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No. 4009145 Name DeVITO, John roCXLL rg 261 residing at 443 Washington Avenue Waterbury, Connec- ticut Age 48 years. Date of order of admission June 15, 1936 Date certificate issued June 15, 1936 by the Common Pleas Court at Waterbury, Connecticut Petition No. 7888 John (Complete and true Livit signature of holder)

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