
; one: New Brunswick 
: g G P. O. Box 608 6495-1 
New Brunswick, N. J. 
ORDER 





DATE 
SHIP TO ae 04 , eae 
STREET AND NO. ; ‘ P. QO. BOX 
POST OFFICE Ra F. Dp. NO. 
FREIGHT 
oR EXPRESS ADDRESS 
COUNTY STATE 
MAY WE SUBSTITUTE? — EQUAL OR BETTER IN NEAREST WE CAN SUPPLY 
IF SOLD UP. ON’ ITEM ORDERED: “ANSWER. 
if 
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= 
Tota 
Dollars 
| Cents 

