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No. 5090310
Name SMITH, Agnes Maud
residing at
372 Remington Street, Bridgeport, Conn.
Age 52
years. Date of order of admission Sept. 17,1941
Date certificate issued September 17, 1941
by the
Superior
Court at Bridgeport, Conn.
Petition No. 25418
agnes mand $milt
(Complete and true signature of holder)
Registration No. 1093544
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Document identity
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Page context
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