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No. 5089903 Name GACIOCH, Josef residing at 180 Franklin Street. New Haven Conn. Age 46 years. Date of order of admission Sept, 16, 1941 Date certificate issued September 16, 1941 by the Superior Court at Bridgeport, Conn. Petition No. 21100 yo welf gacia ch Registration No. 5223305 (Complete and true signature of holder)

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