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[[preprinted]]
Sick Certificate of The Blandensburg Union.
[[line]]

City or Town: ^[[Wash]]
State: ^[[DC]]
Month: ^[[Feb]]
Date: ^[[14]]
Year: ^[[1923?]]

This certifies that ^[[Clarence M[[?]] ]] is sick with  ^[[Bronchitis & Debility]] and under my professional care.

^[[ [[A R [[?]] ]], M.D.

Was taken ^[[Feb 8, 1923]]

^[[W.R. Davis]] Chairman of the Sick.
[[/preprinted]]