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No. 6816671
Name DESRUISSEAUX, Marie Valvina vol 74Pg163
residing at
149 South Elm Street, Waterbury, Connecticu
Date of birth May 6, 1901 Date of order of admission Jan. 18, 1950
Date certificate issued January 18,1950
by the
Superior Court at Waterbury, Connecticut
Petition No. 4413
Alien Registration No. 3081143
marie In aloina Decruisseary
(Complete and true signature of holder)
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Document identity
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