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No. 5773894 Name HERRERA, Lupe C. residing at 306 Requa. Ave.., `Indio; Calif. Age 31 years. Date of order of admission January 15, 1943 Date certificate issued January 16, 1943 by the Superior Court at San Diego,-Calif Petition No. 9662-M , : L 33452 e Herrera (Complete and true signature of holder)