Ho. of Watch Case*. 



No. of Works....... 



No. of Bank Book 

 No. of Bicycle 



My Weight on 



Height 



Sice of my Hat ». Gloves 



" Hosiery Collar 



" Cuffs Shoes.. 



«« 



Drawers Shirt 



This hook belongs to 



>r. 



In ease of accident notify 



1 



Thursday 20 



Ther. 



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Friday 21 Ther. 



