Translated from Polish:

Death Record No. 79, Konin, Evangelical-Augsburg Parish, of Jan Milbradt, who died in Nowy Czarków on 19th December 1929, death reported on 20th December 1929, he lived 82 years, he was born in Godowo, son of Gottlieb and Luiza, born Fenger, he was a permanent resident of gmina (District) Kramsk. At death he left his widowed wife, Matylda, born Fenior. Death reported by Ludwik Hennig, resident of Nowy Czarków, and Fryderyk Milbradt, resident of Wola Podłężna, both adults. Signatures of Ludwig Hennig and Friedrich Milbradt.