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No. 4804453 Name FALLON, Anna residing at 193 Winthrop St., Torrington, Conn. Age 35 years. Date of order of admission January 14, 1941 Date certificate issued January 14, 1941 by the Superior Court at Winsted, Connecticut Petition No. 4345 Conn. A R No. 1518890 ama I allow (Complete and true signature of holder)

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