USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 47
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18 BIRTHPLACE OF
FATHER (City)
(State or country)
England
19 MAIDEN NAME
OF MOTHER
Mary A. King
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
21 Informant Ilary A. Ryan
(Address) 42 Sunnyside Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health /or other) Aldette Gliche 12/7/6/
(Official Designation)
(Date of Issue of Permit) v
TV.F
M R-301A 1
0
RUCTIONS FOR . CERTIFICATE
giving OF DEATH
not enter ; than one · for each (b) and (c)
oes not mean le of dying, heart failure, etc. It means se, or compli- which caused
ons, if any, gave rise to cause (a), the under- cause last.
itions contrib- death but not the terminal ndition given
- Chapter 137, 1954. requires ans to print or he cause or of death on ertificates, and 48. Acts of :quires Physi- print or type ider signature.
-928145
PARENTS
St
(1f nonresident, give city or town and State)
Registered No.
No.
That I attended deceased from 19
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
:
TON
THROP
DEC -171961 FM
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 un- related 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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting 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 occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .-- Precise statement of occupation is very impor- tant, 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. Chil- dren 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.
MR-301A 1
TRUCTIONS FOR L CERTIFICATE
1 giving OF DEATH not enter : than one e for each (b) and (c)
does not mean le of dying, heart failure, etc. It means se, or compli- which caused
ons, if any, gave rise to cause (a), the under- cause last.
tions contrib- death but not the terminal ondition given
Chapter 137, 1954, requires as to print or cause f death on tificates.
50M-5-57.920345
PLACE OF DEATH
Suffolk (County) Winthrop, Mass. (City or Town)
1-8-62
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
[(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,
no
if so specify WAR)
(a) Residence.
No ..
90 Grady Ct. East Boston, hass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death years 2. . months days. In place of residence. __ years months. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
December 5, 1961
(Month)
(Day)
(Year)
8 SEX
Lemale
9 COLOR
white
10 SINGLE
(write the word)
married
MARRIED
WIDOWED'
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Samuel Ciampa
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
44
Years.
Months
Days
If under 24 hours
Hours ...
Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
at home
Due To Multiple Myelomata
(c)
with metastasis
1 yr
OTHER
SIGNIFICANT
Laminectomy
CONDITIONS
9 mo $
Was autopsy performed?
no
What test confirmed diagnosis?
Laminectomy
5 Was disease or injury in any way related to occupation of deceased? If so, specifyAN Caplan
(Signed)
ar Caplan
M. D.
(Address) 106 Princeton StDate.
12-5-61
East Boston, hass.
6 St. Michael Cemetery
Place of Burial or Cremation
(City or Town)
21
Informant
John Ciampa (son)
(Address) 90 Grady Et. East Boston Class
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of
of Agqu cof Board of Health or other)
HO
Nec: 8, 1961
(Official Designation)
(Date of Issue of Permit)
To be filed for burial permit with Board of Health or its Agent.
211
No.Winthrop Convalescent Home, 142 Pleasant the Frances Chianpa Ciampa
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
4 I HEREBY CERTIFY,
That I attended deceased from
June.
1961
19
61, to Tec, 5,
I last saw helalive on December 5, 1961, death is said to
have occurred on the date stated above, at
1:45 mm
INTERVAL BETWEEN ONSET AND DEATH
1 weel
Due To
(b)
Hyperchromic Anemia
1 Ko.
15 Social Security No. not known
16 BIRTHPLACE (City)
(State or country)
East Boston Mass.
17 NAME OF
FATHER
Gaetano Golisano
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Grace Micciche
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
DATE OF BURIAL December 9,
Vincent Ronino
7 NAME OF
FUNERAL DIRECTOR
9 Chelsea St., Cost Boston, Mass.
ADDRESS
Received and filed [19 - 8 1961 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
PARENTS
Boston
Housewife
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Cardiac Decompensation
KOSTEN
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- 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 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, 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 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 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 inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the 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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6 , as amended by Chap. 632, Sec. 4, Acts of 1945.
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.
. 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 follow- ing 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 deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.
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, ete. 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
)RM R-301A 1
INSTRUCTIONS FOR ICAL CERTIFICATE
In giving SE OF DEATH do not enter more than one ause for each a), (b) and (c)
is does not mean mode of dying, as heart failure, tia, etc. It means isease, or compli- s which caused
ditions, if any, ch gave rise to ve cause (a), ing the under- g cause last.
Conditions contrib- to death but not l to the terminal ! condition given nº C.
::- Chapter 137, f 1954. requires :ians to print or the cause or of death on certificates, and :r 48, Acts of requires Physi- :o print or type inder signature.
51-11-59-926662
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No. 74 Washington Avenue
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
212
[(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)
No
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
74 Washington Avenue
St.
Winthrop
(Usual place of abode)
Length of stay: In place of death.1 .. 2 ...
... years ...
......
.. months .............. days. In place of residence
.years.
... months ....
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED Single
or DIVORCED
10a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
If under 24 hours
12
AGE 76
Years.
Months.
