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No. 5378234 Name Goodwin, Simone residing at RFD #1, New Hartford, Conn. Age 23 years. Date of order of admission December 15th, 1942 Date certificate issued December 15th, 1942 by the Superior Court at Winsted, Connecticut. Petition No. 5026 chemome 402649 G rodwin (Complete and true signature of holder)

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Document identity
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