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English translation:

It happened in Zaręby on the eighteenth of February, eighteen hundred and thirty seven at three o’clock in the afternoon. Appeared Aron Mordkowicz, grain trader, age twenty two, and Jankiel Abramowicz, day laborer, age twenty seven, both of whom residing in the village of Zaremby, [and] testified that on the sixteenth of the current month at three o’clock in the afternoon died Juszk Szymanowicz Tachna, age thirty, residing in Zaręby, earning his living from tailoring, leaving behind his widowed wife Dwrea Leybówna. After the undersigned had convinced himself with his own eyes about the death of Juszk Szymanowicz Tachna, this document was read to the witnesses, both the witnesses cannot write.