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No. 5090462
Name
CAMPBELL, David Strachan
residing at
10 Merrell Avenue, Stamford, Conn.
Age 34
years. Date of order of admission January 13,-1942
Date certificate issued
January 13, 1942
by the
Superi or
Court at Bridgeport, Conn.
Petition No. 25538
David Alrachan Bamhbell
(Complete and true signature of holder)
Registration No.
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Document identity
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