FOR IDENTIFICATION. 

 My Name 



My Residence^ 



My Business Address. 



My Home Telephone 



My Office Telephone 



My Home Fire Alarm Box 



My Office Fire Alarm Box 



•e of accident, or serious illness please notify 



in oase of accident, or serious illness please n. 



its Number „. 



Number on case of my Watch . ■ ■ LYa. . . .H. .. 9s^j.. Q. . . 

 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 Gloues 



" Shirt Collar 



" Hosiery Shoes 



