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No. 7060623 Name FONG, Helen Hui Shuk residing at 167 Euclid Ave., San Diego, Calif. Date of birth 3/1/19 Date of order of admission 11/21/52 Date certificate issued N ovember 26, 1952 by the Superior Court at San Diego, California Petition No. 16806 Alien Registration No. 6855789 Helen Her shok 70mg (Complete and true signature of holder)