ORDER BLANK 
CARL PURDY, Ukiah, Calif. 
Please forward the following ORDER for amount enclosed. 
Name . 
(Say whether Mr., Mrs. or Miss; write name plainly) 
Street.R. D.Box. 
Post Office.P. 0. Box—. 
County.State. 
Date.193. 
Amount Enclosed 
Money Order. 
Cash . 
Stamps . 
Check . 
QUANTITY 
NAME OF ARTICLE WANTED 
PRICE 
1 
TOTAL 
Reverse side may be used for more space. Extra blanks on application. 
1937 9M. 
