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No. 7059900 Name LEKSELL, Anna Mary residing at 2966. Boston Aves, San Diego, Cal. Date of birth 2/17/02 Date of order of admission 1/16/53 Date certificate issued January 19,1953 by the Superi or Court at San Diego, Calif. Petition No. 17268 Alien Registration No. 6427805 anna mary Leksell (Complete and true signature of holder)