3 
-'.'©ware, A.1W 
strap left aide, Injured rib b 
<ejr 
of T0. 
b&Mi ' - 
'>vm 'Bear” of Baraau of Hiolo 
*5* 
■.u,? 
X-myi 
j #f <$*- 
L 'it* w 
Y<®5 
no tiapea. 
;.u: USt 27 . IS 
fiei ?jji 
sy "r. C. . 
at rsr.vmmt 
S3 X.l-i 
ttm 
i 
St 
a ms re -mi rod of 
aplojred on the vessels o 
f 
A - 
* a* 
! tw 
% 
m 
rape rarioTed fr 
:© by 
doctor at Ketchikan, A 
3 . Previzm injury of 
Be 
no 
aboro, I 
obtained ,3. 
for use in read ins. bon I 
•mime 
-mg’ 
fs ,,w 
, prior to beoomlnr employed on the 
Tea 
ft 
doctor found no trouble with my 
S3 
I certify that 
foregoing 
If. 
sge and 
to*. a 
ub scribed and tWBrti to before sx© 
day of 
A.D 
* « 
vemtowm 
