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No. 8821155
Name DIEM, Jeanne Marie Vol.83, Pg.319
residing at 155 Citizens Avenue, Waterbury, Conn.
Date of birth Nov.6,1911 Date of order of admission.,NOV. 15, 1966
Date certificate issued November 15, 1966
by the
SUPERIOR
Court at WATERBURY, CONNECTICUT
Petition No. 7533
Alien Registration No.A8 621 802
Geanne (COMPLETE Marie AND TRUE SIGNATURE Diam OF HOLDER)
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