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No. 4082015
Name MACLURE DIEUDONNE
residing at 1153 Main St., Willimantic, Windham, Conn.
Age 32 years. Date of order of admission
Dec.8,1936
Date certificate issued
December 8, 1936
by the
Conn.
Superior
Court
at Windham @@@@@@
Petition No.
2038
(Complete and true signature of holder)
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