Two hands, with four fingers each divided into two sets of two fingers, is the symbol of a priestly blessing — this signifies a Kohen, a descendant of Aaron.
Hebrew Translation not available due to leaves in the way.
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BillionGraves.com record for David Kahn (1880 - 1951), BillionGraves Record B'nai Amoona Cemetery, University City, St Louis, Missouri, United States, North America