Quantity. 



VARIETY AND SIZE. 



Amounts. 



DOLLARS. 1 CENTS. 





! 









1 

 1 















1 







! 



! 







1 



















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i 



i 









! 



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1 









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T otal amount of order 











J{aine^ . — — — - 



Mr., Mrs. or Miss— write plainly: 



Post Office — 



County - State. 



Ship hy 



