This image is a bit light due to age. Â Text (typos and all) on it says:
“This is to confimr that on August 19, 1983 you were offered placement of a male child born August 14, 1983 and that you declined this placement indicating that from this point on you would like to be considered only for placement of a fe-male child.
We will adjust our records to reflect this preference”
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