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Form No. 6 —Pan American Sanitary Bureau, Washington, D. C. 
INTERNATIONAL CERTIFICATE OF VACCINATION 
Place... Washington,.. D. C. Date. January. .14.,. . 19 . 4.4 
This is to certify that.A» WstlllOr©.. 
Sex. .I&.Age. ; 57 . . .Color.... .W..Nativity USA. 
was on the dates indicated vaccinated against: 
(Cross out portions not applicable) 
XJK2CaSs£-Doses: jst ^ 2 nd . , 3 rd 
Smallpox—Rreaction: Immune .1.2y/^Xya4^i°id.Vaccinia ......... 
8t .2 nd ..Ref.. . 
Typhoid— RtLS/jl./. .2 nd . 1/7/443 rd .. ,l/l4/44 ef .. 
(Signature of person vaccinated) 
(Title) 
(Seal) 
