It happened in the town of Mlawa on the fifteenth of August, eighteen hundred and sixty seven at nine o’clock in the morning. Iciek Jankiel Tachna, age thirty four, trader residing in the town of Mlawa, appeared in the presence of the witnesses Lewin Szmulowicz Lando, age seventy seven, and Zelman Niborski, age fifty four, both of whom synagogue sextons residing in the town of Mlawa, and showed us a child of female gender that was born here in Mlawa on the first day of the current month and year at four o’clock in the morning to his wife Chana Laja née Cytryn, age thirty. This child was given the name Sura. This document was read aloud to the declarant and the witnesses and signed by the witnesses, whereas the father of the child cannot write. ╒ [in the margin] the father of the child cannot write.

The Holder of the Civil Records               illegible

Lewin S. Lando