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NARA 745

on or about the 16th day of September 1867. 
Witnesses
John A Burney, Constable
J.H. Bryan, Citizen. 

[[stamp]] The National Archives of the United States [[/stamp]]

[[stamp]] Rec'd Dep't of the South NOV 3 1867 [[/stamp]]

R.T. Frank
Bvt Lt Col and Capt 8th Infy
Comdg Post