ORDER BLANK 
THE POTTERS: Successor To Paid 
The TOOlIgS of Garry-nee-Dule 
Z 
oO. 
BARABOO, WISCONSIN Received __ 
Name 
Write Plainly 
Local Address 
Avenue or Street and Number or R. F. D. No. 
Postoffice States) a 
Express Office (if different from Postoffice) 
Amount Enclosed $ Date 
Quantity DESCRIPTION Price 
a 
(OVER) 
