i 
ORDER BLANK e 
Humphrey-Coker Seed Co. 
Hartsville, S. C. 
Dates et Ree ae eee ee eee “ 
Deliver ; 
Ship the Following Seed To: 
Namie it I ee 
Post Offices ee es ee ee 
Shipping Point... Pama Maeraes 2) nM eT Sh uh ae 8 
Date Shan fo kets oe Phe Se] fi): See EL ane! 
Dratt Through. 2)... ee eee basiy a ba 2 Or GP Glan ala Ge 
(Bank) 
QUANTITY | Sco te Onno | PRICE VALUE 


TOTAL AMOUNT OF ORDER 
AMOUNT PAID 
BALANCE DUE MM, A aba Te 

