HomeMy WebLinkAboutCHONKO_HELEN_4852874No.4852874
Narne C1iONJ[O_.~ll _
residing aL_J.J.J'~.~~.k;1.n3_)~·~en.\.u~_~J~Qn.Qr_a.,_J:)a.L _
Age .3.9 years.Date of order of admission_Sep..t.ember_.26-,.-1.9-40
Date certificate issued Sep.t.ember_26~_~94n by the
__.flomm.on--Pleas Court aL __Washi ngt-on.~_Ea.._
Pe';';on NO._-!b661--~/'l J..~~
---~~~--------------------------------(Complete and true signature of holder)