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Physician's Statement of Examination of Applicant for Marriage License (2) |
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Physician's Statement of Examination of Applicant for Marriage License |
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Physician's Statement of Examination of Applicant for Marriage License (2). |
This is to certify that I, Aaron Burman M.D. am a duly licensed physician of the State of New York and do hereby make the following statement pursuant to Section 13-a of the Domestic Relations Law of the State of New York:
Upon the basis of a complement fixation test for syphilis, upon a specimen taken on April 8, 1949 reported by Bureau of Laboratories Dept of Health of 766 Irving Avenue Syracuse, NY under the date of April 11, 1949 and a physical examination performed by me on April 8th, 1949, it is my opinion that Jack Richards of Irish Hotel, North Syracuse, NY whose signature appears below, is not infected with syphilis in a communicable stage. signed Aaron Burman M.D. 537 E. Genessee St.
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