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No. 6051317 Name TOMASCHYK, Demetry residing at 20 Burton St., Watertown, Conn. Age 56 years. Date of order of admission December 21, 1943 Date certificate issued December 21, 1943 by the Superior Court at Winsted, Connecticut. Petition No. 5437 Demetry Tomaschyk (Complete and true signature of holder)

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