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No. 5090538 Name GAEWSKY, Czeslawa residing at 4433 Main Street, Bridgeport, Conn. Age 51 years. Date of order of admission January 13, 1942 Date certificate issued January 13, 1942 by the Superior Court at Bridgeport, Conn. Petition No. 25745 Creslawa Goewky Registration No. 484264Complete and true signature of holder)

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