Frarikltn iV ursery 
61st and Portland Avenue 
Minneapolis^ Minn. 
Date . 
Name (Miss, Mrs. or Mr.) . 
.Street or R. R . 
City and .State . 
•S 'h ipp ing A ddress 
if not same as P. O . 
Amount Inclosed .□ Check □ M. O. □ Cash 
QUANTITY 
VARIETY 
PRICE 
EACH 
1 
TOTAL 
! 
1 
! 
j 
1 
\ 
■ i 
‘<V‘ 
AMOUNT TO CARRY FORWARD 
