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No. 4082031 Name LAVALLEE MARY ALICE residing at Moosup, Plainfield, Conn. Age 34 years. Date of order of admission Dec -8,1936 Date certificate issued December 8, 1936 by the Superior Court at Windham , Conn- Petition No. 2064 i Mary alice holder) Lavallee (Complete and true signature of

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Document identity
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Page context
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