Front:
M. W. of A. Sanatorium Series
No. 3. RECEIVING HOSPITAL
Woodmen, Colorado
Back:
Clerk's Official Receipt-M. W. of A.
RECEIVED on.
Mas 3 lg 1923
from Neighborkos...
(Write name in full)
the sums due from him on the following accounts:
Benefit Asst. No. 6
5.
Dues to....
19
per month on annual subscription for THE
MODERN WOODMAN.)
Other Payments
ADVANCE PAYMENTS
Benefit Assts. No.
Dues to..
19.____
per month on annual subscription price of
20c for THE MODERN WOODMAN.)
Total,
92
Form 77%-11-21-24M
210
170
10.
$280
Stale...
Clerk Camp No........
PLYMOUT
ONL 2 M
U.S.POSTAO:
Mr Jamer Skow
Walkerton
Indiana.
TREN # 3
