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

City or Town: ^[[Wash]]
State: ^[[DC]]
Month: ^[[ March]]
Date: ^[[21]]
Year: ^[[26]]

This certifies that ^[[Harriet Moss]] is sick with ^[[Nephritis]], and under my professional care.

^[[Marie B Lucas]], M.D.

Was taken ^[[March - 16th.]]

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