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ST. LUKE'S HOSPITAL
No. 661 Date received [[blank]]
Property of Frida Kahlo
Address [[blank]]
To be held for safe-keeping in safe of the Hospital.

[[underlined]]INSTRUCTIONS FOR USING VALUABLES ENVELOPE[[/underlined]]
After depositor places valuables in envelope, clerk should write name and address of depositor in place provided.
The envelope must be sealed and signed by the person depositing the valuables, and the sealing must be done in the presence of a witness who is a representative of the hospital. [[underlined]]If the patient is unable to seal the envelope, a list of the valuables must be made by the clerk in the presence of another employee, both of whom must sign the list, and place it in the envelope. They must then seal it in the presence of each other, and then sign on the envelope.[[/underlined]]
The attached receipt must be presented and signed by the depositor when the envelope is delivered. The receipt must then be attached to patients' Valuables Register as a permanent receipt for return of deposit intact.