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%foo = (
  11 =>{ 4 => 'Four' },  
...
               keys %$ref_HoH ) {
...
}

use strict;
use warnings;
...
for my $k ( sort { $a <=> $b } keys %$ref_HoH ) {
   print "$k\n";
}

hf@flux[30] perl /tmp/testit
2
11
33