FOR IDENTIFICATION. 



My Residence. ■ ■ 



My Business Address. 



IV! ij Home Telephone. 

 Mu Office Telephone 

 My Home Fire Alarm Box 

 Mu Office Fire Alarm Box 



In case of accident or serious illness please notify ■ ■ 

 $** dvfc.^V*- 



The mal<e of my Automobile . 



Its Number 



Number on ease of my Watch 



Number of the works 



Number of my Bank Book 



Number of my Ins. Policy 



Name of Ins. Co 



My Weight was On 



and my Height feet . . .Inches 



Size of Hat Oloues 



" Shirt Collar 



" Hosiery ■ ■ -Shoes 



