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No. 4454330
Name AVON, Edward Richard
residing at 1358 Huntington Turnpike, Nichols Ct.
Age 26 years. Date of order of admission May 4, 1938
Date certificate issued
May 4, 1938
by the
Superior
Court at Bridgeport, Connecticut
Petition No.
20898
Edward Richard Dwo
(Complete and true signature of holder)
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