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No. 4847669 rolxLIX ng225 Name ZDANIS, Frank Decl XXX Rg 216 residing at 51 Drayer Avenue, Waterbury, Connec- /ticut Age 79 years. Date of order of admission May 15, 1940 Date certificate issued May 15, 1940 by the Common Pleas Court at Waterbury, Connecticut Petition No. 10075 oranis Belanis (Complete and true signature of holder)

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Document identity
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