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No. 3651494
Name GEORGE, Francis
residing at
R.F.: D. #2, Box 156, Shelton, Conn.
28
Age XNX years. Date of order of admission Feb. 6, 1934
Date certificate issued
February 6, 1934
by the
Superior
Court at
Bridgeport, Conn.
Petition No. 17654
Francis Know
(Complete and true signature of holder)
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Document identity
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