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English translation:

It happened in Zaręby on the seventeenth of March, eighteen hundred and thirty seven at ten o’clock in the morning. Appeared the Jews Peysak Waygord, synagogue sexton, age seventy one, [and] Simsio Ruskołęker, miller, age sixty one, both of whom residing in the village of Zaręby, [and] testified that on the fifteenth of the current month at ten o’clock in the morning died Judka Michlowicz Tachno, age sixty one, resident of the village of Smolewo who had come to the village of Zaręby for alms, widower. After the undersigned had convinced himself with his own eyes about the death of Judka Michlowicz Tachno, this document was read to the witnesses and signed by Simsio Ruskołęker, whereas the second witness cannot write.