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No. 7234517 SIKORA, Veronika Name 131 Wolcott Ave. Torrington, Conn. residing at Mar 29 1906 Date of birth Date of order of admission June 17 1955 Date certificate issued June 17th, 1955 by the Superior Court at Winsted, Connecticut Petition No. 6799 A7 237 075 Alien Registration No. Veraniko Sikova (Complete and true signature of holder)

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