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No. 5378282
Name Mary Stanulis Mary Stanulis
residing at Box 448, Kellogg Ave., Terryville, Conn.
Age 37 years. Date of order of admission December 15th, 1942
Date certificate issued
December 15th, 1942
by the
Superior
Court at
Winsted, Connecticut.
Petition No. 4911
Mary (Complete Standir and true signature of holder)
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