Front:
An
000
lo
M. W. of A. Sanatorium Series No. 16. PATIENTS ASSEMBLING FOR DINNER
Woodmen, Colorado
Back:
Clerk's Official Receipt-M. W. of A.
RECEIVED on.
Benefit Asst. No.
OHP
5°
from Neighbor
(Write name in full)
the sums due from him on the following accounts:
hal
Dues to..
per month on annual subscription for THE
MODERN WOODMAN.)
Other Payments
ADVANCE PAYMENTS
24
19
WOODMAN.)
Form 772-6-23-24M
19.
Benefit Assts. No.---
in
pus.
Dues to.
19.
per month on annual subscription price of
20c for THE MODERN
HE MOSEEN YOOU
Total,
8774
Clerk Camp No...
25
27
BRO
AP
OW
LY
WA
CENA
50
