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No. 4804443 Name GOTTSCHALL, Betty residing at 43 School St., Torrington, Conn. Age 40 years. Date of order of admission January 14th, 1941 Date certificate issued January 14th, 1941 by the Superior Court at Winsted, Connecticut Petition No. 4485 A.R.No 5118505 & Betty (Complete Johns true signature of lb holder)

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