
Order Blank 
GILBERT H. WILD & SON 
SARCOXIE MISSOURI 



DATES evens es ccna nsmee oes 194 
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NAME 
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FREIGHT, PARCEL POST OR EXPRESS 
THE FOLLOWING 
QUANTITY || ITEM AND UNIT PRICE || TOTAL 
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SIGNATURE 
SUBSTITUTIONS will not be made unless you request. If supply of a variety you have ordered 
is exhausted, may we send you another, of equal or greater value? Please answer yes or no....,. 

