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No. 5089881
Name MUDRIK, Mary
residing at 268 Church Street, Bridgeport, Conn.
Age 46 years. Date of order of admission May 8, 1941
Date certificate issued
May 8, 1941
by the
Superior
Court at
Bridgeport, Conn.
Petition No. 24930
Jman
many Insdrik
Complete and true signature of holder)
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Document identity
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