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[Ed. Form, No.3.]
X
TEACHER'S MONTHLY
SCHOOL REPORT

For the month of January, 1869.
District or County, Worcester Co.
State, of Md
Name of School, 
Name of Teacher, [[?Abom]]

Forwarded  
Received

EXPLANATIONS.

If any of the within questions cannot be answered by the teacher, they may be left for the superintendent. Place each answer, to the extent of your knowledge, opposite the question, and will fill the remaining spaces.
Night and sabbath schools taught by a group of teachers should be reported but once. 
In the "Remarks" notice any important fact which the blank does not call for. 
It is hoped that the Educational Societies will adopt this form of Report; if so, the Bureau can furnish the blanks.
[[Icon of hand pointing to the right proceeds text]] Should more extended forms to be used, it would oblige the Commissioner to have them include all the items of this. 
BUREAU R., F., & A.L, Washington, D.C., Jan. 1, 1868.