Page:United States Statutes at Large Volume 27.djvu/898

 CONVENTION-COSTA u10A. Jmmr 4, 1890. 875 FORM N0. 3. pom Nm 3_ Dew gums nf the Date szsmgur the} P"°°l bm Umteel hates Parcels from the United Statcafor Goth Riva. CMN `¢=¤ Pest-Omoo. - Peat-Oliiee. lParcel Bill No. ..., dated ... 18.. ; per S. S. " ... "  I 2 b Origin of parcel. Name of addxusee. Address of parcel. Remarks. ¤  ' Wh mcretbau nb tis ulrcd fcrtheentrycftboparcelsnentb themall itwllllnsuhb cient flathe uudemgodonm pumulm are entered on the Int sheet of t& Parcel Bill. Da. Coda Rica -. 'Humber of boxs or other receptacles funn- *D•d\wt weight of receptacles ing the mail .. . . . . -——-——-— Signature of dispatching officcr at the Unimd * Net weight of mail -··--· . -.--- States Post-Oliice . _ _  Signature of recenving officer nt Costa Rnca Post-Office.
 * Sheet No ..
 * Total number of parceln sent by the mail w “Total Weight 0{ mail.