The State of Ohio County of Wood ss
On this 6 day of June A.D. 1881, personally appeared before me W. S. Eberly, Clerk of the Court of Common Pleas, within & for the county & state aforesaid Samuel Shroyer who being duly sworn says that, he was ____ treated by Geo. A. Collamore while in the service. That he herewith sends the affidavit of Robert Johnston late assistant surgeon of the 100 O.V. I. who treated.
Writes his mark Samuel Shroyer his mark
E. Eberly
J. W. Brownsberger
Sworn to before me & in my presence subscribed this 6 day of June A.D. 1881 & I certify that I am not interested in the prosecution of this claim.
W. S. Eberly Clerk of Wood County Ohio
From Civil War pension file of Samuel Shroyer