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No. 5078987 Name LAJOIE, Leontine residing at R.F.D. #1, Danielson, Connecticut Age 33 years. Date of order of admission May 13, 1941 Date certificate issued May 13, 1941 by the Superior Court at Putnam, Connecticut Petition No. 2936 Loutine Lajoie (Complete and true signature of holder)

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Document identity
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