.MTEzMQ.NTQ2OA
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� [the following is a form with stamped and handwritten notations] VOUCHER No. 4 [stamped] MEMORANDUM [double line]
Ledger No. 18 [handwritten] Page 38 [handwritten] [vertical line] APPROPRIATION: War Purposes [handwritten] [double line]
In Favor of Deorsay, J.H. Waterville
DATE Dec. 22, 1918, Amt. $128.88 [double line]
CLASSIFICATION OF CLAIM [lines] [two columns:] Dollars Cents Medical supplies 128 [Dollars] 88 [Cents]
On account of Halifax releif
Approved for 128 [Dollars] 88 [Cents] [double lined]
Received A.G. O. Jan. 15, 1918 Filed with Auditor Feb 25 1918 [stamped] Paid [line] Check No. [line] Deduct for [line]
4-23-17-1000