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