No. ©f Watch Caaei 



No. of Work* 



No. of Bank Book 

 JTo. of Bicycle 



My Weight on 



Height 



Sice of my Hat 



Hosiery - 



CuJTa 



Drawers. 



<« 



Thin hook belong to 



,€rlove» 

 .Collar 

 .(Shoes 

 .Shirt 



la ease of accident notify 



•••••••••• •••• 



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1 Ml 



I ~~~^Wed. April 19, 1922 - Ther. 







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Thursday 20 Ther. 



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1 



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1 ' ' 11 



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Jdriday 21 Ther. 













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