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

City or Town: ^[[Wash]]
State: ^[[DC.]]
Month: ^[[12]]
Date: ^[[26]]
Year: ^[[25]]

This certifies that ^[[Betty Davis]] is sick with ^[[La Grippe]], and under my professional care. 

^[[S. LePoint Took]], M.D.

Was taken ^[[Dec. 1st 1925]]

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