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5-50-200M—U F O R M 4205-1 STORES DEPARTMENT INVOICE Storekeeper at M Shipped to OQ- ^(2/2/te^/a............. fertC&i Requisition Date. |no. ^ 2 ^ L -f-' At / b o Os (7 j LA . Purpose. Zt/- (S ta tio n ) (S t a t e ) (D iv is io n ) __ Work Order__________ Q uantity Required |— - , : r — DESCRIPTION Furnished o r Shipped New, S. H. or Scrap M easure o f Unit Extension P rice Amount A cct. No. Class No. Q u antity Unit Quantity Unit Amount U n it c x W , ^ - ^ ^ - 4 - 5 / Z - f < £ t r » ^ A & £ & L u s t / d L (2 tu < S ld L * * 4 6 r f H1. 0 f / > A * cv & 2 *5 J " h 2 ^ 4 4 , PhAZ&ZOjZt (j O > . 7 ------------- > h > V - ' ’A \ 0 V j £ i / *JU 4 < f i £ * • J < / -S B -s ip £/ i / \ A/iT ^ ;mA Back Ordered Date. Date Original Requisition Received. TOTAL A pproved: Approved: Approved: Signed: Z -/ ? _Tittf JTItle R eq’ n re c'd by Stockm an 19 R egistered 19 Filled bv CONTAINERS W EIGHT Car No. . Int...... Shipped 19 Bag Reg. No. Date . i S ta tio n W. B. No. Date Car No. ............... Int. R eceived 19 Ree. N o . ______ ___ Date S tation S ign ed