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No. 6148272 Name BELLIVEAU, Mary Ethelle residing at 145 Otrobando Ave., Norwich, Conn. Age 25 years. Date of order of admission Dec. 19,1944 Date certificate issued December 19, 1944 by the Superior Court at New London, Conn. Petition No. 7976 many (Complete Echeble and true signature Belline ace of holder)

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