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No. 5090256 Name FITZ, Marie residing at 194 Orchard Street, Bridgeport, Conn. Age 31 years. Date of order of admission Sept. 17, 1941 Date certificate issued September 17, 1941 by the Superior Court at Bridgeport, Conn. Petition No. 25222 V Marie (Complete fitz true Registration No. 3997031 and signature of holder)

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