RECEIVED FROM 
COLLECTED BY 
When 
Collected 
(UljudzM (PltUruJ 
I. d. ■J-lAA&'X 7)UjU4*A 
Original No. Determined by 
When Entered 
REMARKS 
J12$ 
^.3.0aJI /s 
/ 
C?^UJ 
