HomeMy WebLinkAboutBACHNA_LENHART_3925653No.3925653
Name J!~9J~~AJ J.._~_IJ~J!'!'_
residing aL :L_~eJ'_!].~_t~:ttrL~j[~~_,__G.Q..nQn.~J:21J.rE.,,_J.>AL _
Age 1:_~__~s.Date of order of admission Apr_il_J3.tlJ..,,__19~5
Date certificate issued ltPr_~J-__fJ tJJ.-,__;L_~J2 by the
____9_~I!1P.!?~_?J~_~~Court aL WC!~_l}tng~_C?PJ._R?_._
Pet;';on No.JX"1Q;l.-y-;r::fJ
-----~--/J-~-~----------(Complete and true signature of holder>