ORDER BLANK. 



Date 190d. 



J". T. X.O"V"ETT, 



Little Silver, New Jersey. 



Enclosed find the sum of $ for which send the follow- 



ing goods: 



Quantity. VARIETY AND SIZE. 



Amounts. 



DOLLARS. CEXTS. 



Total amount of order 



Xame 



Mr^ Mrs. or Mlsa— Twrlte plainly. 



Post Office 

 County 

 Ship hy 



State 



to. 



r 



