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No. 4356560 Name METIVIER PHILEMON residing at 46 Maple Ave. 2 Willimantic, Conn. Age 31XX years. Date of order of admission Dec. 14, 1937 Date certificate issued Dec. 14, 1937 by the Superior Court at Windham, Conn. Petition No. 2201 Philaron (Complete meterior and true of signature holder)

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