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No. 5450589 Name FREDERICK, Mona Harriet residing at 5021 Niagara_§ St.. Ocean Beach, Calif Age 28 years. Date of order of admission June 12, 1942 Date certificate issued June a9th, 1942 by the Superior Court at San Diego, Calif Petition No. 8413 1873210 Monn Hamit Frederick (Complete and true signature of holder)