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Bureau of Refugees, Freedmen & A L
H^d Qrs Sub Dist of Warren
Franklinton, N. C. Dec 10. 1866.

Colonel
I have the honor to apply for a [[underline]] Leave of absence [[/underline]] for twenty five days for the purpose of visiting my family in the City of New York and of procuring a new Artificial Leg.

Very Respectfully
Your Obdt Servt
[[signature]] Tho H. Hay [[/signature]]
Capt V R C Bvt Maj. U S V 
Asst Supt

Bvt Col A. G. Bready U S V. 
Supt Cent District.
Raleigh. N. C.