ORDER TO 
WILLIAM C. DUCKHAM 
MADISON, NEW JERSEY 
Your Name . 
Post Office . 
County . 
Street No . 
Amount Enclosed: . . 
Supt.'s Name . 
Date . 
Very Plain 
. P. 0. Box . 
. State . 
....Forwarded by . 
Mail, Express or Freight 
. Cash, f . Money Order, f . 
. Draft or Check, $ . 
State how much money you enclose 
Please do not write here 
QUANTITY 
NAME OF ARTICLE 
Dollars 
Cents 
In making your order, please give the price, to avoid delays and errors. 
