Anti-Plague Inoculation Certificate.
Na.................................. of      190 . ................................ District.
Name                        
Father's or
husband's
name
Caste
Sex
Age
State of Health
Residence.     (In
large towns note
street or mohalla).
If  previously inoculated
date    place
and     number    of
inoculation   certiticate

Inoculated this day Date
Place
Date  c. c.
Number of brew
Left thumb Mark
Inoculating Medical Officer.
Keep this certificate carefully
and show it when  you are
again inoculated.
Salam  Press.-Jullandur