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No. 4186051 Name COTA, RITA ARBALLO residing at Rt#1, Box 23, El Cajon, Calif. Age 40 years. Date of order of admission Dec. 18 1936 Dec. 21 1936 Date certificate issued by the Superior San Diego, California Court at 5033 Petition No. Rita Arballo Cota (Complete and true signature of holder)