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OCR Page 1 of 2No. 6382519
Name
ITEN, Lena
residing at Aloha St.. Box 8, Palm City, Calif.
Age 57 years. Date of order of admission August 2, 19:4
Date
certificate issued August 3.1944
by the
Super ior
Court at San Diego, California
Petition No. 11451
Lenaten
(Complete and true signature of holder)