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HomeMy WebLinkAboutCERILLI_CATALDINA_5030160A.R.R.NO.4132176 No.5030160 Name ---CERILL.I,--Cata.ld1n&----------------------------- residing aL R._.D,__#__2-._Bur.ge_tt.s.t.mm.,_-fa.._ Age_.3.2 years.Date of order of admission -&lune __23.,_--l9.4~_ Date certificate issued -June.-_2..3.,__1.94~by the .G.ommon_.Fl.eas.Court aL Wash1ng~_P....a....._ Petition No._-50£6 _ .~~~----~~------------------(Complete and true signature of holder)