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NARA

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. | 
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |

| 14 | Charles Perry | Nurse | Aug 1st 66 | Aug 31st/66 | 10 | 00 |   |   | 10 | 00 | 10 | 00| Charles his x mark Perry | Geo. S.C. Hussey Jr. |

| 15 | Emma Jackson | Cook | Aug 1st/66 | Aug 31st/66 |10 | 00 |   |   | 10 | 00 | 10 | 00 | Emma her x mark Jackson | Geo. S.C. Hussey Jr. |

| 16 | Sally Sloyde | Cook | Aug 1st/66 | Aug 31st/66 |10 | 00 |   |   | 10 | 00 | 10 | 00 | Sally her x mark Sloyde | Geo. S.C. Hussey Jr. |

| 17 | Elizabeth Rains | Cook | Aug 1st/66 | Aug 31st/66 |10 | 00 |   |   | 10 | 00 | 10 | 00 | Elizabeth her x mark Rains | Geo. S.C. Hussey Jr. |

| 18 | Sally Killingsworth | Laundress | Aug 1st/66 | Aug 31st/66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Sally her x mark Killingsworth | Geo. S.C. Hussey Jr. |

| 19 | Eliza Radford | Laundress | Aug 1st/66 | Aug 31st/66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Eliza her x mark Radford | Geo. S.C. Hussey Jr. |

| 20 | Hattie Houston | Laundress | Aug 1st/66 | Aug 31st/66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Hattie her X mark Houston | Geo. S.C. Hussey Jr. |

| 21 | Caroline Battle | Laundress | Aug 1st/66 | Aug 31st/66 | 10 | 00 |   |   | 10 | 00 | 10 | 00 | Caroline her x mark Battle | Geo. S.C. Hussey Jr. |

[[Coppied?]]
DM White
Lt AAQM

I certify that the above Receipt Roll is correct and just, Geo. Lt. C. 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:
---------- Reopened for Editing 2024-04-03 17:14:07 None of the rows had been transcribed before someone marked for review, pls read instructions - everything should be trancribed ---------- Stamp needs to be transcribed There is no stamp