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VolXL 152
No. 4008767
Name TERENZI, Mary Dect XXVII Pg134
residing at 38 Hill Street, Waterbury, Connecticut
Age 35
years. Date of order of admission September 16,1935
Date certificate issued
September 16, 1935
by the
Common Pleas
Court at Waterbury, Connecticut
Petition No. 7492
Mary Tereny
(Complete and true signature of holder)
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Document identity
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