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[[Obverse Text]]
拾 / 0000000 / 青島地方銀行 / 0000000 / 拾 / 樣本 / 拾圓 / 拾圓 / 拾 / MANAGER. / 憑票即付中國國幣拾圓 / PRESIDENT. / 拾 / 中華民國十三年 / 財政部印刷局製 / 71.348.1265

[[Reverse Text]]
10 / TSINGTAO CITY BANK / 10 / 樣本 / PROMISES TO PAY THE BEARER ON DEMAND AT ITS OFFICE HERE. LOCAL CURRENCY VALUE RECEIVED. / 此票係樣本不能兌現收到 / 樣本 諸君務即出具收據 / 為荷 財政部印刷局敬啟 / 10 / 拾圓 / 10 / TEN YUAN / 10 / APR 15TH 1924 / 10 / BUREAU OF ENGRAVING AND PRINTING PEKING CHINA