v2419-449

Document Title Page

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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