Form Bl-647. 
April, 1922. 
Schedule No. 5. 
Name and P. O . Address of Sender, 
UNITED STATES DEPARTMENT OF AGRICULTURE, 
BUREAU OF BIOLOGICAL SURVEY. 
STOMACH BLANK-FOR THE REGISTRATION OF DATA CONCERNING STOMACHS, GIZZARDS, CROPS, AND GULLETS SENT TO THE DEPARTMENT. 
GeVEUNMfiN'M’littWSNe-OFfiOE 
BIOLOGICAL 
SURVEY NO. 
(LEAVE VACANT.) 
COLLECTOR'S 
NO. 
V£ 
fsv - ; 
NAME OF BIRD. 
SEX. 
DATE. 
HOUR. 
!/ 
/I 
& isLhr*\. Ck Jvui 
• i 
( 7 ) S 
3) 3 
£ 
su 
$ 
7 , 0 &U 
*y fiat/’ 
- 9 
UlA&ASUXJuc( ^ 
£ </ A 
■ / 
$ 10 } ^IjUVAC l 
2 > 
F I 
\ i 
iltXVJCiAAJL 
\4*,Q*4 
WoXt 
Y‘*« A*4i 
l( 
ft 
I I 
I. 
2 ^ 
( 
h 
y / 
V 
OUt>J(z 
i/ 
COLLECTOR. 
LOCALITY. 
CHARACTER OF PLACE 
WHERE KILLED, 
REMARKS 
