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NARA 733

Form 7.

We, the subscribers, do hereby acknowledge to have received, at  of  , the sums set opposite our names, being in full of our services for the time herein expressed, having signed duplicates hereof.

[15 Columned Table]]
| No. | Names. | Occupation. | Period of Service. From. | Period of Service. To. | Rate of Pay. Dollars. | Rate of Pay. Cents. | Stoppage. Dollars. | Stoppage. Cents. | Total Am't Due. Dollars. | Total Am't Due. Cents | Amount Rec'd. Dollars. Amount Rec'd. Cents. | Signatures. | Witness. |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1 | Israel Deemer | Steward | Aug 1 /66 | Aug 31 /66 | 75 | 00  | 1 | 25 | 73 | 75 | 73 | 75 | Israel Deemer | D M White |
| 2 | Sally Parker | Matron | Aug 1 /66 | Aug 31 /66 | 18 | 00 |  |   | 18 | 00 | 18 | 00 | Sally Parker her x mark | Geo. S. H. Hussey Jr. |
| 3 | George Washington | Ward Master | Aug 1 /66 | Aug 31 /66 | 15 | 00 |   |   | 15 | 00 | 15 | 00 | George Washington his x mark | Geo. S. H. Hussey Jr. |
| 4 | Simon Taylor | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Simon Taylor his x mark | Geo. S. H. Hussey Jr. |
| 5 | Jemina Peters | Nurse | Aug 1 /66 | Aug 31 /66 | 12 | 00 |   |   | 12 | 00 | 12 | 00 | Jemina Peters his x mark | Geo. S. H. Hussey Jr.  |
| 6 | Jemima Ricks | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Jemima Ricks her x mark | Geo. S. H. Hussey Jr. |
| 7 | Emiline Ferrell | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00  |   |   | 10 | 00 | 10 | 00 | Emiline Ferrell her x mark | Geo. S. H. Hussey Jr.  |
| 8  | Eliza Cockrell | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Eliza Cockerell her x mark  | Geo. S. H. Hussey Jr. |
| 9 | Elsie Finch | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Elsie Finch her x mark  | Geo. S. H. Hussey Jr.  |
| 10 | Mary Lockwood | Nurse | Aug 1 /66 | Aug 31 /66 | 10 00 |   |   | 10 | 00 | 10 | 00 | Mary Lockwood her x mark | Geo. S. H. Hussey Jr. |
| 11 | Madison Jones | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Madison Jones his x mark | Geo. S. H. Hussey Jr. |
| 12 | John Culijon | Nurse | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | John Culijon his x mark | Geo. S. H. Hussey Jr. |
| 13 | [[strikethrough]] James Smith | Baker | Aug 1 /66 | Aug 31 /66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | James Smith his x mark | Geo. S. H. Hussey Jr. [[/strikethrough]] |

I certify that the above Receipt Roll is correct and just,
Geo. S. H. Hussey M.D.
A.A. Surg USA in charge Howard Hospital

Approved and payment ordered,
[[strikethrough]] Col. 64th U.S.C.I., [[/strikethrough]]
Ass't Commissioner Freedmen's Bureau, State of Miss.

Transcription Notes:
same as last image ---------- Reopened for Editing 2024-04-03 10:21:12 Pls read instructions on how to format tables, there are 15 columns here, not 11, 'his/her X mark' is to be transcribed after the full name ---------- Reopened for Editing 2024-04-03 10:45:28