v2419-449
Harry Liitz, etc. vs. New England, etc.
(Plaintiff's Exhibit No. 27)
40^
MAR 2 1 1345
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When compleccd, iv to the Agmt or iruumif Prampllvio the Ccnenl Agent.
ulScicni, eoter additional dttaUi under Quesnoa 71 or fomrd bv letter and to uate under QueMion
Repon of Medical Examiner
la lectrf to Home Ottrir.
71 0KUL IMfWUATION
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*NOTEi Microscopic analysis by our Chemist is required when the insurance applied for. or togechcr with that in
fotc in thi Company, exceeds $30,000; when the Proposed Insured has passed his sixtieth birthday or is twentv-6ve per cent
or more over normal weight. The specific gravity of the ipecimen must be 1.015 or higher.
Chemise
In accordance with these requiremeno, a specimen h.TS been transmitted to
because of
liitlfKii Ajjcnt.
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