Translated from Polish:

Birth Record No. 1, Blizanów, Kalisz, Wielkopolskie, of Agnieszka Kucharzak, born in Janków on 29th December 1858, at 11 am, christened on 2nd January 1859, at 10 am, daughter of Wojciech Kucharzak, a tenant farmer, resident of Janków, 32 years old, and of his wife, Jadwiga, born Jędrusiak, 43 years old. Witnesses: Józef Dankowski, a tenant farmer, 36 years old, and Paweł Biczyński, a farmer, 60 years old, both from Janków. Godparents: Józef Dankowski and Ewa Woczok from Janków.