour of injury .. 19
Where did
Injury occur?
16 Social Security No.
17 BIRTHPLACE (City)
(State or country)
Germany
M. ]
53
T.
R-305 1
No.
Din
(Usual place of abode)
(Was deceased a
U. S. War Veteran, WW I
if so specify WAR)
Winthrop, Mass
(Give maiden name of wife in full)
RECEIVED
TO !!
OF
11.72 7
C
7
6
5
VTHROP
MAY-6 AM
R-303 A 1
No. PLACE OF DEATH Sulla (County) furtheres (City or Town)/ Hundred Commento Hospital Curran
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
91
2 FULL NAME ..
Sheila
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
90 Loring Rd. Hunthrob.
St.
(If nonresident, give city or town and State)
5
Length of stay: In place of death.
years.
20
months.
days. In place of residence ..
3
.years
months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
april
-
24
1953
(Year)
9 SEX
Female
White
11 SINGLE
MARRIED
WIDOWED
or DIVORCEIngle
(write the word)
(Month)
(Day)
4 I 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.) Lecetteple Custuscosas Labrador
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE ..
3
Years
5
Months.
20.
Days
If under 24 hours
Hours .... .. Minutes
14 Usual
Occupation :.
None
(Kind of work done during most of working life)
15 Industry
or Business:
16 Social Security No.
None
Winthrop
17 BIRTHPLACE (City).
(State or country)
Mass
18 NAME OF
FATHER
John Curran
19 BIRTHPLACE OF
FATHER (City)
Somerville
(State or country)
Masg
20 MAIDEN NAME
OF MOTHER
Elinor Flynn
21 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country)
Mass
22
Informant
(Address)
John Curran
90 Loring Road Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter
(Signature of Agent of Board of Heakh of other)
Seattle prices 4.27,53
(Official Designation)
(Date of Issue of Permit)
25M (B).8.50.902 592
Winthrop Winthrop
7 Place of Burial, or Cremation. DATE OF BURIAL
{City or Town)
April
53
........
8 NAME OF
FUNERAL DIRECTOR
Winthrop Ma'ss
ADDRESS
Received and filed 1 APR 27 1953 19
(Registrar)
PARENTS
6 Was disease or injury in any way related to occupation of deceased?
If so, specify .........
(Signed)
M. D.
Water -24-1053
(Address) Besten
(Specify type of place)
Injury
unused ly in aute at Huntheresa
Nature of
Jn-24-1953
(How did injury gegur?)
Pedestrian
Injury
While at work?
Was autopsy performed?
Did injury occur in or about home, on farm, in industrial place, or in public place?
5 Accident, suicide, or homicide (specify) ..
accident
Date and hour of injury.
alm-24-
19 33
Where did
Injury occur?
(City or town and State)
Crushed best & abdomen
Jubavial Juinrier
10 COLOR OR RACE
j(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT 1
J (Was deceased a U. S. War Veteran, if so specify WAR)
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. of Death. See reverse side for extracts from the laws relative to the return of certificates of death. 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 stato CAUSE AND MANNER OF
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 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.
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