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No. 4723190 Name D'AGOSTINO, Giuseppe VOCXLIX ng92 rg 92 Declxxix P9504 residing at 80 Hamden Avenue, Waterbury, Conn. Age 48 years. Date of order of admission January 15, 1940 Date certificate issued January 15, 1940 by the Common Pleas Court at Waterbury, Connecticut Petition No. 9942 gusepher (Complete and D'tyortine true signature of holder)

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Document identity
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