Viewing page 204 of 240

This transcription has been completed. Contact us with corrections.

NARA 738

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. Dolls. | Rate of Pay. Cents. | Total Amount Due. Dolls. | Total Amount Due. Cents. | Stoppage. Dolls. | Stoppage. Cents. | Amount Received. Dolls. | Amount Received. Cents. | Signatures. | Witness. | 
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1 | Israel Deemer | Steward |  |  | 75 | 00 | 1 | 25 | 73 | 75 | 73 | 75 | Israel Deemer | DM White | 
| 2 | Sally Parker | Matron | Aug 1/66 | Aug 31/66 | 18 | 00 | - | - | 18 | 00 | 18 | 00 | Sally her x mark Parker | Geo St. C. Hussey Jr. | 
| 3 | George Washington | Ward master | Aug 1/66 | Aug 31/66 | 15 | 00 | - | - | 15 | 00 | 15 | 00 | George his x mark Washington | Geo St. C. Hussey Jr. |  
| 4 | Simon Taylor | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Simon his x mark Taylor | Geo St. C. Hussey Jr. |  
| 5 | Jemima Peters | Nurse | Aug 1/66 | Aug 31/66 | 12 | 00 | - | - | 12 | 00 | 12 | 00 | Jemima her x mark Peters | Geo St. C. Hussey Jr. |  
| 6 | Jemima Ricks | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Jemima her x mark Ricks | Geo St. C. Hussey Jr. |  
| 7 | Emiline Terrell | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Emiline her x mark Terrell | Geo St. C. Hussey Jr. | 
| 8 | Eliza Cockrell | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Eliza her x mark Cockrell | Geo St. C. Hussey Jr. |    
| 9 | Elsie Finch | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Elsie her x mark Finch | Geo St. C. Hussey Jr. |  
| 10 | Mary Lockwood | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Mary her x mark Lockwood | Geo St. C. Hussey Jr. |    
| 11 | Madison Jones | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | Madison her x mark Jones | Geo St. C. Hussey Jr. |    
| 12 | John Culigan | Nurse | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | John his x mark Culigan | Geo St. C. Hussey Jr. |    
[[strikethrough]] | 13 | James Smith | Baker | Aug 1/66 | Aug 31/66 | 10 | 00 | - | - | 10 | 00 | 10 | 00 | James his mark Smith | Geo St. C. Hussey Jr. | [[/Strikethrough]] 

I certify that the above Receipt Roll is correct and just, 
Geo. St. 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:
only partially transcribed - pls complete ---------- Reopened for Editing 2024-04-04 21:06:17