if*’ Use other side of this order blank first. 
AMOUNT 
BROUGHT FORWARD 
Clerk 
Chk. 
Quantity 
ARTICLE WANTED 
Size 
Container 
Price Each 
TOTAL 
. . - - • - • 
....... ‘ 
(For Billing Dept. Only) 
TOTAL AMOUNT 
PAID 
a/c 
c/s 
• -* ' - • 
DUE Sr 
-— 
__Lk&K! 
