Form Bl-647. 
April, 1922. 
Schedule No. 5. 
Name and P. O. Address of Sender, 
UNITED STATES DEPARTMENT OF AGRICULTURE, 
BUREAU OF BIOLOGICAL SURVEY. 
BIOLOGICAL 
SURVEY NO. 
(LEAVE VACANT.) 
COLLECTOR’S 
NO. 
. 
STOMACH BLANK- 
TOR THE REGISTRATION OF DATA CONCERNING STOMACHS, GIZZARDS, CROPS, AND GULLETS SENT TO THE DEPARTMENT. 
NAME OF BIRD. 
SEX. 
DATE. 
HOUR. 
COLLECTOR. 
LOCALITY. 
CHARACTER OF PLACE 
WHERE KILLED, 
REMARKS. 
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