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English translation:

It happened in Zareby on the third of January, eighteen hundred and thirty eight at four o’clock in the afternoon. The Jews Peysak Waygord, synagogue sexton, age seventy two, and Abraam Szwab, tailor, age thirty six, both of whom residing in the village of Zareby, appeared and testified that on the first day of the current month at six o’clock in the morning died Gitla, nine weeks old, daughter of Leybka Judkowicz and Cipa Szaykówna [bat Szajka] married couple Blumenfelt, residing in the village of Zareby and earning their living with tailoring. After having convinced ourselves with our own eyes about the death of Gitla, this document was read to the witnesses who appeared. Both the witnesses cannot write.