We the Minister and Church Warden
of the Parish and Parish Church of Saint
Andrew Holborn
Do hereby Certify That William Boutler< no role >
on Sunday the Thirteenth Day of September
did receive the Sacrament of the Words Supper in the Parish
Church aforesaid immediately after Divine Service and
Sermen according to the Usage of the Church of England
In Witness whereof we have hereunto subscribed our
Hands the said Thirteenth Day of Seper:
1778

Wm Lee< no role > Curate {Minister of the Parish and
Parish Church aforesaid

E [..] {Church Warden of the said
Parish and Parish Church

William Symons< no role > & William Warner< no role >
Do severally make Oath That they did see the said
William Boutter< no role > in the
above written Certificate named And who now present
hath delivered the same into this Court Receive the
Sacrament of the Words Supper in the Parish Church
aforesaid And that they diet see the said Certificate
subscribed by the said Minister and Church Warden

W.

Wm Symons< no role >
Willm. Warner< no role >