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[[preprinted]]
Sick Certificate of the Bladensburg Union.

City or Town: ^[[Wash]]
State: ^[[D.C.]]
Month: ^[[Oct]]
Date: ^[[2]]
Year: ^[[1931]]

This certifies that ^[[ [[strikethrough]] [[?]] [[/strikethrough]] Lizzie Gant]] is sick with ^[[acute neuritis neurasthenia]], and under my professional care.

^[[Hamilton T Martin]], M.D.
[[double line]]

Chairman of Sick ^[[Sept. 30, 1931]]

Was Taken ^[[^Walter R. Davis.]]
[[/preprinted]]

Transcription Notes:
Seriously, the information is all there and presented as the form is printed. Why would anyone just change to suit their version of what is appropriate??? I don't understand!!