# 
ORDER BLANK 
Humphrey-Coker Seed Co. 
Hartsville, S. C. 
Date- 
Ship the Following Seed To: 
« 
N ame-- 
Post Office- 
Shipping Point 
Date Ship 
Draft Through 
(Bank) 
QUANTITY 
PEDIGREED SEEDS 
VARIETY 
PRICE 
VALUE 
CERTIFIED SEEDS 
TOTAL AMOUNT OF ORDER 
AMOUNT PAID 
BALANCE DUE 
