Form Bi-647. 
April, 1922. 
Schedule No. 5. 
Name and P. O. Address of Sender , 
- STOMACH BLANK- 
UNITED STATES DEPARTMENT OF AGRICULTURE, 
BUREAU OF BIOLOGICAL SURVEY. 
BIOLOGICAL 
SURVEY NO. 
(LEAVE VACANT.) 
COLLECTOR'S 
NO. 
YX, 
V 
W 
V 
■FOR THE REGISTRATION OF DATA CONCERNING STOMACHS, GIZZARDS, CROPS, AND GULLETS SENT TO THE DEPARTMENT. 
ernes 
NAME OF BIRD. 
SEX. 
DATE. 
HOUR. 
COLLECTOR. 
LOCALITY. 
r~ 7 TT 3 — 
/Y 
•• U » /? 
9 zo 
/. • * 
CHARACTER OF PLACE 
WHERE KILLED. 
REMARKS 
* 
fit? Kjlv '• 
» . 
VotAS&** 
/h Jis>H0 S^L r :Ma. 
I ~ u 
vim 
\/ 
?l<s 
y . v - - i - * ^ t&Awc c 
A W3. , dr 
'77- 
J* 
r ozf 
T/ 
rw 
V0$7$ 
o^tZ^r^ou/oo 
CU 7 Vt<xX>^ 
» yv 
U)&Ko*a4S9 
s3%^3l*s> Jrt3ledu4 
str^3c{ C^aA^tYLe^ 
/^vlyffTc^TtA cLq ip 
$ 0>icks3uY^ J^IAaJy^3i^J^c3a^ 
fl 
/y 
AT 
m 
>. 
>• fb 
fin J\ 
<^W .. 3f 
'» £(>IA^8 • / 
• t 
- 3 
/f 
M 
• • 
chdu* Z / J/& 
GuUAZaa, 
- r 
q£< 
K 
•i 
•? 
