

ORDER BLANK tho Not \weice gers 
WILSON NURSFRIFS, JACKSONVILLE, FLORIDA | Date R¢ca | 
Rt 4, Box F6l-A ... 1OSrd St Amt with ordar | 
Ship To _ ;Ordcr No | 
ARGreas — Pa aN lr tek eta Shipped : 
Oity, state is ie Recorded | 
pate wanted Ae yia | 



—_—— — 


re 

—-———. a ne RR 
301d By Gash C.0aDe Charge On Acct 
ae varictics Wantcd price Amount 


Total order 

Pos tage < 
(Per-Florida-custom rs) —3zales pa. és 

Amount cncloscd 35 
