HomeMy WebLinkAboutBORKOWSKI_ANNA_4289169No.4289169
Nam BORKOWSKI,ANNAe _
Age_A~years.Date of order of admission __~~~~_?::7l,:_l.9 3.8 _
Date certificate issued ?~~_e:_~7J __~9.~~by the
__9_~~C?~_~_~~_~~Court aL __'!§l._~~~~g~9_l?__J_~!'_~~_
Petition No ..3J5~_4 C!l ()p'.
---~~----~--------------(Complete and true signature of holder)