English Translation

18a odV Assignment For consideration! According to § 14 paragraph 5 of the General Conditions of Employment (insert receipts) the collected documents are transferred to the property of Werein. A subsequent submission is not applicable. Copies for requests for emergency assistance, Stener-reduction-antrge etc. we ask you to prepare the submission yourself. Zarif. The cost was borne by supporting documents in the single unit No. RM #6 RM IIA Health assistance: (but not hospital treatment, see below for B) Medical treatment Arzueien and Verbandmittel c t aed dee ge c Argueikosten-Refund by the district administration eaaig @umme Cumme 5 100 0 4 2.— 08900 8 inferberung Sungipz 75/80 % 2 0 X-ray, light, hot air and other curative treatment medicinal baths (carbonic acid, oxygen, steam, bog, mud, sol, etc.) Baths) Health Transhort Health care for days . . . Drthobic aids . .. Goggles and gnaws . . B Hospital treatment: Food class Dispensing for zage each _ RM Doctor's costs Medicines and associations Other costs Dental treatment: 1. Artificial teeth. Individually. 2. Culinary leaves . . ensol stellug on 3. Crowns or pen teeth . . all Rickiele 135 4. Clamps, feathers, spring carriers -2085 band .des. Support: 5. bridged teeth . lung 6. Tooth or root pulling 135 7. - Tooth seals . . D weekly help (add birth certificate) E p tariff (add death certificate). Cause of death: Z hospital daily allowance for days of each R.M weekly allowance. 135 sum Bv a d d a d