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C
LUNACY ACT 1870
A "J.P."
53.Vict. c 5. Sect.335.
or Clerg7-
I Alfred Chaithan
being
en, residence
to be stated
Arxstant Curatt f
57 Kashwoord
SLATES FOR..
158
SChad
Hadwar Heath
Rad
Grodmayes Exp
hereby certify that I know the said
Walter Brett
Charles
and that I believe him or her to be unable by means
of mental disability, to manage his or her affairs,
and I further certify that I believe the family of the
said
Charles Walter Brecc-
to consist of Wife
DARID Gail & Pa Signed A Cheetham
(Place of abode)
191 7.
57 Eastwood Blad