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[[preprinted]] Application - Bladensburg Union. City or Town: ^[[Hyattsville]] State: ^[[Md.]] Month: ^[[9]] Date: ^[[9]] Year: ^[[1935]] I hereby make application for admission into the Bladensburg Union. Age last birthday ^[[48]] years ^[[Priscilla Johnson]] Name of applicant [[double line]] This certifies that the above-named applicant is in reasonably good health. ^[[H. T. Willis]], M. D. [[/preprinted]]