ite, arr Thersery Company 
Weiser Park ° Pennsylvania 
DO ee ee: Le 
Ship to (Name) | 
Street or R.F.D. No. 
DIOLOTE DY eM on ore ere ee me a 8 ee eS a Stata 
Shipiby Pama Pou en Express | Deliver eT Will Call 
Charge to, Name (If different) 
Address 

Quantity VARIETY PRICE EACH TOTAL PRICE 

SSS ef ee 
8 eS | ee 
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| | |) 
30 day terms to established credit (Over) 
