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No. 3806415 Name DALE, John Walter residing at 205 Black Rock Avenue, Bridgeport, Ct. Age 53 years. Date of order of admission Sept. 18, 1934 Date certificate issued September 18, 2 1934 by the Superior Court at Bridgeport, Connecticut Petition No. 17963 John Walled Dade (Complete and true signature of holder)

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Document identity
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