Document in Russian dated August 15, 1916. Says "Certification" across the top in Russian. Maria studied art in Russia but this could be a nursing or medical care related certificate. Mentions a person with the name Anna Arturonvna Bätge (rendered БЕТГЕ in Cyrillic) This would be a daughter to Arthur Ernest Bätge, and sister to Maria Loewenstein. It refers to the period April 1915 to January 1916, and was issued from a difficult to decipher named evacuation hospital no. 131.