Reichs-Gesetbl. 
1899. 
— 257 — 
Ce. 
Sterbeurkunde. 
Nr. 
................................................................................ anI»»»»«»«»«»m»«««»«»»«»m»«»«»«».10 
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wohnhaftin...........·......·.........................·...............·............·..................·........·....·...·.......................··.................. 
undzeigtean,daß............................................................................·.....·......................·............·...............·. 
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wohnhaftin.................................................-...............................·...........·.......·....·...·............ ....................·...... 
geborcnzu..............................·......·.......·..·..........................................................................................................·. 
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dchahIcstausendneunhundert...............................·..........·....................·........................·...................... 
................................. nnttags um 1llu 
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(Siegel.)