It took place in the city of Mława on May the fourteenth, nineteen hundred and two, at three o’clock in the afternoon. Zeruch Młaceski, age fifty years old, and Wułek Wileski, age sixty five years old, both residing in the city of Mława, have appeared testifying that Frymeta Gitla Jabłoń, a widow, age sixty two years old, daughter of Wułek Jakob Tachna and Mindla, passed away yesterday at noon.  We have confirmed the death of Frymeta Gitla Jabłoń.  This document was read to the testifiers and signed by us and them.

 Clerk of the Civil Registry Office – signature