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No. 5197497 Name BALCZIUN, Frances residing at 122 Roath St., Norwich, Connecticut Age 57 years. Date of order of admission Dec. 8, 1942 Date certificate issued December 8, 1942 by the Superior Court at Norwich, Connecticut Petition No. 6944 Frances Balcziun (Complete and true signature of holder)

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Document identity
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Page context
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