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No. 7029005 Name ORSTROM. Emma residing at 3333 - 42nd St. San Diego, Calif Date of birth 2/4/12 Date of order of admission 12/21/51 Date certificate issued December 31, 1951 by the Superior Court at San Diego, Calif. Petition No. 16177 Alien Registration No. 6351331 bmma Onstran (Complete and true signature of holder)