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`~,..T^ INVOICE NO. , <br /> -~~T ~~64 <br /> , „ - <br /> - ' Si~ <br /> r <br /> r <br /> <br /> } ~ SHIP TO: ~ <br /> SOLD TO: ~ r j' <br /> i ~ ~ ADDRESS: <br /> ADDRESS: ' ~ <br /> ;i <br /> CITY. STATE. ZIP <br /> CITY. STATE. ZIP ~ <br /> ~ ~,.v~,.,,....,, _ e%v F.O. DA: <br /> c ,,.W,~. T <br /> a <br /> SOLD BY. ~ <br /> . <br /> t. W ~ CUSTOMER'S ORDER - w~ <br /> ® ' <br /> ~~.d PRICE A1~40~1'1'?' <br /> f: 6. <br /> 0 I w...._ <br /> V_ + <br /> .~....w _ Df=SCRIPTI N. <br /> ~ QUANTITY. <br /> L <br /> © 2' ~Y' <br /> i ~ ~ <br /> ~ 3 <br /> n <br /> 4 ` ` <br /> r 5, ~ Q <br /> 6 ~ <br /> , ~ <br /> - ~ <br /> t <br /> 8 <br /> , <br /> 9 ~ <br /> -29-04-A09~09 RCVD _ F~.~„ <br /> . <br /> rte.. <br /> ~ . <br /> <br />