The following description was prepared by William Gross:

This amulet was printed from a handwritten manuscript.  It contains most of the elements often found on birth amulets. The names of the patriarchs and their wives are printed on the amulet, as well as the "shir le-malt prayer" and specific formulas aimed at thwarting the evil influence of Lilith.  The invocation of the names of the three angels, Sanoi, Sansanoi and Samgalaf, printed here, are aimed at the same protection.  The Gross family collection contains two copies of this amulet. At the bottom of one of the amulets, the inscriptions state that this amulet was printed in Satmar, a city not known for the printing of such amulets. At the top is the statement that this amulet is according to the Ba'al Shem Tov.