ORDER BLANK 
Humphrey-Coker Seed Co. 
Hartsville, S. C. 
Date 
Deli 
ener the Following Seed To: 
Ship ) 
Name 
Post Office Z 
Shipping Point 
Date Ship Pa Te ee ae 
Draltelhrough a ee ee 
(BANK) 
CERTIFIED & SELECTED SEEDS 
QUANTITY VARIETY PRICE VALUE 
| 
TOTAL AMOUNT OF ORDER 
AMOUNT PAID 
BALANCE DUE 
