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No. 4356556 Name METIVIER CLEMENT residing at 46 Maple Ave., Willimantic, Conn. Age 27 years. Date of order of admission Dec. 14, 1937 Date certificate issued Dec. 14, 1937 by the Superior Court at Windham, Conn. Petition No. 2198 Clement Matwier (Complete and true signature of holder)

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