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No. 5435994 Name LACHANCE, Antoinette residing at 360 Hanover Street, Bridgeport, Conn. Age 49 years. Date of order of admission March 10, 1942 Date certificate issued March 10, 1942 by the Superior Court at Bridgeport, Conn. Petition No. 26578 Lachanee (Complete and true signature of holder)

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