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[[book checkout form]]

[[preprinted] 
[[image - drawing of hand pointing to right]] Use a separate slip for each title [[image - drawing of hand pointing to left]]

Author: [[[/preprinted]] Almanach franco-Americain
[[preprinted]] Title: [[/Preprinted]] latest
[[preprinted]] Books must not be taken from the room 
Class mark (in upper right hand corner of card) [[/preprinted]] IEE
300
[[line across page]]
[[preprinted]]
Seat number 
form 28g |
Name ------- |
Address -----|
[[/preprinted]]