It happened in the town of Mlawa on the ninth day of December in the year nineteen hundred and five at ten o’clock in the morning.  Chil [Yechiel (Hillel) son of Shmuel Yitzhak] Szrenski, age twenty, tradesman, residing in the town of Mlawa, appeared in the presence of the witnesses Zoruch Mlawski, age fifty three, and Josek Asz, age forty three, both of whom synagogue sextons residing in the town of Mlawa, and showed us a child of the male gender, declaring that it was born in the town of Mlawa on the second of December of the current year at eight o’clock in the morning to his wedded wife Merka née Czarna, age twenty.  The child was given the name Samuil [Shmuel son of Yechiel (Hillel)].  This document was read to the testifier and the witnesses, signed by us and them, the father of the child cannot write.  Holder of the Civil Registry records, the Mayor of the Town of Mlawa.