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Passport ID: Court/Consulate Location: Passport Type: Application Number: Oath Date: Name: Immigrant ID: Age: years Birth Date: Birth Place: Occupation: Height: Eye Color / Hair Color: / Residence Address: Left Country: Other Relationship: Name: Immigrant ID: Occupation: Current Residence / Purpose: / Comments:bearer of passport 259 issued 10-May-1916 / signed: Leon Matteossian