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No. 6063104 vol64pg35 Name DOUCETTE, Joseph Decl XXXXII rg 409 residing at 596 South Main Street, Waterbury, Connecti- cut Age 70 years. Date of order of admission January 19, 1944 Date certificate issued January 19, 1944 by the Superior Court at Waterbury, Connecticut Petition No. 1785 Joylah (Complete and true signature of holder)

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