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No. 5090386 Name MELODIE, Theodore residing at 199 Federal Street, Bridgeport, Conn. Age 33 years. Date of order of admission Nov .12,1941 Date certificate issued November 12, 1941 by the Superior Court at Bridgeport, Conn. Petition No. 25120 Theodore melodie (Complete and true signature of holder) Registration No.1317231

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