FOR IDENTIFICATION. 

 Ma Name.... 



Mu Residence ....rL"3.. .^YrMrV^*^ . ££„ . . 



Mu Bus 









My Home Telephone. 



Mu Office Telephone 



In case of accident or serious Illness please notify 



The make of my Automobile.. 



Its number 



_ Number on case of mu Watch 



Number of the works 



Number of mu Bank Book 



Mu Weight was 



On 



and mu Height. feet inches 



She of Hat Clones 



" Hosieru Collar 



" Cuffs Shoes 



" Shirt Drawers 



