FORM No. 95.

Voucher for boarding and lodging. (Paragraph 532.)

Voucher for hospital expenses and medical aid. (Paragraph 532.)

CONSULATE OF THE UNITED STATES OF AMERICA AT

Το

DR.

For medical aid and attendance supplied the following- amed destitute American seamen admitted in and discharged from [here insert the name of the hospital] by order of the quarter ending

188-.

Consul at

for

(Here name all articles of clothing furnished, including
cost thereof.)..........

For burial expenses of the following-named destitute American seamen, during the quarter ending

who died at

day of

18-:

FORM NO. 99.

RETURN OF EXTRA WAGES. (Paragraph 534.)

United States Consul at

in account with the United

States Government, for amount of the one month's extra wages received on account of discharged seamen, from

DR.

to

188-.

CR.

Dec. 31 Loss by exchange on my draft No. - on the Secretary of State. 21

318 50 2 50

321 00

E. & O. E.

UNITED STATES CONSULATE AT

December 31, 188-.