Translated from Polish:

Death Record No. 43, Tłokinia Parish, Kalisz, Wielkopolskie, Poland, of Julianna Kura, an infant who died in Tłokinia on 28th July 1864 at 8 am, death reported on 30th July 1864 at 8 am. She lived one and a half years, she was born in Nędzerzew and lived in Tłokinia, she was daughter of Jan and of her deceased mother, Agnieszka, married couple Kura, tenant farmers in Tłokinia. Death reported by Jan Kura, father of the deceased, 46 years old, resident of Tłokinia, and Piotr Piątkiewicz, 70 years old, both tenant farmers living in Tłokinia.