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<br />132025 <br /> <br /> DATE <br />TO CUSTOMER'S <br /> ORDER NO. <br />Address . <br /> State SHIP <br />City <br />Ship To VIA , <br /> SALESMAN <br />CASH 1 CHARGE I C, O. 0, I PA'D OUT I RETURNED MDS,E, I RECEIVED ON ACCOUNT <br />QUANTITY DESCRIPTION PRICE AMOUNT <br /> ;- <br /> , <br /> " . . '. <br /> -. j ~ ., <br /> . : <br /> - <br /> <br />ALL Claims and Returned Goods MUST Be Accompanied By This Bill <br /> <br />SIGNATURE <br />