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No. 6782605 Name Gagne, Germaine residing at RFD #2, Winsted, Conn. Date of birth Aug 21 of order of admission June 17, 1948 Date certificate issued June 17th, 1948 by the Superior Court at Winsted, Conn. Petition No. 6214 Alien Registration No. 7506603 Germaine G agre (Complete and true signature of holder)

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Document identity
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