Gratis : Si partono da questa magnifica città, (per la DIO gratia), libera d'ogni sospetto di mal contagioso; l'infrascritti ... per andar a ... anni statura pelo, anni statura pelo, anni statura pelo con suoi arnesi ... veronae ex Offic. Sanitatis die ... mensis ... anni ... / Provisores Sanitatis Veronae.

Health pass (fede di sanità) issued by the Verona health authorities enabling the bearer to pass freely despite there being quarantines and heavy restrictions on travel due to plague. There is a woodcut at the top of the sheet in the centre of the text of a man with a staff, halo holding an ornate (shield?) with a cross in an oval on it. Details of the person concerned would be entered by hand in the spaces provided, along with height, weight and age.