Ship to Check or M. O. Enclosed $ 
_Charge to 
Gare-of + tates fh ter ee Address 
PPOs ou 
or R. F. D. Address 
Freight or 
Express Address _Notify 
County Gage ss '. fj). | State 
Mail Freight Express Boat Parcel Baggage Local Deliver To Call 
Pest Master Express 
ORDERED BY FILLED BY D. CHECKED BY PACKED BY NOTIFIED 
Date Date Date 
DLR. WH. TER. 
CHECK 7 5 
QUANTITY DESCRIPTION PRICE UNIT TOTAL 
V Lae 
Las ES ee 
eee. 
\|- de 
| i} 
| | 
| ni 
(OVER) RAYMOND A. FLECK Phila. 24, Pa. (OVER) 
