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To Temple Goffney
April 30th
For two months board at $15.00 pr Month
$30.00

Mrs. McNeil authorizes Robert Coleman FC. 37th U.S.C.T. to draw $30.00 for Board when her claim is collected by Capt Lee. Capt Lee will deduct the said amount provided Mrs. McNeil is willing it should be done at the time her claim is collected by Capt Lee.

Raleigh N.C.
April 29th 1867 Susan her x mark McNeil
Witnessed 
Harry Frye

Transcription Notes:
1. name is something close to Mrs. McMil, not sure if it's spelled entirely correctly though 2. furnished? founded? starts with an f, ends in ...ed? Based on the previous page, I have updated the transcription from McMill to McNeil.