Toxin 4 b. 
USE ONE SIDE ONLY. 
No. 
Approved by the Comptroller of 
the Treasury May 28, 1914. 
Subvoucher for Supplies, Livery and Miscellaneous Services, 
and Expenses. 
11. B. Srpartmnti of Agrirultttrr, 
To , Dr. 
Address: _ 
191 . 
For 
Total, - $ 
TO BE COMPLETELY FILLED IN BEFORE SIGNATURE BY PAVEE, AND THERE 
MUST NOT BEANY ERASURE OR OTHER ALTERATION WHATEVER. 
Received in Cash this day of 
191 , from 
100 
Dollars, in full 
of the above account, which I CERTIFY TO BE CORRECT. 
Do not sign in duplicate. 
(Signature) 
(Title) ..... 
Witness to signature by mark. 
(Name.) 
S — 2707 
(Address.) 
