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No. 4804562
Name TESTA, Salvatore
residing at Valley View, Norfolk, Connecticut
Age 34
years. Date of order of admission January 15, 1941
Date certificate issued January 15, 1941
by the
Superior
Court at Winsted, Connecticut
Petition No. 4441
AR No.
1306850
Salvatore Testa
(Complete and true signature of holder)
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