Translated from Polish:

Death Record No. 21, Tłokinia parish, Kalisz, of Urszula Tataś, born Sobek, who died in Kolonia Nowa on 18th March 1850, at 4 pm, death reported on 20th March 1850, at 6 pm, she was 70 years old, a widow, living with her daughter, Antonina Kurowa (wife of Kura), a housewife in Kolonia Nowa. She was born in Godziesze Wielkie, daughter of Sebastian and Maryanna, married couple Sobek, already deceased. Death reported by Hilary Olejnik, 72 years old, and Wojciech Chołys, 33 years old, both tenant farmers in Kolonia Nowa. After confirming with my own eyes the death of Tatasiowa (wife of Tataś), this record was read and signed.