Days
13 Usual
Occupation :
Retired Clerk
(Kind of work done during most of working life)
14 Industry
or Business :
Suffolk County Court
15 Social Security No.
None
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
James P. McLinaney
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Mass,
Boston
(Signed)
Arthur @ Murray,
M. D.
OF MOTHER
19 MAIDEN NAME
Lucy E. Martin
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
St. John
New Brunswick
21 Rose E. McEnaney
Informant (Address)
74 Washington Ave., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of dea was filed with me BEFORE the burial or transit permit was issued:
L
(Signature of Agent of Board of Health or other)
(Official Designation)
(Date of Issue of Permit)
TIB
(write the word
3 DATE OF
DEATH
December 5
1961
(Month)
(Day)
(Year)
4 I
HEREBY CERTIFY,
That I attended deceased from
19
19 ...
I last saw h ........ alive on
19 ..........
.. , death is said to
have occurred on the date stated above, at 1:15 pm.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Natural Causes
Due To Presumably Coronary (b)
sudden
Occlusion
Du (c) ...
· Arterio sclerotic Heart
Disease
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed ?
NO
What test confirmed diagnosis? Post-mortem judgement
5 Was disease or injury in any way related to occupation of deceased ? mno. If so, specify
Arthur C. Murray (PRINT OR TYPE SIGNATURE) Winthrop Board of Hea Date 5 Dec 10 61
6 Holy Cross, Malden
Place of Burial or Cremation (City or Town) DATE OF BURIAL December 7. 1961
7 NAME OF
FUNERAL DIRECTOR
John C Kelly
ADDRESS 286 Meridian St., East Boston
Received and filed DEC 6 1901 19
هـ
(Registrar)
PARENTS
Years
Last Boston
Hours ...
.Minutes
INTERVAL BETWEEN ONSET AND DEATH
12
(If nonresident, give city or town and State)
2 FULL NAME
Lucy C. McEnaney
Registered No.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
RECEIVED
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
TOM.
٢٠٠
1
6
Di
RULES OF PRACTICE DEC - 61961 AM
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 un- related 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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting 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 occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, 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. Chil- dren 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.
M R-301A 1 Suf.f.o.1k (County)
winthrop
(City or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
213
S(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Ethel M. Kelly
(First Name)
( Middle Name)
(Last Name)
[ (Was deceased a
U. S. War Veteran,
(If deceased is a married, widowed or divorced woman, give also maiden name.)
49 Bartlett Road
St.
Winthrop
Length of stay:
In place of death.1.2
.years.
.. months.
.days. In place of residence
12
years ..
.months.
.....
... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
OF December
9
1961
(Month)
(Day)
(Year)
8 SEX
Female
9 COLOR
white
10 SINGLE
MARRIED,
WIDOWEDlarried
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
19
19
I last saw h ........ alive on
19.
death is said to
have occurred on the date stated above, at
6:00 p.m.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
Natural Causes
INTERVAL
BETWEEN
ONSET AND
DEATH
Due To
(b)
Presumably Coronary Occlusion
Due To
(c)
Arteriosclerotic Heart Disease
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
NO
What test confirmed diagnosis? Post- mortem judgement
5 Was disease or injury in any way related to occupation of deceased? No. If so, specify
(Sig ) Arthur C. Murray
Arthur C. Murray
(Winthrop Board of H . Date. 10 Dec 1961
6
Holy Cross
Malden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
December 13,
61
19
7 NAME OF
FUNERAL DIRECTOR
John C. Kelly
ADDRESS
286 Meridian St., East Boston
Received and filed
DEG-12-1961
.. 19.
(Registrar)
PARENTS
17 NAME OF
FATHER
Nathan Bates
18 BIRTHPLACE OF
FATHER (City)
East Boston
, M. D.
(State or country)
Mass.
19 MAIDEN NAME
OF MOTHER
Margaret O'Neil
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
East Boston
21
Informant
John C Kelly
(Address)
49 Bartlett Road, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other
(Official Designation)
(Date of Issue of Permit).
TRUCTIONS FOR L CERTIFICATE
1 giving : OF DEATH
not enter e than one e for each . (b) and (c)
does not mean de of dying, heart failure, etc. It means ise, or compli- which caused
ions, if any, gave rise to cause (a), the under- i cause last.
elitions contrib- I death but not ) the terminal ondition given
1
:- Chapter 137, 1954. requires ians to print or the cause or of death on ertificates, and r 48, Acts of equires Physi- o print or type Inder signature.
)-928145
PLACE OF DEATH
No. 49 Bartlett Road
{if so specify WAR) No
(write the word)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
John C. Kelly
(Husband's name in full)
11 IF STILLBORN, enter that fact here. -
12
AGE
72 Years.
Months.
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
14 Industry
or Business :
Own home
15 Social Security No.
None
Last Boston
16 BIRTHPLACE (City)
(State or country)
Mass,
(PRINT OR TYPE SIGNATE)
0
Registered No.
(a) Residence. No.
(L'sual place of abode)
(If nonresident, give city or town and State)
(a)
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
TO
n
6
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance 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 frommescast 421961 AM related 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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting 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 occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, 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. Chil- dren 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.
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