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[ED. FORM, No. 3.]

TEACHER'S MONTHLY
SCHOOL REPORT
For the month of Jan, 18[[strikethrough]]69[[/strikethrough]]70
District or County, Dallas Co
State, Ala
Name of School, Burrell
Name of Teacher, S.O. Ostraneter
Correct
T.H.H.

Forwarded Feb 12 '70
Received Feb 15 '70