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No. 5378614
Name TICHON, Anna
residing at 26 Main St., Terryville, Connecticut
Age 54 years. Date of order of admission May 18th, 1943
Date certificate issued
May 18th, 1943
by the
Superior
Court at
Winsted, Connecticut.
Petition No. 5369
ama Jichoan
(Complete and true signature of holder)
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Context sent to Scholar
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