The inner and outer portions of one panel of a diptych, the other one of which is lost. The document was likely written in duplicate, once inside and once outside, which accounts for missing portions of the beginning and end of each copy, respectively, along with the middle of both texts. The end of the official text (scriptura interior) is preserved in six lines of ink on the bare wood where the wax would have been (similar to Add. MS 41203); the outer side contains names of seven witnesses to the document followed by a space for the placement of seals. The second copy (scriptura exterior), which preserves ten lines of the beginning of the document, appears perpendicular to the witness list and then breaks off at the bottom of the tablet.
There are four holes for the string, three on the inner rim and one about the middle of the outer rim.