Translated from Russian:

Death Record No. 99, Konin, Evangelical-Augsburg Parish, of Emilia Lorentz, born Busse, who died in Święte on the 22nd July 1895, death reported on the 22nd July 1895, she lived 37 years, she was daughter of a deceased farmer, Andreas Busse, and of his deceased wife, Henrietta, born Milbradt. At death she left her widowed husband, Ludwik Lorentz and two children. Death reported by Ludwik Lorentz, 31 years old, and Adam Lauf, 30 years old, laborers living in Święte. Signatures of Ludwik Lorentz and Adam Lauf.