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5755776 No. Name WILLARD, Marian Stoen residing at 3233 Ocean Front, Mi ssión Beach, Calif. Age 48 years. Date of order of admission Aug. 21, 1942 Date certificate issued August 31, 1942 by the Superior Court at San Diego, California Petition No. 8648 Marian 2345788 Story Willard (Complete and true signature of holder)