Single page 7" x 4 ½", front only. The release form states that Tifon Chernov is released from active duty for one month for medical reasons, and must appear in the Korochansky Military Commissariat in one month, on 27 April 1919, for a medial evaluation. The form is hand-signed by the Korochansk District Military Commissar and Chief of the Mobilization Department, and is dated 27 March 1919.

In very good condition. Part of the left margin is missing, probably torn off when the form was removed from the file. However, the missing part does not obscure the meaning of the text. The paper is slightly wrinkled. Looking at the verso, it is evident that the form was carried folded in four, and the outer side got mildly soiled. All the printed and handwritten wording is crisp and perfectly legible.

Please note that the pen in our photo is for size reference.