Szapsia Plotka

Held in Warsaw in the Office of the Civil Officer of non-Christian faiths of the Fourth District of Warsaw on July 22 (August 3), 1869, at 10 am. Jacob Ellengold and Nuhim Zhett (?), Servants of the Jewish hospital, the first 50 years of age, and the second 29 years old, both residing in Warsaw, appeared and announced that yesterday Shakespe Pliotka, 56 years old, had died in a Jewish hospital, (? - the word is not readable) the son of Mordka and the mother, declaring not known, a resident of the city of Brest, Wloclawski County, leaving ... a widower. By personal evidence of the death of Shapsa Pliotka, the present act has been read by the applicants and we have only signed it, because those who declare can not write.