Physical description

Blue paper Memo A.O.F. Court King of the Forest No. 3770 dated Sep 16/1876. I hereby certify that Chas Lear of Victoria Hill is unable to follow his usual employment. Signed by ?. Signed at the end by Charles Lear declaring himself on the Sick Funds of the Court. Note at the end: Was injured Sep 7th & has not worked since that day.