ter. 



No. of Watch Case*. >.*... . . •. 



No. of Works 



No. of Bank Book 

 No. of Bicycle 



!fy Weight on 



Height 



Size of my Hat >. Gloves 



" Hosiery Collar 



" Cuffs Shoes.. 



Drawers Shirt 



This hook belongs to 



her. 



ter. 



In ease of accident notify 



BBMSJB 



Wea " 



%). Arm. 19, 19 22 



Thursday 20 



Friday 21 



Ther. 



