Page:United States Statutes at Large Volume 59 Part 2.djvu/353

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59 STAT.] MULTILATERAL-SANITARY AERIAL NAVIGATION-JAN . 5, 1945 International Sanitary Convention for Aerial Navigation, 1944 INTERNATIONAL CERTIFICATE OF INOCULATION AGAINST TYPHUS FEVER THIS IS TO CERTIFY THAT_ (Age Sex- ) whose signature appears below was on the dates indicated inoculated against typhus fever. Date Material Origin Batch No. and Type Inoculating Officer Signature (Signature of person inoculated) Official Title (Home address) (Date) Official Stamp of Inoculating Officer (This certificate is not valid for more than 1 year from date of issue.) 1019