ORDER BLANK 
Amount Enclosed, $ 
Pitzonka s Pansy Farm 
“The Home of the Pansy ” 
BRISTOL, PA. 
Date. 
Gentlemen: Please send the plants listed below to 
Name,__ 
Please Print Name 
Post Office- 
City_ 
Street or Rural Route 
.State- 
Ship by_ 
Mail or Express 
.Shipping point. 
193. 
Box No.. 
Quantity 
NAME OF VARIETY 
j Dollars 
Cents 
1 aPseoatioT 1 ■' • ■ ' • ». 
- 
> 
l c . r*. 
Shipping charges 
---- TOTAL 
See other side for table of shipping rates 
ACCOMPANY ORDER 
