ORDER FORM—B

BUREAU OF SPECIAL RELIEF
Department of Relief and Rehabilitation
San Francisco Relief and Red Cross Funds
GEARY AND GOUGH STREETS
San Francisco, 190
Name
Address
Dear Sirs:
Please deliver to
the following articles
and charge to Bureau of Special Relief.
Cost Cost
Apples (dry), Potatoes,
Beans, Prunes,
Bread, Rice,
Butter, Salt,
Cocoa, Soap,
Coffee, Sago,
Condensed Milk, Sugar,
Eggs, Tea,
Flour, Pepper,
Macaroni, Candles,
Mush,
Total Total
Received above articles
Superintendent.
IF UNABLE TO DELIVER, NOTIFY THIS OFFICE AT ONCE

Above form as [illustration]