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No. 3462673
Name BETTLES Jean Johnston
residing at
159 State St., New London, Conn.
Age 39
years. Date of order of admission
May 19, 1931
Date certificate issued
July 1. 1931
by the
Superior
Court at
Norwich, Conn.
Petition No. 3702
Jean (Complete Johnston and signature of holder) Bettles
true
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Document identity
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