Unfortunately Barefoot doesn't say anything about its purpose. I tried to translate the title which seems to say "Hospital Dispute" or something similar.
Barefoot also lists under the same Rostov heading as "Court Circuit of the Town" Barefoot #2 10 kopeck black on pale green from 1909, as "Court Circuit of the "Nokolaev District" Barefoot #3 10 kopeck black on yellow and Barefoot #4 30 kopeck black on green also from 1909 and from 1919 "arms as 1898 but inscribed gorodskoi in the circle" (rather than gorodskaya as in the stamp shown here) Barefoot #5 1 ruble blue-black & red and Barefoot #6 1 ruble dark blue & violet.
So maybe these are all court revenues associated with medical charges or taxes of some kind?
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