By the time the doctor arrived, the patient ______ .

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A died
B had died
C has died
D was dying

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Answer: B. had died

Answer: B. had died
Explanation: In a sentence with two past actions, the earlier action (patient dying) takes the Past Perfect (had + V3) and the later action (doctor arrived) takes the Simple Past.

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By the time the doctor arrived, the patient ______ .

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