Ship to 
Check or M. O. Enclosed $ 
_Charge to 
Care of Address 
Prov ol 
or R. F. D. Address 
Freight or 
Express Address Notify 
County State 
Mail Freight Express Boat Parcel Baggage Local Deliver To Call 
Post Master Express 
ORDERED BY FILLED BY D. CHECKED BY PACKED BY NOTIFIED 
Date Date Date 
DLR. WH. TER. 
CHECK 
COLUMN QUANTITY DESCRIPTION PRICE UNIT TOTAL 
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(OVER) RAYMOND A. FLECK Phila. 24, Pa. 
