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No. 7234472 Name CHARDENET, Leontine Marie residing at 43 So. Hi ghland St., West Hartford, Conn. Date of birth Jun 10 1903 Date of order of admission Mar. 11, 1955 Date certificate issued March 11th, 1955 by the Superior Court at Winsted, Connecticut Petition No. 6754 Alien Registration No. 1,464 035 464 035 Leontine Marie Chardene (Complete and true signature of holder)

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