Queries required by the directors of the Palladium Life Assurance Society to be put by their medical examiner to a party whose life is proposed for assurance ... : queries to be answered by the official medical examiner of the society in relation to the proposed assurance on the life of.

Life insurance questionnaire completed (in this case) on 18 and 20 June 1846 with regard to Charles Henry Vizer who had been vaccinated against smallpox and did not suffer from consumption, asthma, fits, palsy, dropsy, rheumatic fever, piles, liver complaint, stone or gravel. The signature of the medical examiner looks to be that of a William Thompson, M.D.