COPY.

1.

CO

43162

Received

Red || DEC 07 I, Ella Loder, wife of Frederick William

15

Loder now in the Hongkong Asylum, hereby declare that I have no

objection to the said Frederick William Loder being sent to

England.

2.

I am not in a position to contribute towards

his maintenance.

(Ella Loder.

In the presence of

(sd.) Chas. H. Godfrey.

Shanghai, 18th October, 1907.

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