It happened in the town of Mlawa on the nineteenth day of November in the year eighteen hundred and ninety nine at ten o’clock in the morning. Judka Baumgold, age forty six, shop-keeper, and Boruch Goldsztejn, age thirty six, both of whom residing in the town of Mlawa, appeared and declared that yesterday at two o’clock in the afternoon Chana Laja [Channah Leah daughter of Moshe Tzvi] Tachna died in the town of Mlawa, age sixty two, daughter of the married couple Cytryn (Citrin), Moszek Hersz [Moshe Tzvi] and Rywka [Rivke], leaving behind her widowed husband Icek Jankief [Yitzhak Yakov son of Yehudah Ha-Levy], age sixty eight.  After having convinced ourselves with our own eyes about the death of Chana Laja Tachna, this document was read to the testifiers, signed by us and them.