Translated from Polish:

Birth Record No. 10, Blizanów Parish, Kalisz, Wielkopolska, Poland, of Franciszka Bociańska, born in Żerniki on 17th February 1859, at 11 pm, christened on 20th February 1859, at 10 am, daughter of Maciej Bociański, a steward, 46 years old, living in Żerniki, and of his wife, Marianna, born Maćkowska, or Maćliak, 30 years old. Witnesses: Wojciech Szurmiński, a farmer from Kurza, 39 years old, and Stanisław Kudsak, a tenant farmer from Żerniki. Godparents: the above-mentioned Wojciech Szurmiński and Małgorzata Żukowska from Żerniki.