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No. 4454674
Name SERNA, Anne
residing at 70 Alexander Street, Greenwich, Conn.
Age 44 years. Date of order of admission Sept 22, 1938
Date certificate issued
Sept. 22, 1938
by the
Superior
Court at
Stamford, Connecticut
Petition No.
21209
x
anne Serva
(Complete and true signature of holder)
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Document identity
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