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No. 5435820
Name
LeBLANC, Louise
residing at
45 Stuart Avenue, Norwalk, Conn.
Age 37
years. Date of order of admission
January 15, 1942
Date certificate issued
January 15, 1942
by the
Superior
Court at Bridgeport, Conn.
Petition No.
26383
Loveirse LeBlane
(Complete and true signature of holder)
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Document identity
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