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No. 8573342 Name BERNIER, Leo Alphege 139 residing at Chestnut Sto, Norwich, Conn. Date of birth 10/9/1909 Date of order of admission June 24,200 1965 Date certificate issued June 24, 1965 by the Superior Court at New London, Conn. Petition No. 10945 Alien No. A4 771 546 Registration Leo (COMPLETE alphege AND TRUE SIGNATURE Berncer OF HOLDER)

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