Snip BY | Charge Ti Our Order No.

FORM NO, 194
P. P.

KANSAS CITY |=““<4- Te ——

ORDER BLANK oe

Customer’s Order No.

CHECK ONE

OWE & CiMPBELL L, Date Received

ATHLETIC GOODS Co. 7
1509-11-13 BALTIMORE AVE., KANSAS CiTy, MO.

STOCK PRICE PLEASE DO NOT USE

oe ARTICLE—EXACT COLOR SHADE—SIZE
NO. pe EXTENSION THESE COLUMNS

= 6
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ORR,

il

QUOTED PRICES ARE SUBJECT TO ACCEPTANCE BY OFFICE

TRANSPORTATION & gue tee ee
INSURANCE CHARGES
Total Amount Remitted $

: Ordered
ORDER PLACED 3S a. By ACKNOWLEDGED

BY

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ORDER om CLE ES yt?

PLACED ATi Approved

By

SHIPPED FROM