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No. 7571679 Name DANISAVAGE,-Constance VOL-79,Pg,Pg.260 residing at 361 Highland Avenue, Waterbury, Conn, Date of birthMay 21, 1901 Date of order of admissioNov.20,1958 Date certificate issued November 20, 1958 by the SUPERIOR Court at WATERBURY, CONNECTICUT Petition No. 6160 Alien Registration No. 5-831-005 /Go mstance Demorage (Complete and true signature of holder)

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Document identity
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