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This is to certify
That[groom]
of [groom's birthplace]
and [bride]
of [bride's birthplace]
Were by me
United in Marriage
according to the Ordinance of God and the
Laws of the State of[state]
at [city & state of ceremony location]
on the [day] Day
of [month] in the year of our Lord [year]
What therefore God hath joined
together, let no man put asunder
Witnesses
