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No. 5090461
Name
RIESEN, Bertha
residing at
Dublin Road, Greenwich, Conn.
Age 44 years. Date of order of admission January 13, 1942
Date certificate issued
January 13, 1942
by the
Superior
Court at
Bridgeport, Conn.
Petition No. 25277
V
Mather Rieren
Registrati on No.1115303 (Complete and true signature of holder)
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Document identity
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