Page:United States Statutes at Large Volume 59 Part 2.djvu/309

 SCHEDULE TO THE DECLARATION Particulars of every case of illness or death occurring on board Class or Rating Age Sex Nationality Port of Embar- kation Date of Embar- kation Nature of Illness "State whether still on board; landed at (give name of port); buried at sea. Name Date of its Onset Results of Illness* Disposal of Case" P an -- - - . - I - I I
 * State whether recovered: still ill; died.

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