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No. 4544892 Name SMITH, Ida Gertrude residing at 321 Beechmont Avenue, Bridgeport, Conn Age 43 years. Date of order of admission May 3,1939 Date certificate issued May 3. 1939 by the Superior Court at Bridgeport, Connecticut Petition No. 21879 x Ida G Smith (Complete and true signature of holder)

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Document identity
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