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No 12.
The United States,

To Elsworth Russell & Co DR.

[[4 columned table]]
|Date of Purchase. |---||Dollars.|Cents.|
|---|---|---|---|

|   | June 21st 1866 |   |   |
|   | 1 Pad Lock | 1 | 50 |
|   | For Store Room at Hitchcock Press |   |   |

I certify that the above account is correct and just; the articles are to be accounted for on my property return for the month ending on the ... of ... 186
Quartermaster.

Received at ... the ... of ... 186
Quartermaster U.S.
Army, the sum of .... dollars and .... cents, in full of the above account.

(SIGNED IN DUPLICATE.)
Elsworth Russell & Co
Per GA Russell