of the Poor in Mimich. 



RECOMMENDATIONS 



For the Poor of the division of the 



for the month of 179 



quarter 



To 



Number 



Remarks. 



[REMARK. In order that every district commissary may know 

 exactly how many recommendations he has sent in to the 

 Armen-Institut each month, and whether each one of them 

 has been concurred in by the committee, he keeps an account 

 of his recommendations for each month on this form.] 



Commissary of the District. 



