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1 hu.by certify tt,is to be . trw .nd oonea copr ot +r~e coal Q'
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' Registrar's rocwd on file in the Manin County HQaitfi O~par~• I""
: : S 1 U p~ T4~ ~ ment at Stuart, Fbride. ~1
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' z% ~ f' ~ ~ County Ftealth bepartme:~t is aff~xed.)
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. - . ' ~`~L~ N. D. MIItER, M. D. ~
r t; County Heaith Officer 3, loca! Re~istrar
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