Use this blank if possible—It aids in tilling orders promptly and properly 
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Received_ 
Amount_ 
O. K/d_ 
Filled by _ 
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Packed by_ 
Pkgs._Post 
Date_ 
Our Order No. 
ORDER SHEET 
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1515 Champa Street 
P. O. Box 1345 Date__193 
Phone KEystone 1351 
Gentlemen: Please forward the following goods by_ - (Mail, Express or Freight) 
fMiss 
Name*! Mr. 
(.Mrs. 
Postoffice 
R. F. D or Street-- State 
Express or Freight Office 
if different from Postoffice-_ 
(Do not Jfi 
write 2 
in these ® 
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columns) » 
Quantity 
Name of Goods Wanted 
Please carry out 
the price 
Special Collection 
Special Collection 
Added for postage where required 
Insect:* 
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t be sent 
Ig pOiSOnS Amount Carried Forward, 
by mail 
$ 
■S* TO* 
Have you forgotten anything? Be sure to give your name and postoffice. Read on other side 
about postage. How do you want goods shipped? (Please circle routing at top of page, or 
mark here). 
