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No. 6063101
Name TOMASIELLO, Lucy
Vol 61 Pg 242
residing at 77 Walnut Street, Ext., Waterbury, Connecti-
cut
Age 52 years. Date of order of admission January 19, 1944
Date certificate issued January 19, 1944
by the
Superior Court at
Waterbury, Connecticut
Petition No. 1242
Suiva (Complete and Tombasiello true signature of holder)
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Document identity
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